Medical Applications for Biomaterials in Bolivia

Various organizations are taking an initiative to help advance the state of global health. The United Nations has established the Millennium Goals for 2015, and the National Academy of Engineering has instituted fourteen Global Grand Challenges, three of which are directly tied to improving healthcare. While significant progress has been made, according to the World Health Organization (The top 10 causes of death, 2013b), the greatest proportion of deaths in developing countries are early deaths due to infectious diseases and labor complications. Bolivia is a Latin American country with one of the highest instances of income inequality and sanitation concerns. The country’s struggle with healthcare development is reflected in one of the highest infant mortality rates (IMRs) in South America (World Health Organization in World health statistics, 2013a). A variety of natural biomaterials obtained from abundant Bolivian commodities will be examined as potential sources of more cost-efficient, safer, and easier-to-access medical treatments.

Barley has been a staple in the agricultural world for many years due its many health benefits, e.g., better control of glucose levels, blood pressure, bad cholesterol, and weight gain (Whole Grains Council in Health benefits of barley, 2013). Suggested medical applications for barley currently under investigation include use as a low-cost biological catalyst (Nagaoka in Biotechnol Prog 20(1):128–133, 2004), use as a host for the production of endotoxin-free recombinant proteins (Magnusdottir et al. in Trends Biotechnol 31(10):572–580, 2013) and use as a potential source of improved water sanitation through algal inhibition (Xiao et al. in Environ Microbiol 16(5):1238–1251, 2013).

South America has the largest production of sugarcane, a crop of great commercial importance, in the world (Food and Agriculture Organization of the United Nations in Faostat, 2014b). The crop has sparked interest due to its potential benefits across environmental, energy, and economic fields (Sugarcane in Sugarcane benefits, 2014); however, expansion of the crop should be carefully evaluated and controlled in light of past human rights violations surrounding its production practices (International Labor Organization in Sugarcane labor in Bolivia, 2014). Applications of sugarcane in the medical field involve potential use as immobilization cell carriers (Silva et al. in Appl Biochem Biotechnol 141(2–3):215–227, 2007) and as a source of biopolymers for middle ear surgeries grafting (Mayer et al. in Braz J Otorhinolaryngol 77(1):44–50, 2011).

Maize, commonly known as corn, is a widely produced grain with an abundance of commercial and nutritional uses. Corn is a source of antioxidants and has other known health benefits in digestion, fiber, and glucose level maintenance and nutrition (The World’s Healthiest Foods in Corn, 2014). The microbial resistance and hydrophobic coating of the corn protein zein may prove useful in the area of drug delivery (Mathiowitz et al. in U.S. patent no. 5,271,961. U.S. Patent and Trademark Office, Washington, DC, 1993); films composed of a blend of cellulose and corn show promise as natural polymers for tissue scaffolding purposes (Yang et al. in Macromol Biosci 9(9):849–856, 2009), and maize endosperm could potentially be a major source of an important HIV antibody (Rademacher et al. in Plant Biotechnol J 6(2):189–201, 2008).

Sorghum is a common and resilient cereal crop grown worldwide. It provides a gluten-free option for celiac patients and contains a high presence of antioxidants that could potentially lower the risk of cancer, diabetes, heart disease, and specific neurological conditions (Whole Grains Council in Sorghum June grain of the month, 2014). Sorghum is being investigated for applications in bulk nanoparticle production (Njagi et al. in Langmuir 27(1):264–271, 2010). Nanoparticles provide many advantages in drug administration due to their long-circulating and target-specific nature (Moghimi et al. in Pharmacol Rev 53(2):283–318, 2001). Nanoparticles are being especially examined for improved uncontrolled inflammation (Wang et al. in Int J Nanomed 8:1377–1383, 2012; Kamaly et al. in Proc Natl Acad Sci 110(16):6506–6511, 2013) and tuberculosis (Clemens et al. in Antimicrob Agents Chemother 56(5):2535–2545, 2012) treatments.

Sunflower seeds contribute to a large percentage of the world’s vegetable oil production (United States Department of Agriculture in Sunflowerseed, 2014b). They are also a healthy snack rich in vitamins and other nutrients with a variety of anti-inflammatory, cardiovascular, energy, and other health benefits (The World’s Healthiest Foods in Sunflower Seeds, 2014). The topical application of sunflower seed oil (SSO) on the skin of premature newborns has been found to reduce the incidence of invasive bacterial infections compared to control groups (Darmstadt et al. in Pediatr Infect Dis J 23(8):719–725, 2004). This reduction in preterm infant bacterial infections with a treatment that requires very little training is especially significant for medical care in low-income countries whose high infant mortality rates are often due to lack of trained personnel capable of delivering treatment (World Health Organization in Neonatal conditions, 2013, in Newborn death and illness, 2014).

Quinoa is a nutrient-rich crop that originated in the Andean communities many years ago. It is a source of antioxidants, flavonoids, anti-inflammatory compounds, essential amino acids, vitamins, trace elements, and other nutrients (The World’s Healthiest Foods in Quinoa, 2014). The United Nations has recognized quinoa’s value in the alleviation of world hunger and malnutrition. Expansion of quinoa production and demand may also help improve the economic prospects of the small farmers who grow it (Food and Agricultural Organization of the United Nations in Faostat, 2013). Studies have supported quinoa’s ability to reduce the risk of various diseases such as diabetes and other cardiovascular conditions (Farinazzi-Machado et al. in Food Sci Technol (Campinas) 32(2):239–244, 2012); Parkinson’s, Huntington’s, and other neurodegenerative disorders (Sian et al. in Annals Neurol 36(3):348–355, 1994); cancers (Estrela et al. in Crit Rev Clin Lab Sci 43(2):143–181, 2006); pulmonary diseases (van der Toorn et al. in Am J Physiol-Lung Cell Mol Physiol 293(5):L1156–L1162, 2007); and potentially many other health risks.

Whether or not it is feasible for locally grown biomaterials to be translated into effective medical treatments in the Bolivian healthcare environment requires an assessment of cost, manufacturing capabilities, distribution, shelf life, etc. Of the biomaterials examined, sunflower seed oil seems to show the greatest promise due to its low cost and ease of use (Darmstadt et al. in Pediatr Infect Dis J 23(8):719–725, 2004). Other biomaterials requiring structural changes in development and manufacturing practices may face challenges in their assimilation. When introducing new medical technologies into the Bolivian landscape, it is vital to acknowledge and carefully work with the cultural norms and traditions of the region. For many Bolivians, traditional herbs and remedies may be regarded as just as valuable as, or more than, pharmaceuticals (Centellas in Sun god pharma: Bolivian pharmaceuticals and symbolic power, 2011). Concerns regarding good manufacturing practices in products manufactured locally (Bate in Local pharmaceutical production in developing countries. Campaign for fighting diseases, 2008), and tensions with American aid donors (Neuman in U.S. Agency is expelled from Bolivia. The New York Times, 2013) could be mitigated through Bolivian partnerships with other Latin American countries more established in the field of medical research and development.