5. Introduction
Human body is basically an extremely complex
system of interacting molecules (i.e., a
molecular machine)
therefore technology required to truly
understand and repair the body is the molecular
machine technology : nanotechnology
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6. Nanoscale
Nanoscience: involves research and
technology development at 1 nm to 100
nm range (nanoscale)
“nano” indicates 10-9
A nanometre is 10-9 meter.
one nanometre is a billionth of a metre
or a millionth of a millimetre
a single human hair is around 80,000 nanometres
thick
A typical protein size lies between 3 to 10
nanometres (nm)
red blood cells are a standard size of about
6000‐8000 nm
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7. Nanomedicine: Definition
The official definition of the US National Nanotechnology
Initiative says that
nanotechnology involves ‘research and technology
development at the atomic, molecular, or
macromolecular levels, in the length scale of
approximately 1 to 100 nm range.
European Science Foundation (ESF) has defined
nanomedicine as
‘the science and technology of diagnosing, treating and
preventing disease and traumatic injuries, of relieving pain,
and improving human health, using molecular tools and
molecular knowledge of human body
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8. Aim of Nanomedicine
comprehensive monitoring, control,
construction, repair, defence and improvement
of all human biological systems, working from
the molecular level
using engineered devices and nanostructures,
ultimately to achieve medical benefit.
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9. History
On December 29, 1959, physicist
Richard Feynman gave a radical
lecture at an American Physical
Society meeting at Caltech titled
“There’s Plenty of Room at the Bottom”.
Feynman suggested that it should be
possible to make machines at a nano-
scale that "arrange the atoms the way
we want", and do chemical synthesis
by mechanical manipulation.
This lecture was the birth of the idea
and study of nanotechnology.
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10. History
Professor Norio Taniguchi of the Tokyo
Science University, introduced the
term “nanotechnology”, in 1974
He described nanotechnology as the
processing of, separation,
consolidation, and deformation of
materials by one atom or by one
molecule."
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11. History
In the 1980s, Dr. K. Eric Drexler, promoted nanoscale
phenomena through books:
Engines of Creation: The Coming Era of
Nanotechnology
Nanosystems: Molecular Machinery,
Manufacturing, and Computation
He was ultimately responsible for the term
nanotechnology to acquire its current sense.
he was presented the first PhD in nanotechnology.
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12. History
Hollywood provided the
public with a glimpse of
the future of nano-
science with the release
of the film Fantastic
Voyage in 1966,
which depicted a
surgical team that was
miniaturized and injected
into a man to operate on
a blood clot in his brain
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13. History
Bhasma, is a ayurvedic metallic/mineral
preparation, treated with herbal juices or
decoction and exposed for certain quantum of
heat as per puta system of Ayurveda
Bhasma are claimed to be biologically
produced nanoparticles (ethno-nanomedicine)
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14. Nanotechnology: Timeline
In early 2003, the European Science Foundation launched its
Forward look on nanomedicine; a policy briefing was published on
23rd February 2005 which summarised the recommendations of the
Forward Look.
In 2004 High Level Group European Technology Platform
Nanomedicine was launched
In September 2005, its Vision Paper and Basis for a Strategic
Research Agenda for Nanomedicine was released, as a first step
towards setting up a European Technology Platform on
Nanomedicine
in 2007, the European Foundation for Clinical Nanomedicine was
established in Basel (Switzerland)
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16. Nanotechnology: Timeline
The US National Institutes of Health (NIH) released their
first roadmap on nanomedicine in 2004
In 2004, the National Cancer Institute (NCI), as part of
NIH, launched the Cancer Nanotechnology Plan, a
strategic initiative to transform clinical oncology and
basic research through the directed application of
nanotechnology
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18. Current status
The market analysis reported that market for the
nanomedicine is continuously growing at the rate
of 28 % with a 35% increase in the revenues
generated
The National Science Foundation estimated the
market for all nanotechnologies to be $1 trillion.
Huge investments are being made in
nanomedicine to develop novel therapeutic
deliveries.
Currently more than 38 nanomedicine based
products are on the market with estimated sales of
$6.8 billion and the efforts to bring them on the
market are increasing continuously
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20. Application of Nanomedicine
• Diagnostic
Imaging and identification
• Therapeutic
Delivering medication to the exact location.
Killing of bacteria, viruses & cancer cells
Repair of damaged tissues.
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22. Diagnostic use: Imaging
Nanomaterials are being used extensively as contrast
agents in non-invasive medical imaging tools, including
computed tomography, magnetic resonance, positron
emission tomography, single photon- emission computed
tomography, ultrasound, and optical imaging
The contrast agents used: nanosized metal oxides,
dendrimers, quantum dots, etc.
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23. Diagnostic Use: Imaging using
Quantum dots
Quantum dots Nano crystals (nano
cadmium & nano zinc) are
semiconductors used to tag biological
molecules
have applications in medical
diagnostics, targeted therapeutics,
and high-throughput drug screening
tiny crystals, produce sequence of
colours when subjected to
ultraviolet rays
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24. Diagnostic use
Currently in vitro diagnostics are costly and
it is hoped that new generation nanoscale “lab-on- a-
chip” will offer advantages including reduced costs,
portability, and shorter and faster analysis.
Applications may include measurements of saliva for
periodontitis, heart disease, insulin detection and
improving healthcare accessibility
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25. Diagnostic tools
a lab-on-a- chip with the size of a postage stamp is already
commercially available and is used to monitor lithium medication
levels for manic depressive patients at home at much lower cost
and with greater convenience
Other diagnostic applications using nanotechnology and already
on the market include:
colloidal gold particles which, due to their stability, have been widely
used to rapidly test for pregnancy, ovulation, HIV and other indications
magnetic nanoparticles used for cell sorting applications in clinical
diagnostics
superparamagnetic iron oxide nanoparticles for magnetic resonance
imaging – first approved in Europe in 1993
Magnetic iron oxide nanoparticles also show great promise in the
detection of Alzheimer plaques
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26. Medical instruments
Medical instruments are also being increasingly
miniaturised, with nanomaterials for increased efficiency
carbon nanotubes may be used instead of glass
pipettes for delivery into cells
Nanosilver is increasingly incorporated into catheters
and other instruments as a coater because of its
antimicrobial effects
Wound dressings may also incorporate some sort of
nanosilver, for the same purpose
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27. Therapeutic uses: Drug delivery
using Nanoparticles
Nanopharmacology: an application of nanotechnology to the
development and discovery of drug delivery methods.
Application
to deliver Medication to the exact location.
Lesser side effects & high efficacy
Improves bio-availability
Molecular targeting by nano engineered devices
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28. Therapeutic uses: Drug delivery
using Nanoparticles
Nanoformulations of existing drugs can overcome common
pharmaceutical problems by increasing solubility, limiting systemic
toxicities, increasing bioavailability and improving immuno-
compatibility and cellular uptake
Nanotechnology has also been used for targeted drug delivery
which will allow
controlled drug release at just the right place and dose, improving
patient safety and compliance and reducing side effects.
Drug delivery vehicles under investigation include:
polymeric particles, dendrimers, nanoshells, liposomes, micelles and
magnetic nanoparticles
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29. Therapeutic uses: Drug delivery
using Nanoparticles
Advantages & of a targeted drug delivery system
Encapsulation of a drug (such as in a liposome or micelle) can avoid
local irritation and decrease local and systemic toxicity,
Disadvantages
The drug delivery mechanisms may also introduce toxicities of their own
and have unintended side effects.
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30. Therapeutic uses: Drug delivery
using Nanoparticles
Metal-based nanoparticles – Au, Ag, Cd-Se, Zn-S etc
Lipid-based nanoparticles – Liposome & Neosome based
Polymer-based nanoparticles – Dendrimer, chitosen, micelle based
Biological nanoparticles – arginylglycylaspartic acid (RGD) peptides
based
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31. Liposomes
Liposomes are small spherical vesicles, composed of lipid
bilayers surrounding aqueous inner phase
Liposomes are usually composed of phospholipids or
cholesterol, which are used to encapsulate various active
drugs.
At the target site liposomes fuse with the cell membranes
and deliver the molecules
Liposomes are 200 nm or smaller
Applications
targeted drug delivery
cancer treatment
Some liposome based pharmaceuticals:
Amphotericin B, Daunorubicin, Doxorubicin, Amikacin
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32. PEGylated Liposomes
PEG (polyethylene glycol) makes the liposome less vulnerable to immune
system
PEGylation, by increasing the molecular weight of a molecule, can impart
several significant pharmacological advantages over the unmodified form,
such as:
Improved drug solubility
Enhanced protection from proteolytic degradation
Increased drug stability
Extended circulating life
Reduced dosage frequency, without diminished efficacy with potentially
reduced toxicity
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33. Niosomes
Niosomes, non-ionic surfactant vesicles,
widely studied as an alternative to
liposomes
similar to liposomes in terms of their
physical properties
Niosomes alleviate the disadvantages
associated with liposomes, such as
chemical instability, variable purity of
phospholipids and high cost.
They have the potential for controlled
and targated drug delivery
Niosomes enhance the penetration of
drugs
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34. Dendrimers
Dendrimers are manmade molecules
having a tree like structure having number
of small branching molecules around a
central core molecule.
Dendrimers measure between 2-20
nanometers across and are branching
molecules with the branching beginning at
the core.
Nano devices based on dendrimers may
be used for cancer cell recognition,
diagnosis of cancer cause, drug delivery,
reporting drug levels in tumors and
reporting cancer cell death.
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35. Nano shells
Nano shells have a core of silica and a metallic outer layer.
Nano shells can be linked to antibodies that can recognize tumor
cells
Once the cancer cells take them up, by applying a near infra red
light that is absorbed by the Nano shells, it is possible to create
intense heat that selectively kills the tumor cells and not the
neighboring healthy cells
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36. Carbon nanotubes
Single-wall carbon nanotubes are tiny
hollow rods that are one-atom-thick
10,000 times smaller in diameter than a
human hair
extraordinary optical, mechanical, thermal
and electronic properties
being used to produce lightweight and
extremely strong materials, which enhance
the capabilities of devices such as sensors,
and provide a novel means of delivering
drugs with great specificity.
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45. Drug discovery
Nano and micro technologies are part of the latest
advanced solutions for decreasing the discovery and
development times for new drugs, and potentially
reducing the development costs.
High-throughput arrays and ultra-sensitive labeling and
detection technologies are being used to increase the
speed and accuracy of identifying genes and genetic
materials for drug discovery and development.
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46. Therapeutic uses: Cancer
treatment
Thermotherapy, a form of cancer treatment that uses
heat to destroy cancer cells.
By using nanoparticles to generate the heat, the
treatment can be more successfully localised and result
in fewer side effects.
The devices use a number of different nanomaterials
including nanosized iron oxides, gold-coated silica
nanoparticles and hafnium oxide nanoparticles
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47. Tissue repair & replacement
Implant coatings:
biocompatible nanomaterials and coatings to
increase the adhesion, durability and lifespan of
implants.
For example, nanopolymers such as polyvinyl alcohol
(PVA) can be used to coat implantable devices that
are in contact with blood (e.g. artificial hearts,
vascular grafts, catheters) for dispersing clots or
preventing their formation
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48. Tissue repair & replacement
Tissue Regeneration Scaffolds
Nanostructures are being researched for the preparation and
improvement of tissue regeneration scaffolds
For example, PVA is also being investigated for the cornea by having
corneal epithelia cells seeded in a PVA hydro gel structure.
Structure implant materials for
Bone repair: e.g. High strength nanoceramic materials, such as calcium
phosphate apatite (CPA) and hydroxyapatite (HAP)
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49. Nanorobots – A future vision
• Nanorobots are nanodevices.
• Potential applications include
• To repair or detect targeted damages and
infections.
• early diagnosis and targeted drug delivery
for cancer,
• biomedical instrumentation, surgery
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50. “A microscopic
machine roaming
through the
bloodstream,
injecting or taking
samples for
identification and
determining the
concentrations of
different
compounds”
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54. Advantages of nano medicine
• Drug delivery to the exact location.
• Lesser side effects, high efficacy
• Molecular targeting by nano engineered devices
• Detection / Diagnosis of diseases relatively easy & fast
• No surgery required.
• Diseases can be easily cured.
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56. Nanotoxicity
The nanoparticles can have off target effects such as
triggering an immune response, crossing blood brain
barrier and affecting CNS or can cause tissue toxicity if not
properly eliminated
Several toxicological responses of nanomedicine based
on in-vivo characterization have been reported such as
hypersensitivity reactions, element specific toxicity and
generation of reactive oxygen species
for example multiwalled carbon nanotubes (MWCNT)
were found to cause asbestos- like effects on the
mesothelium following intracavitary injection of high doses
in rodents.
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57. Nanotoxicity
In 2006, there was a disaster during the clinical trial phase-I
study;
6 healthy volunteers were recruited and administered with
TGN 1412 (CD 28 MAB) intended for the treatment of
rheumatoid arthritis and lymphocytic leukaemia. It was
humanised monoclonal antibody and CD 28 receptor
agonist.
The drug was administered as intravenous infusion and within
half an hour all the subjects suffered from life threatening
conditions.
So it was concluded that in-vivo behaviour in animals is not a
true representation of humans and more work is need to be
done to reduce the risks involved in the clinical trials
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58. Nanotoxicity
There is a need for a detailed examination of the
physico- chemical properties of nanoparticles
such as size, shape and surface chemistry and
correlating them with their in-vivo behaviour
could help in understanding the most important
technical issues and also for the development
suitable models for studying nanotoxicity
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60. Regulatory issues
There are two primary regulatory problems posed by nanomedicine:
classification difficulties
lack of scientific expertise
The FDA classifies medical products for regulatory purposes as drugs,
devices, biologics, or combination products
In the long run, sophisticated nanomedical products will blur the
distinction between “mechanical”, “chemical”, and “biological”
and make it difficult to determine if a product is a drug, device,
biologic, or combination product.
Effective regulation requires that the FDA maintain expertise in
cutting edge technologies and scientific advances
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61. Environmental risks
National Science Foundation and Environmental Protection Agency
have raised concerns over potential impact of nanomaterials on
the environment and the adverse effects have been reported
The possible excretion mechanisms are suggesting that it would be
mainly disposed in water and air.
The excretory materials would mostly be suspended in air for longer
times due to their small size which can cause respiratory disorders
and affect the health of individuals
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62. Social issues
Firstly, the prices would be very high and the patients from the
low income groups would be deprived of these novel
therapeutics and the developing nations would be affected
most.
Nanomedicine will generate social and ethical debates
regarding issues such as whether implantable nano-devices
that can constantly monitor for illness compromise privacy
rights and risk abuse
whether neurobiochips that stimulate brain function give
humans machine-like qualities and steer society on a path
toward mental manipulation through implantable devices in
the brain
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63. Ethical issues
Bioethical researchers believe that nanomedicine could be
manipulated to harm the human body rather than healing it.
How would the use of a technology that can’t be seen be
regulated? What if, they say, the guiding system on the
medicine malfunctions and takes the medicine to the wrong
part of the body, such as the brain?
What if the nanomedicine technology is used for terrorism
purposes? Particles that can’t be seen or easily controlled
would enter the body and deliver harmful substances such as
toxins.
Will the materials used for the nano-medicinal technologies
be non-toxic and eco-friendly?
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64. Conclusion
• Although realization of the full potential of nanomedicine
may be years or decades away, recent advances in
nanotechnology-related drug delivery, diagnosis, and drug
development are beginning to change the landscape
medicine.
• The possibilities are endless, but will take time to develop.
• Nano therapies could, in the long term, be much more
economical, effective and safe and could greatly reduce
the cost of current medical procedures.
• So, Nanomedicine is the future medicine.
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65. To conclude …..
Richard E. Smalley, PhD, 1996 Nobel Laureate,
once said,
“Human health has always been determined on
the nanometer scale; this is where the structure
and properties of the machines of life work in
every one of the cells in every living thing. The
practical impact of nanoscience on human
health will be huge.”
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