Nano Technology –Potential Applications in Medicine
Merlin N.J.*,
Shaji Selvin, Sukesh T.N.
Ezhuthachan College of Pharmaceutical
Sciences, Marayamuttom, Neyyattinkara,
Thiruvananthapuram, Kerala
ABSTRACT:
Nanotechnology
is the science that deals with the processes that occur at molecular level.
Nanotechnology is a multidisciplinary field, convergence of basic sciences and
applied disciplines like biophysics, molecular biology, and bioengineering. It
has created powerful impact in various fields of medicine including cardiology,
ophthalmology, endocrinology, oncology, pulmonology,
immunology etc., and to highly specialized areas like gene delivery, brain
targeting, tumor targeting, and oral vaccine formulations. Nanotechnology
provides intelligent systems, devices and materials for better pharmaceutical
applications.
KEYWORDS:
INTRODUCTION:
Nanotechnology
is defined as the engineering of functional
systems at the molecular scale. Nonomaterials are important sources for
the development of nanotechnology and its application. Nanoparticle
research is currently an area of intense scientific research, due to wide
variety of potential applications in biomedical, optical and electronic fields.
Nanoparticles for therapeutic purpose are made by
forming nanocrystals or drug-polymer complexes. They
have successfully removed many bottlenecks related to drug/gene delivery in the
biological systems. Current trends in this field include functionalizing these nanoparticles by using polyethylene glycol (PEG) to
increase circulation, which makes them stable in blood serum against the effect
of enzyme nucleases to enhance immunological cross reaction. Due to its fine
size, nanoparticles are easily taken up by the cells
and once into target tissue or cell, they allow controlled release of entrapped
drugs.
Nanoparticles
are small enough to move easily inside the body. There are different routes
followed to target the drug/ gene-encapsulated nanoparticles
to the target cell/ tissue. Route of
administration plays a significant role because not all drug/ gene encapsulated
nanoparticles can simply cross the mucosal surface
and biological membranes. They can be easily denaturized and cleared rapidly in
the liver. A drug delivered in gastrointestinal tract faces many problems like
acid induced hydrolysis in stomach enzymatic degradation, acid base variations
in the intestines and bacterial fermentation in colon.
Therefore
the best route followed to avoid all such problems is the preoral
route. Liposomes, micelles, dendrimers
are best for pulmonary delivery via aerosols, metered dose inhalers and nebulisers. Trans tissue and local
delivery systems favour hydrogels
as drug delivery carries as they produce elevated pharmacological effects and
minimize toxicity associated with systemic administration. Cell based delivery
that is gene transducted through through
oral mucosal epithelial cell (OMEC) implanted sheet and device directed
delivery with rechargeable drug infusion device that can be attached to the resected site.
Pharmaceutical
nanotechnology’ embraces
applications of nanoscience to pharmacy as nanomaterials, and as devices
like drug delivery, diagnostic, imaging and biosensor.
Types of nanoparticle:
Chitosans:
It
is a linear polysaccharide composed of B-(1-4) linked D-glucosamine (deacylated unit) and N- aetyl
–D-glucosamine (acetylated unit) and act as bioadhesives,
which helps them to penetrate nasal mucosa and brain endothelium. They can be administered
orally and are stable in acidic and neutral solution.
Liposomes:
They
are spherical vesicles with a phospholipids bilayer
membrane ranging from size nm to m and are used to deliver drugs or genetic
materials into a cell. In some cases, liposomes fuse
to form bigger liposomes. To avoid such a condition
phospholipids liposomes are mixed with charged nanoparticles i.e. carboxylated
modified polystyrene, sonicated to mix at low volume
fraction so as to produce particle stabilized liposomes
that repel one another and do not fuse.
Hydogels:
Hydrogels
are 3D hydrophilic components that swell in aqueous media, have cross linkages
which makes them an insoluble polymeric network facilitating regulated drug
release. The latest technology involved in hydrogels
includes molecular imprinting based drug delivery involving rate programmed
drug delivery, activation modulated drug delivery and feedback regulated drug
delivery. Water soluble cytotoxic agents are
encapsulated in hydrogels to target tumours so as to minimize toxicity to reticuloendothelial
systems. Hydrogels can be used for selective local
delivery of drugs.
Quantum dots:
Quantum
dots are bright hot stable fluorescent nanocrystals.
They exhibit extensive range of size and composition and can transform the colour of light i.e from blue to
near infra red by altering the size and composition. This property allows them
to be used as invivo tags for localizing tumours.
Polyplexes:
Polyplexus
are assemblies that are formed between nucleic acid and polycations.
They are widely used in therapeutics like gene transfer protocols since they
mimic the properties of proteins.
Nanobodies:
Nanobodies
are derived from heavy chain antibodies that are found naturally in camels. It
is used in psoriasis, solid tumour and Alzeimers disease. Nanobodies
have unparallel stability and can be delivered in variety of ways, thus
overcoming the delivery issues associated with full sized antibodies, which can
be delivered by injection.
Nanospores:
Nanospores
are integrated into artificially constructed encapsulated cells of silicon
wafers. These pores allow small molecules like glucose, O2 and
insulin to pan, however they prevent large immune system molecule like
immunoglobulin to leave the cell.
Gold nanoparticles:
Gold
nanoparticles are the metal of choice because gold
remains unioxidised at the nanoparticulate
size. Gold remains its nanoparticle property to
produce great contrast
in optical images. Gold particles can be used for imaging cancer,
monitoring blood flow, mapping blood vessels and allow for 3D imaging.
Dendrimers:
Dendrimers
are nanostructured materials, which are tree shaped,
have a branching system starting out from a central core. It has potential
therapeutic applications as the group of atoms that
form its outer boundary consist of meaner molecular groups that can act as
hooks and therefore can attach onto molecules like DNA. They act as effective
therapeutic agents because they can insert DNA into the cell without triggering
a immune system response. Dendrimers
are used as invitro diagnostics for heart muscle
damage, drug delivery, targeting tumour cells.
Nanotubes:
Carbon
nanotubes are used to deliver therapeutic molecules
and micro structures to targeted cells and organs in a safe manner, which
generates a low immunogenic response and is generally low in toxicity. Two
types of CNTs are used in biomedical applications. The first is a SWNT, or
Single Walled Nano Tube consisting of a single sheet
of carbon benzene rings wrapped into the shape of a cylinder. The second is
MWNT or Multi Walled Nano Tubes, which is similar to
SWNT, but contains multiple concentric layers of carbon sheets.
Fullerenes:
Fullerenes
are natural hollow spheres, one nanometer in diameter made up of 60 carbon
atoms. They are powerful antioxidants, reaching readily and at a high rate with
free radicals and are often the cause of cell damage or cell death.
NANOMEDICINE:
Nanomedicine
is the application of nanotechnology in health care, offers promising
possibilities to improve medical diagnosis, therapy and follow up care leading
to an affordable higher quality of life for everyone. It exploits the improved
and novel physical, chemical and biological properties of materials at the
nanometer scale.
Medical uses
of nanomedicals:
Drug Delivery:
Nanomedical
approaches in drug delivery system aims in improving the bioavailability of the
drug i.e maximizing bioavailability both at specific
places in the body and over a period of time and is achieved by molecular
targeting using nanoengineered devices. Lipid or
polymer-based nanoparticles are designed to improve
the pharmacological and therapeutic properties of drugs. The nanoparticles have unusual properties which can improve
drug delivery where larger particles are cleared from the body and the cells
take up the nanoparticles because of their size.
Nanotechnology
and Cancer Treatment:
Cancer: Cancer is caused by damage of genes which control the
growth and division of cells. Genes carry the instructions for basic functions
of cells. Cancerous cell need blood supply to grow. A hormone like molecule
causes nearby blood vessel to grow towards the cell to supply the oxygen and
other nutrients. Cancer can be cured by rectifying the damaging mechanism of
the genes or by stopping the blood supply to the cells or by destroying it.
Detection/diagnose is possible by confirming the growth of the cells. One
nanometer (nm) is one billionth, or 10–9 of a meter. For comparison,
typical carbon-carbon bond lengths, or the spacing between these atoms in a
molecule, are in the range 0.12 - 0.15 nm, and a DNA double helix has a
diameter around 2 nm. On the other hand, the smallest cellular life forms, the
bacteria of the genus Mycoplasma, are around 200 nm in length. Many of the
cells are of the dimensions of micro meter. These provide the possibility of nanoparticles entering the cells and detect/treat the
molecular changes that occur due to cancerous causes, in small percentage of
cells. Therefore, the necessary tools must be extremely sensitive. Scientists
and researchers hope that nanotechnology can be used to create therapeutic
agents that target specific cells and deliver the toxin in a controlled,
time-release manner. The basic aim is to create single agents that are able to
both detect cancer and deliver treatment. The nanoparticles
will circulate through the body, detect cancer-associated molecular changes,
assist with imaging release a therapeutic agent and then monitor the
effectiveness of the intervention.
Cancer
Detection:
Nano-particles (NP) are of a few of nm and the cells are of
the size of few microns. So NP can enter inside the cells and can access the
DNA molecules/Genes and, there is a possibility that the defect in the genes
can be detected. DNA molecules can be detected in their incipient stage. This
could be possible in vivo or in vitro. It will be shown latter that NP does
show potential of cancer detection in its incipient stage.
Cancer
Treatment:
Certain nano
particles can be designed to absorb preferentially certain wave length of
radiation and gets heated. Such a NP if enters in the cancerous cell will burn
it if irradiated by suitable wavelength radiation. This is the kind of,
analogue of radiation therapy. As mentioned before, nanotechnology can be used
to create therapeutic agents that target specific cells and deliver toxin to
kill them. The NP will circulate through the body, detect cancer associated
molecular changes, assist with imaging release a therapeutic agent and then
monitor the effectiveness of the intervention.
Tools of Nanotechnology:
Some of the tools of
nanotechnology having applications in cancer detection and treatment are the
following:
(i)
Cantilevers: Tiny bars anchored at one
end can be engineered to bind to molecules associated with cancer. These
molecules may bind to altered DNA proteins that are present in certain types of
cancer. This will change the surface tension and cause the cantilevers to bend.
By monitoring the bending of cantilevers, it would be possible to tell whether
the cancer molecules are present and hence detect early molecular events in the
development of cancer.
(ii) Nanopores:
Nanopores (holes) allow DNA to pass through one strand at a time
and hence DNA sequencing can be made more efficient. Thus the shape and
electrical properties of each base on the strand can be monitored. As these
properties are unique for each of the four bases that make up the genetic code,
the passage of DNA through a nanopore can be used to
decipher the encoded information, including errors in the code known to be
associated with cancer.
(iii) Nanotubes:
Nanotubes aresmaller than Nano pores. Nanotubes and carbon
rods, about half the diameter of a molecule of DNA, will also help identify DNA
changes associated with cancer. It helps to exactly pin point location of the
changes. Mutated regions associated with cancer are first tagged with bulky
molecules. Using a nano tube tip, resembling the
needle on a record player, the physical shape of the DNA can be traced. A
computer translates this information into topographical map. The bulky
molecules identify the regions on the map where mutations are present. Since
the location of mutations can influence the effects they have on a cell, these
techniques will be important in predicting disease.
(iv)
Quantum Dots (QD): These are tiny crystals that glow when these are
stimulated by ultraviolet light. The latex beads filled with these crystals
when stimulated by light, the colors they emit act as dyes that light up the
sequence of interest. By combining different sized quantum dotes within a
single bead, probes can be created that release a distinct spectrum of various
colors and intensities of lights, serving as sort of spectral bar code.
(v) Nanoshells
(NS): These are another recent
invention. NS are miniscule beads coated with gold. By manipulating the
thickness of the layers making up the NS, the beads can be designed that absorb
specific wavelength of light. The most useful nanoshells
are those that absorb near infrared light that can easily penetrate several
centimeters in human tissues. Absorption of light by nanoshells
creates an intense heat that is lethal to cells. Nanoshells
can be linked to antibodies that recognize cancer cells. In laboratory
cultures, the heat generated by the light-absorbing nanoshells
has successfully killed tumor cells while leaving neighbouring
cells intact.
(vi) Dendrimer:
A number of nanoparticles
that will facilitate drug delivery are being developed. One such molecule that
has potential to link treatment with detection and diagnostic is known as dendrimer. These have branching shape which gives them vast
amounts of surface area to which therapeutic agents or other biologically
active molecules can be attached. A single dendrimer
can carry/ translates this information into topographical map. A single dendrimer can carry a molecule that recognizes cancer
cells, a therapeutic agent to kill those cells and a molecule that recognizes
the signals of cell death. It is hoped that dendrimers
can be manipulated to release their contents only in the presence of certain
trigger molecules associated with cancer. Following drug releases, the dendrimers may also report back whether they are
successfully killing their targets.
The technologies mentioned
above are in the various stages of discovery and development. Some of the
technologies like quantum dots, nano pores and other
devices may be available for detection and diagnosis and for clinical use within next ten years.1
NANOTECHNOLOGY- IN
HIV/AIDS THERAPY:
HIV primarily infects vital
cells in the human immune system such as helper T cells (specifically CD4+ T
cells), macrophages, and dendritic cells. HIV
infection leads to low levels of CD4+ T cells through three main mechanisms:
firstly, direct viral killing of infected cells; secondly, increased rates of
apoptosis in infected cells; and thirdly, killing of infected CD4+ cells by CD8
cytotoxic lymphocytes that recognizes infected cells.
When CD4+ T cell numbers decline below a critical level, cell-mediated immunity
is lost, and the body becomes progressively more susceptible to opportunistic infections.
Eventually most HIV-infected individuals develop AIDS. These individuals mostly
die from opportunistic infections or malignancies associated with the
progressive failure of the immune system Treatment with anti-retroviral
increases the life expectancy of people infected with HIV. Without
antiretroviral therapy, death normally occurs within a year. Nanoparticles are stable, solid colloidal particles
consisting of macromolecules materials and ranging in size from 10 to 1000nm.
Drugs can be absorbed on the particle surface or can be entrapped or dissolved
in the particle matrix. Nanoparticles are known to
accumulate in the tissue because of phagocytosis by
MO/Mac2. Thus using nanotechnology, engineering researchers have
developed a small but powerful device capable of enhancing the targeted
delivery of drugs to treat life-threatening illnesses3.
Use in Therapy:
Endothelium is an important
target for drug or gene therapy because of its important role in the biological
system. In the case of AIDS, the macrophages of the RES represent one of the
most important therapeutic targets. In addition to the CD4 +T lymphocytes,
these cells play a decisive role as a reservoir for the human immunodeficiency
virus (HIV), apart from having a function in the pathogenesis of the disease,
cells of the macrophage lineage are vectors for the transmission of HIV. So a
fully effective anti-HIV therapy must reach Mo/Mac in addition to other cells. Nanoparticles could be used for localizing therapeutic
agents or gene into endothelial cells. Nanoparticles
localized in the endothelium could provide prolonged drug effects because of
their sustained release characteristics, and also could protect the
encapsulated agent from enzymatic degradation 4. Nanoparticles
can be well targeted to organs like brain and placenta. Targeting drug to
placenta also helps in stopping transmission of disease to fetus. Using Nanoparticles as drug carriers systems can improve the
delivery of antiviral agents to the mononuclear phagocyte system, enhancing the
activity of drug for the treatment of HIV infection. By using Polyhexylcyanoacrylate Nanoparticles
loaded with either the human immunodeficiency virus (HIV) protease inhibitor saquinavir or the nucleoside analog zalcitabine
were prepared by emulsion polymerization and tested for antiviral activity in
primary human monocytes/macrophages in vitro. Both nanoparticulate formulations led to a dose-dependent
reduction of HIV type 1 antigen production 5. Another investigation
shows the possibilities of targeting anti viral drugs such as AZT to
macrophages using nanoparticles as colloidal drug
carriers. In the first series of experiments the body distribution of
14C-labelled AZT bound to nanoparticles and a
similarly prepared control solution with unbound AZT were studied in rats after
I.V. injection. In a second series of experiments polysorbate
80 coated nanoparticles and a solution of AZT was
bound to nanoparticles using the surfactant bis (2-ethylhexyl) sulphosuccinate
sodium (DOSS). AZT concentrations were up to 18 times higher in organs
belonging to the RES if the drug was bound to nanoparticles
compared with unbound AZT. Thus this allows dose reduction 6.Modified
form of nanoparticles, solid lipid nanoparticles (SLNs) as carrier for delivery of lipophillic prodrugs
3’-azido-3’deoxythimidinepalmitate of zalcitabine.
Solid lipid nanoparticles were prepared using trilaurin as the SLNs solid core and a mixture of neutral
and negatively charged phospholipids and coated with PEG. To produce SLNS with
a polyethylene glycol coating, PEG was incorporated in SLNS using dipalmitoyl phosphatidyl
ethanolamine-N-[poly(ethyleneglycol
2000](PEPEG). 3%-azido-3%deoxythymidinepalmitate(AZT-P)with [3H]-AZT-P as
tracer were synthesized and incorporated in SLNS. Biodistribution
studies were performed in mice using free AZT-P, AZT-P incorporated in SLNS or
AZT-P incorporated in PE-PEG coated SLNS (SLN-PE-PEG).SLNs as a drug carrier
increases the bioavailability of incorporated AZT-P, and then the
pharmacokinetic behavior of the incorporated drug can be modified by changing
the surface characteristics of SLNs by using the amphiphilic
solvation enhancer. Unlike the solution, nanoparticles did concentrate AZT very efficiently in the
intestinal mucosa, as well as in the Peyer's patches,
and could simultaneously control the release of free AZT. Concentration in Peyer's patches was 4 times higher for nanoparticles,
compared with the control solution. Nanoparticles
have been shown to be efficient in concentrating AZT in the intestinal epithelium
and gut-associated lymphoid tissues, supporting the view that these particles
may represent a promising carrier to treat specifically the GI reservoir of
HIV.
Use in diagnosis:
Nanotechnology is now being
used by the scientists in U.S. for detecting viruses of diseases like HIV in
not more than one minute. The new technique measures frequency changes of a
near infrared laser as viral RNA or DNA is scattered by it. The frequency
changes are as discrete as fingerprints of each individual. While this phenomenon
is an established one, previous endeavor of using spectroscopy to detect
viruses failed due to the inherent weakness of the signal produced. However a
way of significant amplification of the signal is via nano
rods. The factors of enhancement are extraordinary and this method is cheap,
reproducible and simple to implement. Nanometre-sized
quantum dots can be made to tag biological molecules for the recognition of
proteins that point out disease status. However, this technique doesn’t have
shortcomings, which are associated with regular organic dyes used to mark
cells. Quantum dots could ultimately be used in clinical analytic tests to
rapidly spot molecules linked with cancer cells and HIV/AIDS. This has the
greatest advantage to developing countries; where over 95% of new HIV
infections occurred in last few years.
Use in Prophalaxis:
As it is well said that
prevention is better that cure, so for a condition as lethal as AIDS scientists
are on their way for prophylaxis. The team of engineers at the Yale university
found a new method that may help stop HIV infection. The method delivers short
interfering RNAs into vaginal cells using nanoparticles.
The short interfering RNAs repress specific HIV genes and stop the virus
reproducing in humanized mice siRNAs when transferred
to cells using lipids as carriers are expensive and toxic. In answer approach
scientists pack thousand of siRNAs into nanosized biodegradable and biocompatible plastics which
are already approved for medical use. Such nanoparticles
are incorporated in vaginal gel and applied by women before sex, helps
preventing infection .Testing is on with the monkey version of HIV but still
there is a long way to go. Nanotechnology-based vaccines for HIV are also in
the work.
CONCLUSION:
Nanoscience and nanotechnologies are truly interdisciplinary,
interlacing together physics, chemistry and biology. Materials that exist in nanospace are not only smaller but have entirely different
physical and chemical properties than their macro versions. Nanotechnologies
have enabled the development of entirely new drugs and altered the properties
of already marketed drugs to create potentially safer, more directed and
effective pharmaceuticals.
The whole process of nanotechnological development can take decades, and it is
often evolutionary rather than revolutionary. Nanotechnology offers important
new tools and is expected to have a great impact on many areas in medical
technologies. It provides extra ordinary opportunities not only to improve
materials and medical devices and technologies, but have profound influence on
disease prevention efforts because it offers innovative tools for understanding
the cell as well as the difference between normal and abnormal cells.
Nanomedicine, with safety, ethical and social issues addressed,
will have extra ordinary and far reaching implications for the medical
profession, for the definition of disease, for the diagnosis and treatment of
medical condition and ultimately for the improvement and extension of
natural biological structures and function. The main advantage of nanomedicine on quality of life and on cost for health care
is earlier detection of a disease, leading to less severe and costly
therapeutic demands and an improved clinical result.
ACKNOWLEDGEMENT:
The authors thank Shri. T. G. Hari Kumar, General
Secretary, Ezhuthachan College of Pharmaceutical
Sciences, Marayamuttom for providing the
necessary facilities.
REFERENCES:
1.
Om Pal Singh and R. M. Nehru. Nanotechnology and Cancer
Treatment. Asian J. Exp. Sci., Vol. 22, No. 2, 2008, 45-50.
2.
Kreuter, Tauber U. Nanoparticles in colloidal drug delivery system, 1994,
219-342.
3.
Bryan D., Engineers Treat Cancer and HIV, Mizzou
News , 2007.
4.
Davda J., Labhasetwar V.,
Characterization of nanoparticle uptake by endothelial
cells, International Journal of Pharmaceutics 233, 2002, 51-59
5.
Bender A.R., Briesen.H., Kreuter
J., Duncan I.B., Waigman H.R, Efficiency of nanoparticles as a carrier system for antiviral agents in human
immunodeficiency virus-infected human monocytes/ macrophages
in vitro, Antimicro. Agents and Chemothera.
6 , 1996, 1467-1471..
6.
Lobengerg R., Araujo L., Briesen H. ,Rodgers E., Kreauter
J.,J. Control Release, 50,1998, 21-30
Received on 27.04.2011 Accepted
on 26.05.2011
© Asian Pharma Press All
Right Reserved
Asian J. Res. Pharm. Sci. 1(2): April-June 2011; Page 31-35