6 October 2016
Since the early 2000s, the application of nanotechnology in medicine, or nanomedicine, has earned well-deserved attention for its vast potential to improve the efficiency and effectiveness of healthcare.
From bioengineered nanoparticles that target and destroy cells and biocompatible tissue implants to nanosized implantable biosensors, nanomedicine has exciting applications in disease prediction and detection, treatment and monitoring. But whilst simple applications of nanomedicine (such as bespoke drug and medical tool coatings) have already entered mainstream medicine, it will be quite some time before more ambitious applications, such as multi-component nanomedical devices, are regularly and widely accessible.
Nanomedicine - hot or not? View the infographic here
At the molecular level, where particles measure just one billionth of a metre, it is possible to capitalise on the unique characteristics of these particles, facilitating a high degree of customisation. Working at such a small scale, there is a greater surface area for chemical attachment, thereby facilitating the manipulation of molecules to fine-tune particle behaviour. Nanomaterials are also small enough to penetrate living cells without clogging blood vessels, but large enough to remain in the circulatory system for an extended period. Finally, in combination with synthetic DNA, it is also possible to design and assemble nanostructures to improve target detection and drug delivery, as well as ensure biocompatibility of new cells. It is the unique characteristics of particles at the nanoscale that allows the tailoring of nanomedicine to the particular needs of a given patient.
Nanomedicine will surely have a crucial role to play in the future of personalised medicine, from prediction through to monitoring outcomes. Nanoscale materials will provide the basis for increasingly sensitive sensors and biomarkers that could be used to simultaneously and more accurately detect more diseases at an earlier stage. With improved targeting and chemical sensitivity, nanomedicine will allow very accurate mapping of disease. Once a disease has been diagnosed, nanomedicine could be used to attack cells more effectively while reducing side-effects and damage to healthy cells, thanks to the ability to deliver enhanced specificity of action and drug release rate. Nanomedical implants and increasingly tailored pharmaceuticals with longer retention rates (time spent active in the body) may also facilitate more accurate and long term monitoring of disease.
The improved delivery of pharmaceuticals using nanotechnology is a field that has already seen exceptional progress. A nanoparticle can be engineered with specific molecules to not only improve cell targeting and entry of a drug, but to improve imaging, intracellular targeting and permit the regulated release of therapeutic genes. Clinicians would thereby be able to better identify diseased cells or tumours, allowing them to optimise treatment doses, and better understand their impact. Combined with other types of personalised medicine like genomics, nanomedicine can be tailored to target only diseased cells in an individual patient, minimising side-effects and damage to healthy tissue.
A similarly promising area of nanomedicine is regenerative medicine, particularly tissue engineering and cell therapy. Nanotechnology provides a means of creating the necessary structural ‘scaffolds’ into which living cells can be introduced, and induced to grow, creating new functional structures that resemble native tissues. The new tissues benefit from the fact that the nanoparticles and cells are already biocompatible with the source of the sample and the resulting tissue can be controlled, allowing clinicians to influence cell development, growth and repair processes. The potential applications of such nanomedicine are broad, ranging from the introduction of vital elements for cell survival through to tissue regeneration and even growth of organs for stable transplantation.
There are, however, barriers to overcome before these more ambitious applications of nanomedicine could become mainstream. Scientific and technological obstacles include the challenges of reproducibility and quality control of nanomaterials; creating scalability and enhancing production rates; and dealing with undesirable by-products of nanoengineering. Moreover, the price tag remains very high whilst the wider health and environmental impacts of nanomaterials remain unclear.
Consequently, systemic barriers to implementation persist; investors remain hesitant and the pharmaceutical industry has been relatively reluctant to invest in nanotherapeutics. Part of the reason for this lies in the uncertainty and unpredictability of future regulation in this field, as well as the media’s tendency to exaggerate the dangers and overhype the successes of nanomedicine, often with little or incomplete scientific evidence. There is of course a related ongoing need to educate the general public and disseminate news of developments in this field in an accurate and transparent manner.
While nanomedicine is still in its relatively early days, there is ample commitment to and belief in its role in the future of healthcare from governments, corporations, clinicians and beyond. The nanomedicine, nanoparticle and drug delivery markets continue to expand year after year, while the science and technology grows with them. Just this week, the Nobel Prize in Chemistry was awarded to scientists who developed the world’s smallest machines, which are expected to be foundational in the development of products including new materials, sensors and energy storage systems.
With more than 70 products in clinical trials, covering all major diseases, and with incredible applications in every stage of patient management, there are many reasons to be optimistic about the crucial role of nanomedicine in the future of personalised medicine.