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Nanomedicine and the Future of Healthcare

PFN (12.08.2002): As the phrase nanotechnology slowly enters the househould vocabulary scientists in a wide range of industries is looking for potential applications. This article will examine the consquences nanotechnology will have in the medical industry and subsequently the healthcare industry in general. Keywords: nanomedicine, medical nanosensors, artificial organs, stemcells, genetherapy and molecular imaging.

“In contrast, the medicine of Star Trek is set in a ‘high tech’ future. Scanners are employed that tell the user the patient’s vital parameters and automatically display the diagnosis. Monitoring devices are utilised which constantly watch the patient’s condition and alert medical staff if something is amiss. Special emergency blankets are used to maintain body temperature. Surgery in Star Trek has advanced such that brain transplants are possible. It is clear that much of the above is being developed in modern day medicine and if brain surgery does not yet involve brain transplantation it is not for want of trying; certainly nerve cells have been transplanted into brains of patients with Parkinson’s disease with mixed results.” – Professor Paul Goddard MD


Nanobiology.

Many fundamental biological functions are carried out by molecular machineries that have the sizes of 1-100 nm. One of the most studied and best understood biomechanical motors is the ATP synthase. The ATP synthase is the universal enzyme that synthesizes ATP, the universal fuel that powers most cellular processes. To understand the functions of these machineries, one has to describe their movements, changes in their shapes, and their localization.

This new field, that merges mechanistic biology and morphology, is called nanobiology. The emergence of nanobiology depended on the invention of the scanning probe microscopy, modern optical techniques, and micro-manipulating techniques. This concept of nanobiology was first proposed by the Japanese Agency of Science and Technology, in a group study named “Biological Nano-Mechanisms” in 1992-1998.

Biomolecular imaging.

The report “Biomolcular imaging using atomic force microscopy” published by Elsevier’s Trends in Biotechnology examines how atomic force microscopes (AFM) can be used to directly observe dynamic biomolecular process in vivo. Explained in simple terms this implies the ability to view macromolecules (proteins and DNA) processing in their natural surroundings. This technology is of great importance to the study of how cell’s inner biomachinery works in the human body.

The challenge of using AFM on organic materials compared to in-organic materials is about the effect of the probing on the material. Organic materials, like tissues, reacts and changes with the AFM probing, this requires that the force of the probe is kept very low to avoid deforming of the inspected material. In addition to this challenge, the examination of organic materials in vivo, requires fast scanning of the changes within the cell to capture the processes at work.

Other imaging technology is also making significant progress. Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) is similar to conventional MRI in that it’s a non-invasive method that doesn’t need contrast agents or dyes to produce images of the inside of the body. But DT-MRI differs in that it’s able to measure the three-dimensional random motion of water molecules in soft tissues. That produces intricate images of the soft tissue’s structure that can help doctors better detect development, degeneration, disease and aging in soft tissue.

Progress within cellular communication is also making headway. Researchers are trying to understand the cascade of molecular events that convert signals outside a cell into exquisitely specific responses within. As scientists gain insight into the complex nature of cells the prospect of individualized medicine and gene therapy becomes closer to practical medical administration.

Medical Nanoparticles, BioMEMS, Proteomics and DNA-chips.

The development of DNA-chips (lab on a chip) that first could scan single DNA’s for a genetic marker has evolved to proteomics which initially was defined as the effort to catalog the protein complement of cells and tissues. Proteomics has now come to include the systematic study of the functions, interactions, cellular location, expression and post-translational modifications of proteins on a massively parallel scale. Bioinformatics and biodynamics, the modelling and computational work needed to understand the complete human genome, makes this work more efficient and gives scientists the tools to understand the vast amount of genetic information.

The quest for understanding macromolecular mechanisms and how to engineer drugs to suit individual genetics is the extension of the current research into proteomics. Individualized medicine would make medication more focused on the actual complication, compared with traditional medicine where the body is flooded with medication.

Magnetic nanoparticles containing drugs could be attracted to specific areas of the body by applying a magnetic field. Concentrating the particles in areas requiring treatment would enhance the therapeutic benefits while reducing side effects on other areas of the body. Magnetic nanoparticles for in-vivo biomedical use must be small enough to avoid detection by the immune system, yet large enough to remain in the body long enough to be circulated through the bloodstream.

The Alliance for Nanomedical Technologies.

The Alliance for Nanomedical Technologies is a New York agency funded by the New York State Office of Science, Technology and Academic Research (NYSTAR). A .8 million grant is divided between a variety of projects at Cornell University, the University of Rochester, Wadsworth Center along with several private companies. Some of these companies are involved in the areas of biochemistry, instrumentation and lithography.

The services on the Cornell campus include the Cornell Nanofabrication facility, which include 6,000 square foot class 100 and class 1000 clean rooms. This is a comprehensive facility that gets all the devices fabricated on campus. Cornell also has a nano/biotechnology center with biological cleanrooms, which will permit the use of biological samples. A lot of companies utilize these facilities for prototyping their devices

Companies in the alliance include Welch Allyn doing biomedical instruments, Agave Biosystems doing biosensors, Anvik manufactures photolithographic equipment and Superpose works with faculty on campus to develop a miniature x-ray vision system for imaging. Another venture with Leica Microsystems is developing optical instrumentations for biological devices. All of these technologies are in varying stages of development according to Doctor K.V. Madanagopal in the latest San Franciscio Consulting Group’ Nanotech Business Update.

Medical nanosensors.

Implanted nanosensors that gather medical information would make diagnosis easier and more efficient. These devices can e.g. send a signal to a pump to release more insulin for diabetes patients. Machines that simultaneously measure and administer insulin today are large and cumbersome, but with nanosensors the technology is implanted and the patient will be relieved of being constantly alert. This technology is bringing the physician into the human body in a less invasive manner, and in the future similar devices could be used to deliever any sort of medication.

Nanosensors can also be used to detect DNA sequences in the body. The first use of DNA motors is already beginning to emerge in the form of biosensors. These are instruments that researchers use to detect a very specific piece of DNA that may be related to disease. Such sensors enable detection of only a few DNA molecules that contain specific sequences and thus possibly diagnose patients as having specific sequences related to a cancer gene or not.

NASA is currently working on nanosensors that could help astronauts detect harmful radiation levels in their bodies while in space. Nanosensors will avoid problems associated with current much-larger implantable sensors, which can cause inflammation; and eliminate the need to draw and test blood samples. The devices can be administered transdermally, or through the skin, avoiding the need for injections or IVs during space missions. The nanosensors use dendrimers (tree-like polymers) that have fluorescent tags attached that glow in the presence of proteins associated with cell death. The plan is to develop a retinal-scanning device with a laser capable of detecting fluorescence from lymphocytes as they pass one-by-one through narrow capillaries in the back of the eye.

Artificial blood.

Robert Freitas, a senior Foresight Institute research fellow, is considered to be among the leading researchers on medical nanotechnology. One of his proposals include artificial red blood cells. The artificial red blood cell or “respirocyte” is a bloodborne spherical 1-micron diamondoid vessel able to deliver 236 times more oxygen than natural red cells. The hypothetical system includes an onboard nanocomputer and numerous chemical and pressure sensors that enable complex device behaviors remotely reprogrammable by the physician via externally applied acoustic signals.

Some of the applications of “respirocytes” will include transfusable blood substitution; partial treatment for anemia, perinatal/neonatal and lung disorders; enhancement of cardiovascular/neurovascular procedures, tumor therapies and diagnostics; prevention of asphyxia; artificial breathing; and a variety of sports, veterinary, battlefield and other uses. Respirocytes could also be used as a cooling fluid replacing blood during cryonic suspension.

Medical Implants and Remote Monitoring.

Biomimetics is the study of natural systems to improve the design and functionality of syntehtic systems. It’s obvious that to be able to artificially design a heart you need detailed knowledge of the real one. The AbioCor artificial plastic heart entered medical trials last year, several patients is alive and well with a plastic heart ticking in their chests. Equipped with an internal motor, the AbioCor is able to move blood through the lungs and to the rest of the body while simulating the rhythm of a heartbeat. The AbioCor consists of an internal thoracic unit, an internal rechargeable battery, an internal miniaturized electronics package and an external battery pack. Artififical hearts may be the first on a string of artificial replacements for body parts. Artificial livers, lungs, and other major body parts should be as plausible as an artificial heart.

The “Digital Angel” from Applied Digital Solutions is an implantable device for medical information. The introduction of this product caused an international uproar due to privacy concerns. What is already a far more widespread reality is that contemporary cardiac pacemakers and defibrillators already support wireless transfer of medical information, usually done at the doctor’s office. Medical device supplier Medtronic has now started supporting 2 million defibrillator patients in collecting this data themselves and send it to doctors through the internet. This saves both the patient and doctor’s time and allows for continous remote monitoring of a patient. One day all your medical information might be transfered to your doctor, or to a medical respons-team.

Shape-Memory Alloys.

Shape-memory biocompatible alloys for medical use has been around for several years. One of the first medical applications involved bendable surgical tools that enter the body in one shape and change to the desired shape after having reached the desired position inside the body. Some of the latest shape-memory alloy applications involve bone repair and systems for reinforcing blood vessels. Other applications include skull and craniofacial bone distraction; Rivets, screws and pellets; Vertebral body replacement; Long bone replacement with self-locking capacity. Some future applications include the ability to introduce bodyparts in a small shape that easily enters the body, and after reaching the desired position to return to the shape of the body part that needs to be replaced.

Nanotech Environmental Disaster.

The science-fiction novel, Blood Music by Greg Bear, describes a world where an intelligent virus runs amok and starts evolving into a sort of super-intelligence that absorbs all organic material into it’s pulsating shapeless body (that covers all of northern-america in the end of the story). This science-fiction story has been materialized in the nightmares of nanotechnologists.

Blood Music has been transformed into the pet-story of nanotech in massmedia, the “grey-goo” scenario. This scenario has now been analyzed seriously by the US Environmental Protection Agency (EPA). The background for the research is that companies are producing commercial nanomaterials and nanoparticles for use in cosmetics, paints, coatings, fabrics – to provide added strength or other properties that regular materials can’t offer.

Researchers at EPA found that nanoparticles are showing up in the livers of research animals, can seep into living cells, and perhaps piggyback on bacteria to enter the food chain. Although the promise of materials with highly sophisticated properties hold a great promise for many industries, the consquences for human health and the enivornment is still unknown.

Nanotechnology as vectors in genetherapy.

Carbon nanotubes has been considered used as a system for drug delievery in genetherapy. Nanotubes is at the size where cells don’t recognize them as harmful intruders. The most common used genetherapy method today involves modified viruses as the vector of gene-delievery. This has caused several problems related to immune respones to the virus. With carbon nanotubes this problem might be overcome.

Erick B. Iezzi at Virginia Tech has developed the first organic derivative of a metallofullerene and has figured out how to make the metal-filled buckeyballs soluble, bringing them a step closer to biological applications. One application being the the delivery of medicine or radioactive material to a disease site. This and many other applications of carbon nanotube related technologies show great promise as a vector for drug delivery or gene-therapy vehicles.

Stemcells and cloning.

Stemcells holds the promise of regenerative technology. Obtaining stemcells from your own body and growing these cells into the desired bodypart is considred to be possible in the short-term future. The timeline for creating complete organs based on stemcells is said to be 10 to 15 years ahead of realization.

The Massachusetts-based Advanced Cell Technology attempted recently to clone human embryos but failed because its embryos were only able to divide into a few cells. Zhongshan Medical University in China has grown embryos beyond the 200-cell stage, large enough for the harvesting of embryonic stem cells (ESCs). ESCs are highly-prized because of their potential to be transformed into any body cell to treat a range of diseases. Theoretically, such cell lines can be grown into transplant tissue and eventually into entire organs.

Don’t hold your breath…

Although many of the ideas presented here still only exist in research labratories the “time-to-market” of these technologies may not be as long as people like to think. Although there’s a long process of getting new medical technology to the market, many of these inventions could save millions of lives and therefore gives companies the incentives to hasten their research.

The interest in anti-aging medicine, life-extension and the popularity of cryonics indicates where modern medicine is heading. The desire to live forever has been around for a long time. “The Propsect of Immortality” was published in 1965 and is one of the first books detailing cryonics and other technologies for immortality. Transhumanists consider death to be a minor obstacle and consider life no longer to be limited by aging and death.

The International Necronautical Society is set up to explore death in every aspect. According to their manifesto their “ultimate aim shall be the construction of a craft that will convey us into death in such a way that we may, if not live, then at least persist… Let us deliver ourselves over utterly to death, not in desperation but rigorously, creatively, eyes and mouths wide open so that they may be filled from the deep wells of the Unknown.” These sentiments cause deep ethical and philosophical debates, the driving force being the exponential technological progress pushing death further away.

If immortality isn’t achieved with your physical body, there’s always the concept of mind-downloading. Downloading involves the storage of your entire personal history, memories, emotions and knowledge digitally in a computer. When a new body that suits your needs is ready, you simply upload your information into the brain of your new body.

Remember, don’t hold your breath…

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Ole Peter Galaasen (30) is a freelance researcher and writer based in Oslo, Norway. If you like this work consider using my research services for market analysis, competitive intelligence or other information gathering needs. I’ve researched several topics; ecommerce, banking, public sector, higher education. I’m personally interested in nanotechnology, biotechnology, space and aviation, information warfare and international politics.

References:

Biomolecular imaging using atomic force microscopy NIGMS aims big guns at macromolecular structure A sharper image for imaging

Nanobiotech Makes the Diagnosis

Lasers light way to 3-D imaging in Purdue lab

From The Realm Of The Tiny Come The Tools For Human Regeneration

Biomolecular Systems, Devices and Technologies

Nanopharmaceuticals Open Up Brand New Field Of Study

No Small Matter! Nanotech Particles Penetrate Living Cells and Accumulate in Animal Organs

SCIENTIST, ENTREPRENEUR FINDS MARRIAGE OF NANOTECH AND BIOTECH

DNA nanoballs boost gene therapy

A Mechanical Artificial Red Cell: Exploratory Design in Medical Nanotechnology

Exploring the incredibly small, medical nanorobots

Fantastic Voyage — Filled buckeyball now a step closer to becoming a drug-delivery device

Another Dimension in MRI Scanning

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