Yinyan Wang, Binghe Wang, Fengbo Su, Enqi Wu, Zhaohui Ni, Yan Chen
• Pathogenesis of cerebral ischaemia–reperfusion injury (CIRI): CIRI is caused by local ischaemia, with severe inflammatory responses, oxidative stress, and damage to the blood–brain barrier (BBB) being its key pathological features, leading to neuronal damage and loss of brain tissue function. • Challenges of the Blood-Brain Barrier: The BBB is the primary obstacle in treating CIRI, limiting the ability of drugs to effectively enter brain tissue. Improving BBB permeability is crucial for enhancing drug efficacy. • Innovative Applications of Functionalised Biomimetic Nanoplatforms: The study explores how biomimetic nanoplatforms based on cell membranes (e.g., red blood cells, cancer cell membranes) can enhance targeting and BBB penetration, enabling more precise drug delivery. • Multimodal therapeutic effects of nanodrug carrier systems: Functionalised nanodrug carrier systems can achieve multi-targeted therapy by improving drug stability, loading capacity, and biocompatibility, demonstrating significant potential in CIRI treatment. • Future research directions: Further optimising the design of nanoplatforms, enhancing drug bioavailability, improving BBB penetration capabilities, and combining multiple therapeutic strategies will be key development directions for future CIRI treatment. Ischemia-reperfusion injury (CIRI) is a common pathological process in acute ischemic stroke (AIS). The limited permeability of the blood–brain barrier (BBB) and post-treatment neurotoxicity pose significant challenges to clinical management. Due to the limited efficacy of traditional pharmacological therapies, functionalized biomimetic nanoplatforms have emerged as a novel solution. This review summarizes the pathogenesis of CIRI, current pharmacological treatment methods, and their limitations. Additionally, it explores the interaction between functionalized biomimetic nanoplatforms and the BBB from a unique perspective, systematically summarizing their penetration, release, and clearance mechanisms. Finally, the review highlights the use of functionalized biomimetic nanoplatforms incorporating different types of cell membranes, revealing their potential applications in future clinical treatments for CIRI.