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**PD5NPs** are an experimental myeloperoxidase-responsive, in-situ size-amplifying nanoparticle formulation for rheumatoid arthritis. The particles self-assemble from an acid-sensitive polysialic acid-dexamethasone conjugate modified with bis-5-hydroxytryptamine. Following accumulation in inflamed joints, elevated myeloperoxidase and oxidative stress promote particle aggregation, increasing particle size and reducing lymphatic clearance. The enlarged particles act as local reservoirs that release dexamethasone under acidic inflammatory conditions, enabling sustained glucocorticoid-mediated anti-inflammatory activity. PD5NPs have been reported in preclinical rheumatoid arthritis models and are not an approved medicine.
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