Advanced Targeted Nanomedicine

With the rise in global population, the increase in the number of medically challenging diseases and the low number (as well as uneven distribution) of medical personnel, there is the need for a new approach to global healthcare delivery. In particular, the lack of clear-cut, permanent cures for cancer, Alzheimer’s disease, human immunodeficiency virus (HIV), diabetes, cardiovascular diseases (such as severe coronary artery disease) and Ebola, as well as the projected increase in the proportion of the population at risk of some of these diseases (Jemal et al. in J Nat Cancer Inst 100, 2017 [1], Association in Alzheimer’s Dement 14:367–429, 2018 [2]) means that everyone has something to worry about.

Every system known to man can be categorised as either a living system or a non-living system. There are many features and factors which differentiate the categories. Living systems are distinguishable from non-living systems by their ability to maintain stable, ordered states far from thermodynamic equilibrium (PLoS ONE 6:e22085, 2011 [1]). For the living systems to maintain the ordered nonequilibrium states, they continuously exchange information/entropy with their environments, grow and reproduce. Examples of living systems include humans, animals, plants and cells. On the other hand, non-living systems, if isolated or placed in a uniform environment, usually cease all motion very quickly such that no macroscopically observable events occur, thereby maintaining permanent equilibrium. Examples include all inanimate objects.

In the previous chapters, we discussed the relationship between communication engineering and medicine/healthcare delivery. We have espoused the view that communication between cells is vital to their health and to the effective working of the human body. Hence, breakdown in communication results in diseases, and to treat the diseases implies normalising the communication breakdown among the implicated cells, tissues and organs. The application of the ATN solutions is proposed to normalise the breakdown in communication within the cellular/organ network, and hence treat diseases. The ATN solution is a very complex one that involves the assembly and operation of materials, techniques, components, devices and networks whose dimensions range from the nanoscale to the macroscale.

In a typical ATN solution, nanoparticles are delivered to targeted locations in the body where they are meant to operate. Unless the nanoparticles are delivered to the targeted location (nanonetwork site), no effective delivery of the ATN solution can take place. The journey of the ATN nanoparticles from the points of administration into the body system to the targeted location is a complex one and requires accurate understanding. Indeed, the delivery of the ideals and promises of nanomedicine in general, and ATN in particular, crucially depends on the know-how and accuracy of conveying nanoparticles to the desired destinations in the body.

The development and deployment of ATN solutions require relentless interdisciplinary efforts in order to bring the system and its tremendous promises to reality. The level of the interdisciplinary commitment can encompass diverse fields such as nanotechnology, communication engineering, electronics, medical biology, systems biology, computational biology, synthetic biology, genetic engineering, molecular engineering, molecular/supramolecular chemistry, atomic/molecular physics, biophysics, bioelectronics, signal processing, information theory, advanced mathematics and translational science (Farokhzad and Langer in Adv Drug Deliv Rev 58:1456–1459, 2006, [1]). With this knowledge spread and planning, the design and development/fabrication of an ATN solution for a particular health challenge can be effectively achieved. It is therefore necessary to develop a framework that will serve as a guide for researchers through the design process and the steps in achieving the ATN goal. This exercise will eventually translate the ATN from the paper-based fundamental research, through the experimental stage to clinical reality.

The fundamental idea behind nanomedicine is to improve the efficiency of medical and healthcare systems using nanotechnology concepts, devices, tools, technologies and techniques. On the other hand, another nanotechnology offshoot, molecular communication engineering, considers the design and development of nano-scale devices and machines that can communicate by means of biochemical information exchange.

In this chapter, classical discussions on the possible application of the ATN solution to the treatment of some chronic diseases are provided. The diseases discussed include cancer, Alzheimer’s disease, acquired immunodeficiency syndrome (AIDS) and cardiovascular diseases. For each disease, discussion trails the pathophysiology and pathways of its occurrence.