When will nanotechnology ever revolutionise medicine? These breakthroughs suggest it’s already started
After decades of promise, recent breakthroughs suggest that nanomedicine is finally living up to its potential. And we need to make sure that hospitals are ready for the revolution
Since the emergence of nanotechnology in the 1980s, researchers have been promising a revolution in everything from manufacturing to medicine. Excitement at the possibilities has grown steadily, and with it, government interest and funding. But in a nascent field, research can take decades to translate to real-world impact. Indeed, in a January 21st 2000 speech at the California Institute of Technology, Bill Clinton acknowledged the lag time, stating that some of the potential of nanotechnology can take more than 20 years to realise.
So, we’re just two years shy of the nanotechnology era envisioned by President Clinton’s – has nanotechnology begun to fulfil its promise? Well, it’s true that nanotechnology has been applied in a range of areas. However, these have generally come in the form of titanium dioxide, silver nanoparticles, and zinc oxide particles found in clothing, disinfectants, and sunscreens. Hardly the revolution that had dystopian futurists screaming impending apocalypse and excited journalists predicting utopian salvation.
But recent breakthroughs in nanomedicine suggest that Clinton’s 20 year forecast was actually quite prophetic.
Manipulating our immune system through nanotech
With the emergence of immunotherapy, medicine has become more focused on strengthening our body’s defences so it can fight off diseases and germs by itself. Certainly, the untapped potential of our body’s defences is an exciting prospect, but sometimes our immune system goes too far in the other direction and overreacts. That hayfever that hits you in spring and autumn? That’s an overreaction. But sometimes, that overreaction is far more nefarious.
That’s why one of the most important areas in nanomedicine research is currently focusing on manipulating and managing our immune system. In a recent breakthrough from the University of Michigan, scientists injected nanoparticles to distract the immune system at times when it overreacts. Professors Omolola Eniola-Adefeso and Michael Holinstat found that neutrophils – which are the body’s first line of defence – can be kept busy by plastic nanoparticles. This meant that the neutrophils couldn’t create the excessive inflammation found in conditions such as acute lung injuries, sepsis and atherosclerosis. Whilst there are already treatments for conditions such as sepsis, it is still a complex challenge with severe consequences. In the US alone, 1.5 million people a year get sepsis, and 250,000 people a year die from it.
In essence, one of the tactics nanomedicine uses is to trick the body’s immune system at times when we don’t want it to react as strongly as it does. This is particularly so when it comes to organ transplantation, where recipients of organs are at risk of their own immune system rejecting a donated organ intended to save their life.
From the perspective of our immune system, it’s only doing its job. It’s there to attack things it doesn’t recognise, so when it identifies a foreign body, such as a donated organ, it sends our T Cells to defeat it. This defence mechanisms is even more acute with donated organs from the recently deceased, because they are more likely to be damaged.
One of the ways doctors try and prevent organ rejection is by silencing the proteins that activate our immune response. But at present, they are only able to silence the proteins for a few days. This is problematic because some organs require weeks to be accepted by the body. To overcome this challenge, scientists from Yale University used nanoparticles to slowly release drugs that hinder the expression of targeted proteins. By releasing the immunosuppressant drugs over time, the researchers found the nanoparticle drug delivery system silenced the proteins for up to six weeks – rather than the few days – after organ transplantation. Each year, thousands of people are in need of an organ donation, but only a few hundred are lucky enough to receive one. For their body to reject what is a perfect combination of goodwill and fortune is a bitter irony. That is why breakthroughs such as this are so imperative and why it’s so important to manage our immune system to that it works for rather than against us.
Behind enemy lines - Trojan horse and precision
Another area of focus for nanomedicine is cancer. Getting drugs to effectively penetrate cancer tumours is no easy task. That’s because tumours are very good at keeping the drugs out. Because of this, doctors need to give patients high doses of chemotherapy so that some of it can effectively get into the tumour. This leads to toxicity which can sometimes be so severe it leads to eventual death.
To get around this, researchers from Rice University and Northwestern University Feinberg School of Medicine used gold nanoparticles to safely deliver drugs inside cancer tumours. Once inside, they used an infrared laser to trigger these gold nanoparticles to release the drugs. This Trojan horse method means that the dose of chemotherapy required becomes much more precise and effective: either less of the drug is needed, leading to fewer side effects, or the same amount of the drug can be used but with greater impact. This level of precision is one of the biggest strengths of nanomedicine, and is like adding an extra motor to your car, rather than needing to build a new one.
But chemotherapy isn’t the only area benefiting from the attention of nanomedicine. In an international research collaboration between the University of Surrey, UK and Dalian University of Technology in China, scientists used nanoparticles in a thermotherapy session. By getting the nanoparticles to a temperature of 45C, scientists were able to kill the tumours without harming the surrounding tissue. Importantly, the nanoparticles were able to self-regulate their temperature, meaning that they stopped heating once they reached 45C. This level of precision is important. Traditional thermotherapy treatment uses cumbersome temperature monitoring and control systems which harm the surrounding tissue. By using self-regulated nanoparticles, not only are side-effects minimised, but the use of thermotherapy treatment can be opened up to those who would not have been in consideration.
What recent studies suggest is that breakthroughs in nanomedicine are not necessarily about discovering completely novel materials. Rather, it’s about engineering – and manipulating – existing materials at the nanoscale. An example of the effectiveness of this type of manipulation can be seen in the work of Chad Mirkin and Teri Odom of the International Institute of Nanotechnology at Northwestern University. The researchers took already known molecules and reorganised them into spherical – rather than linear – forms. This allowed them to deliver drugs through the skin in ways that was previously not possible. In doing so, Mirkin, Odom, and their colleagues opened up tremendous possibilities for treating the more than 200 skin diseases than could benefit from this technique.
Spreading nanomedicine capabilities
Being able to master and manipulate atoms and molecules to work for us in ways previously impossible is something that naturally brings excitement and anticipation. But nanomedicine is not without its challenges. Whilst perhaps not subject to the same level of environmental concerns as nanotechnology in consumer goods, nanomedicine nonetheless has to overcome challenges such as cost and accessibility. Up until now, nanotechnology has benefited from huge investment from government and the public sector. But ensuring that hospitals have the right equipment, procedures, trained staff, and financial resources to implement these new technologies will not be easy. Whilst the very best hospitals might be quick to adopt nanomedicine technologies, it might be some time before it’s diffused to an average local clinic.
As we will soon move past Clinton’s 20 year mark of when significant nanotechnology breakthroughs will start to emerge, it’s now time to make sure that all hospitals have the receptive environment needed to benefit and make the most of such advances. And when that happens, treatment will never be the same again.
About the author
I look at emerging technologies from a social science and policy perspective. I completed my PhD on the diffusion of innovations at University College London, looking at how innovation gets implemented in healthcare organisations. My main interests are on policies that encourage innovation and the diffusion of emerging technologies, and understanding their social implications so that everybody wins.