Donya Esmaeilpour, Michael R. Hamblin, Jianlin Cheng, Arezoo Khosravi, Jian Liu, Atefeh Zarepour, Ali Zarrabi, Mika Sillanpaa, Ehsan Nazarzadeh Zare, Jianliang Shen, Hassan Karimi-Maleh
The integration of artificial intelligence, protein engineering, and sustainable nanomedicine is driving a paradigm shift in theranostics by enabling highly precise disease diagnosis and targeted therapy. AI-driven methodologies, including machine learning and deep learning, facilitate the rapid analysis of complex biological and chemical datasets, accelerating protein structure prediction, molecular docking, and structure-activity relationship modeling. These capabilities support the rational design of proteins and peptides with enhanced specificity, therapeutic efficacy, and safety, while enabling personalized treatment strategies tailored to individual molecular profiles. In parallel, sustainable nanomedicine focuses on the development of biodegradable, biocompatible, and environmentally benign nanomaterials to improve drug bioavailability, stability, and controlled release. AI-assisted optimization further refines nanocarrier design by balancing therapeutic performance with safety and environmental impact. Advanced intelligent nanocarriers capable of real-time monitoring, adaptive drug release, and degradation into non-toxic by-products represent a significant advancement over conventional static systems. The theranostic paradigm has become central to precision medicine, particularly in oncology, especially where AI-designed nanoplatforms enable targeted delivery of imaging agents and therapeutics to tumors, while allowing continuous treatment monitoring and minimizing off-target effects. Emerging applications in neurological, infectious, and cardiovascular diseases further highlight the broad clinical potential of this approach. Accordingly, this review summarizes AI-driven protein design strategies, sustainable nanocarrier engineering, and their convergence in next-generation theranostic systems, critically discussing mechanistic insights, translational challenges, and design principles required for developing safe, scalable, and clinically adaptable intelligent nanomedicines.