Some Straight Talk on Nanotechnology in Health Care

“If we can reduce the cost and improve the quality of medical technology through advances in nanotechnology, we can more widely address the medical conditions that are prevalent and reduce the level of human suffering.”

Ralph Merkle, Senior Research Fellow, Institute for Molecular Manufacturing
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I’m probably one of the few people reading this that can remember seeing the 1966 film Fantastic Voyage in the theater. The film is about a submarine crew who are shrunk to microscopic size and venture into the body of an injured scientist to repair damage to his brain. The team faces many obstacles during the mission. An undetected arteriovenous fistula forces them to detour through the heart, where cardiac arrest must be induced to, at best, reduce turbulence that would be strong enough to destroy Proteus. This was science fiction speculating on the development of nanotechnology as introduced by Richard Feynman in 1959. (More on that in a bit.)

Image Credit: 20th Century Fox

Today, we are living at the dawn of the nanomedicine age. If you think that nanorobots and engineered nanoparticles are only part of the world created by the writers of Fantastic Voyage, you might not have heard about the winners of the 2016 Nobel Prize in chemistry. It was awarded to scientists Jean-Pierre Sauvage, Sir J. Fraser Stoddart, and Bernard L. Feringa for having developed molecules with controllable movements. Although molecular nanotechnology is still in its infancy, by awarding the Nobel Prize to these three scientists, the Royal Swedish Academy of Sciences is acknowledging nanotechnology’s huge potential.

In his historic 1959 lecture, “There’s Plenty of Room at the Bottom,” physicist Richard Feynman introduced the world to the concept of nanotechnology. He envisioned a world where we could directly manipulate individual atoms, arranging and rearranging them into useful shapes and configurations. But theory is one thing. Demonstrating feasibility is entirely another. And it’s at this critical nexus point where the work of Sauvage, Stoddart, and Feringa is being acknowledged. All three are being honored for developing molecules with controllable movements and for creating tiny devices that can perform a task when energy is added.

The size of the global nanomedicine market is estimated to grow $291.15 billion by 2026 from $159.43 billion in 2021, growing at a CAGR of 12.80% during the forecast period according to a Market Data Forecast report published in April of this year. So what does the development of nanotechnology mean for the future of health care?

First, some basics – Essentially, nanotechnology comprises science, engineering, and technology conducted at the nanoscale, about 1 to 100 nanometers. It is a well-established branch of science having significant applications in a wide range of medicine. The ability to manipulate structures and properties at the nanoscale in medicine is like having a sub-microscopic lab bench on which you can handle cell components, viruses, or pieces of DNA, using a range of tiny tools, robots, and tubes. Here are a few examples of how this is used in health care:

Researchers from the Max Planck Institute have been experimenting with exceptionally micro-sized – smaller than a millimeter – robots that swim through your bodily fluids and could be used to deliver drugs or other medical relief in a highly targeted way. These scallop-like microbots are designed for swimming through non-Newtonian fluids, like your bloodstream, around your lymphatic system, or across the slippery goo on the surface of your eyeballs.

A team of researchers at the University of Twente (Netherlands) and German University in Cairo has developed sperm-inspired microrobots called MagnetoSperm that can be controlled by weak oscillating magnetic fields. MagnetoSperm can be used to manipulate and assemble objects at nanoscales using an external magnetic field source to control their motion.

Drexel University engineers have developed a method for using electric fields to help microscopic bacteria-powered robots detect obstacles in their environment and navigate them. It means that robots navigate with the help of electric fields, and they can be programmed into getting to a certain point or changing their route, or avoid/go through objects. Bacteria-powered robots might bring tremendous changes in healthcare, which include delivering medication precisely to the point where it is needed, manipulating stem cells to direct their growth, or building a microstructure, for example.

Image Credit: Drexel University

Clottocyte nanorobots function similarly to platelets that stick together to form a blood clot that stops bleeding. They could store fibers until they encounter a wound and then disperse them to create a clot in a fraction of the time that platelets do. Blood–related microbivore nanorobots act like white blood cells and could be designed to be faster and more efficient at destroying bacteria or similar invasive agents.

Respirocyte nanorobots act like red blood cells, but they would have the potential to carry much more oxygen than natural red blood cells do for patients suffering from anemia. They might also contain sensors to measure the concentration of oxygen in the bloodstream.

What are some of the use cases for nanotechnology in health care? – The real advantage of having robots on the nanometer scale is having them work in large groups. Nanotechnology applications in medicine deal with the diagnosis, treatment, monitoring, and prevention of diseases. The recent focus has been shifted toward applying nanoparticle contrast agents in the early characterization of conditions at the cellular and molecular levels, such as atherosclerosis and cardiovascular abnormalities.

The advancement in the nano-based strategies might assist in combining the imaging techniques with conventional drug delivery systems to expedite personalized medicine. Moreover, the development of nano-based, highly efficient markers and detection devices for the early diagnosis and monitoring therapy response will have a significant role in patient management, lowering mortality rates, and improving the quality of life of patients in cases of deadly diseases like cancer and Alzheimer disease. Some specific examples follow below:

Targeted drug delivery – The most significant potential in nanodevices lies in their ability to deliver drugs to the exact location needed. There are many diseases – including cancer – where treatment causes lots of serious side effects precisely because the active substance in the medication cannot differentiate between healthy and diseased tissues. In the future, nanotechnology could provide a great solution.

Imagine programmable nanoparticles, which might help tackle the day-to-day miseries of chronic diseases, such as diabetes. They might deliver insulin to initiate cell growth and regenerate tissue at a target location. In the case of neurodegenerative diseases such as Parkinson’s, nanodevices could deliver drugs, implant neurostimulators, or transport intelligent biomaterials across the blood-brain barrier to direct regeneration within the central nervous system.

Nanotechnology allows primary detection of Alzheimer’s disease – The potential for early detection of AD emerged after two studies conducted in February 2005. The proposed strategies for disease detection in those studies were Localized Surface Plasmon Resonance (LSPR) and Bio- Barcode assay (BCA).

Nanotechnology in liver diseases – Many treatments like targeting hepatitis B virus (HBV) in the liver by adefovirdipivoxil with monostearin-containing solid lipid nanoparticles, in vivo delivery of siRNA against liver fibrosis, lipid-based carrier treatments, OX-loaded nanoparticles in overwhelming HCC drug resistance have been used for various treatments.

Applications of nanotechnology in cardiology – Nanotechnology has applications in cardiology and various vascular processes, which can be diagnostic and therapeutic. They are used to target atherosclerotic lesions, which are further detected by imaging techniques. Genes associated with coronary artery diseases (CAD) can be seen by employing biosensors composed of carbon nanotubes that can interact with the DNA. From the nanotube-DNA interactions, multiple genes can be identified.

Antimicrobial activities of nanoparticles – Studies have shown that silver, zinc, gold, and magnesium NPs possess strong antibacterial activities. Silver nanoparticles have proven to be the most effective antimicrobial agents against bacteria, viruses, and other eukaryotic micro-organisms.

My take – Recent years have seen an explosion in the number of studies showing the variety of medical applications of nanotechnology and nanomaterials. In this post, I’ve highlighted just a small cross-section of this vast field. However, across the range, considerable challenges exist, the greatest of which appear to be how to scale up production of materials and tools and how to bring down costs and timescales. But another challenge is how to quickly secure public confidence that this rapidly expanding technology is safe. And so far, it is not clear whether that is being done. More research is needed to ensure that regulatory agencies can effectively assess the safety of products before they are allowed onto the market. The National Cancer Institute says there are so many nanoparticles naturally present in the environment that they are “often at order-of-magnitude higher levels than the engineered particles being evaluated.” In many respects, they point out, “most engineered nanoparticles are far less toxic than household cleaning products, insecticides used on family pets, and over-the-counter dandruff remedies,” and that for instance, in their use as carriers of chemotherapeutics in cancer treatment, they are much less toxic than the drugs they carry. It would appear, therefore, whether actual or perceived, the potential risk that nanotechnology poses to human health must be investigated and effectively and publicly reported. When technology advances rapidly, knowledge and communication about its safety need to keep pace for it to benefit, especially if it is also to secure public confidence.

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