A healthy future for NanoMedicine
In recent years there has been a massive growth in interest in nanotechnology leading to vastly improved medical treatments. Whether for targeted drug delivery, improved diagnosis, better materials for devices and implants, nanotechnology seems set to have a tremendous impact across the whole field of medicine. This short review will not only look at a few of these new areas of development but also examine the challenges that must be overcome in order to introduce these technologies in a safe and effective way.
New Horizons In Medical Treatment
Science at the nanoscale (generally considered to be between 1nm and 100nm) is not new. What is new is the ability to create new functionalities by manipulating molecules and materials at the nanoscale. The following are just a few examples of areas where nanotechnology is currently being applied to develop new generations of devices or therapies.
In-vivo monitoring of the body’s physiology, using a variety of nanotechnology-based probes and sensors. This will enable detection of conditions earlier than is currently possible. In addition, it will be possible to build up a more detailed model of the body’s systems and processes with the ability to more accurately predict the effects of various diseases or treatments.
More precise and informative diagnosis. This will include the possibility of building hundreds of diagnostic tests into a single device using tiny quantities of samples. In addition, nanotechnology will revolutionize diagnostic imaging with the use of targeted imaging agents, lower levels of radiation or soft energy sources, and far more precise and accurate imaging, e.g. use of fluorescent quantum dots bound to antibodies.
The accurate delivery of minute doses of drugs. Nanoparticles, e.g. biopolymers or encapsulated metallics or semi-metallics, could, if targeted using biomolecules or specialized cells, enable the delivery of minute doses of highly-active drugs, or of novel theranostic products that can be tracked and activated by conventional radiological devices, to specific sites such as tumours.
The further miniaturization of devices. This will facilitate both minimally invasive surgery and enable the development of novel implantable devices such as artificial retinas allowing treatment of hitherto incurable diseases.
Better design and improved performance of surgical tools. e.g. ultra-sharp nano-diamond coated scalpels for microsurgery. Improved techniques for longer replacement of lung function, heart function, and kidney function. This may enable other organs to become candidates for replacement, regeneration or augmentation, including skin, muscle, digestive organs and some sensory functions.
Nanodevices for delivering substances or drugs to specific target areas in the body, e.g. oxygen to poorly vascularized tissues. Actuators based on nanomaterials, e.g. carbon nanotubes, could have a variety of surgical and other applications.
Nanoengineering of implant surfaces will improve their properties and performance. e.g. better biocompatibility or fixation into tissues such as bone. Nanocontoured and nanoengineered scaffolds for human tissue-engineered products. These may be used in various ways to encourage cell growth and proliferation, and differentiation into more complex tissues through the supporting biodegradable medium.
New “smart” nanoengineered materials. These will impart new levels of performance to “conventional” medical devices and drugs
While the application of nanotechnology will potentially bring great benefit patients and the practice of medicine, it will also bring with it a series of challenges to the innovators, regulators and others.
Although existing regulatory frameworks for medical devices or pharmaceuticals in Europe would probably form a suitable basis for nanotechnology-based products, none of these directives were written with nanotechnology specifically in mind. Some of the requirements of these directives, and of supporting tools such as harmonized standards for medical devices, may therefore need to be reviewed to ensure that they are able to adequately address those risks particular to nanotechnology-based products.
Nanomedical products also have a tendency to blur the traditional demarcation boundaries between different regulatory systems. For instance they may act as both an imaging agent/diagnostic and a drug, e.g. theranostics, or they may facilitate the incorporation of a drug into an implanted medical device.
Perceptions of Risk
Addressing the perceptions of risk of nanotechnology will be essential both in introducing new products to the market and in having them accepted by medical professionals and patients. Media alarm has already been raised in the UK concerning nanotechnology. Whatever one may think of these views from a scientific standpoint, they echo the genuine fears many members of the public may have. Many of these fears, e.g. “self-replicating nanotech robots”, are firmly in the sphere of science fiction but scientists and regulators will certainly have to address, for example, concerns related to the ability of nanoparticles to enter the body, and possible toxicological or biological safety issues.
A systemically and transparently applied risk analysis and management process combined with effective communication about the possible risks, and benefits, of nanotechnology-based medical products will be absolutely essential as a precursor to their acceptance by a public increasingly wary of science and industry. Likewise, effective networking with medical professionals will be essential to convince them of the benefits of the value and benefits of nanomedical products and to build their confidence concerning the effectiveness and safety of such products.
Commercialization of Scientific Research
While nanotechnology, including nanomedicine, is a key thematic priority and a well-funded area within the new 7th Framework Programme (FP7), Europe is still lagging somewhat behind the US and some other regions in terms of the commercial exploitation of scientific research. There appears also to be a clear need to better inform investors of the potential for nanomedicine particularly in relation to bridging the innovation “death valley” between research and subsequent product development.
The future for nanotechnology in medicine looks exciting. A vast amount of scientific and medical research is being done in universities, by major companies and in SMEs. The prospect of new medical treatments and products that offer greatly improved outcomes and benefits to patients is high. However, in order to ensure that these developments can be brought to market and made accessible to society, a number of challenges as briefly outlined here have simultaneously to be faced and gradually overcome.
Source: NANO Magazine - Issue 2 /...
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