The Handbook of Nanomedicine

Frontmatter

Chapter 1. Introduction

Abstract

Nanomedicine is defined as the application of nanobiotechnology to medicine. It is a discipline at the interface of medicine and nanobiotechnology but is not a subspecialty of either of these. Its broad scope covers the use of nanoparticles and nanodevices in healthcare for diagnosis as well as therapeutics. Safety, ethical and regulatory issues are also included. Figure 1.1 shows the relationship of various biotechnologies to nanomedicine.

Kewal K. Jain

Chapter 2. Nanotechnologies

Abstract

This chapter will focus on nanobiotechnologies that are relevant to applications in biomedical research, diagnostics, and medicine. Invention of the microscope revolutionized medicine by enabling the detection of microorganisms and study of histopathology of disease. Microsurgery was a considerable refinement over crude macrosurgery and opened the possibilities of procedure that were either not carried out previously or had high mortality and morbidity. Nanotechnologies, by opening the world beyond microscale, will have a similar impact on medicine and surgery. Various nanobiotechnologies are described in detail in a special report on this topic (Jain 2017). Those relevant to understanding of diseases, diagnosis, and development of new drugs as well as management of diseases are described briefly in this chapter.

Kewal K. Jain

Chapter 3. Nanotechnologies for Basic Research Relevant to Medicine

Abstract

Life sciences are the testing ground for many new biotechnologies for applications in medicine. Nanobiotechnology is a good example. Despite the remarkable speed of development of nanoscience, relatively little is known about the interaction of nanoscale objects with living systems. Much of the research in life sciences is directly relevant to applications described in the following chapters. Because of this overlap some of the applications are indicated in this chapter and some of the research in life sciences is described along with applications. Important areas of research in life sciences where nanotechnologies are applied and that are relevant to applications in health sciences are:

• Role of nanotechnology in biological research
• Genomics and proteomics
• Gene sequencing
• Bioinformatics
• Assays

Kewal K. Jain

Chapter 4. Nanomolecular Diagnostics

Abstract

Clinical application of molecular technologies to elucidate, diagnose and monitor human diseases is referred to as molecular diagnosis. It is a broader term than DNA (deoxyribonucleic acid) diagnostics and refers to the use of technologies that use DNA, RNA (ribonucleic acid), genes or proteins as bases for diagnostic tests. The scope of the subject is much wider and includes in vivo imaging and diagnosis at single molecule level. A more detailed description of molecular diagnostics is presented elsewhere (Jain 2017a).

Kewal K. Jain

Chapter 5. Nanopharmaceuticals

Abstract

The term “nanopharmaceuticals”, an important part of nanomedicine, covers discovery/development and delivery of drugs using nanobiotechnology as well as the use of nanoparticles as therapeutic agents. The post-genomic era is revolutionizing the drug discovery process. The new challenges in the identification of therapeutic targets require efficient and cost-effective tools. Label-free detection systems use proteins or ligands coupled to materials the physical properties of which are measurably modified following specific interactions. Among the label-free systems currently available, the use of metal nanoparticles offers enhanced throughput and flexibility for real-time monitoring of biomolecular recognition at a reasonable cost. This chapter will deal with use of nanobiotechnologies for drug discovery and development, an important part of nanobiopharmaceuticals. Some technologies will accelerate target identification whereas others will evolve into therapeutics. Application of nanobiotechnology is essential for optimal delivery of some drug. Use of nanoparticles as anticancer agents, antimicrobials and neuroprotectives will be dealt with in chapters dealing with these therapeutic areas.

Kewal K. Jain

Chapter 6. Role of Nanotechnology in Biological Therapies

Abstract

Biological therapies are playing an increasing role in modern medicine. This term includes recombinant human proteins, monoclonal antibodies (MAbs), vaccines, cell therapy, gene therapy, antisense and RNA interference (RNAi). Some technologies for cell and gene therapy are in themselves sophisticated methods of therapeutic delivery whereas others require special methods of delivery. Role of nanobiotechnology in delivery of biologicals will be discussed in this chapter. MAbs are considered along with drug delivery for cancer in Chap. 7.

Kewal K. Jain

Chapter 7. Nanodevices and Techniques for Clinical Applications

Abstract

This chapter contains use of technologies for clinical applications in general. More detailed description of these technologies will be given in chapters dealing with special therapeutic areas.

Kewal K. Jain

Chapter 8. Nanooncology

Abstract

Biotechnologies are increasingly used in cancer research (Jain 2014). Application of nanotechnology in cancer can be termed nanooncology and includes both diagnostics and therapeutics (Jain 2008). Various applications in diagnosis and drug delivery for cancer are discussed in this chapter. Two nanotechnology-based products are already approved for the treatment of cancer – Doxil (a liposome preparation of doxorubicin) and Abraxane (paclitaxel in nanoparticle formulation). Approximately 150 drugs in development for cancer are based on nanotechnology. Some of the nanotechnologies and their applications in developing cancer therapies are described in this section. The most important factor in the fight against cancer, besides prevention, is early detection.

Kewal K. Jain

Chapter 9. Nanoneurology

Abstract

Neurology deals with study and management of disorders of the nervous system. Considerable research is in progress in basic neurosciences and clinical neurology. The management is mostly medical. Many neurological disorders require surgical intervention and the closely related specialty of surgical neurology or neurosurgery will also be considered in this chapter. New technologies are being used for research in neurosciences, neuropharmacology and clinical neurology (Jain 2013). There is a considerable scope for application of nanobiotechnology in neurology and hence the term nanoneurology (Jain 2009). Nanobiotechnology has been applied for neurophysiological studies, diagnosis, neuropharmacology and refinement of surgical tools. Neuroprotection is an important objective in treatment of diseases of the central nervous system (CNS).

Kewal K. Jain

Chapter 10. Nanocardiology

Abstract

Nanocardiology is the application of nanobiotechnology to cardiovascular diseases. Recent rapid advances in nanobiotechnology offer a wealth of new opportunities for diagnosis and therapy of cardiovascular diseases (Jain 2011). As far back as 2003, the National Heart, Lung, and Blood Institute of US convened a Working Group on Nanotechnology for translational applications to heart, lung, blood disorders and cardiovascular complications of sleep apnea to solve clinical problems.

Kewal K. Jain

Chapter 11. Nanopulmonology

Abstract

Pulmonology deals with treatment of respiratory diseases, which is a challenging task with rising incidence and limitations of currently available treatments. Application of nanobiotechnology to pulmonology, nanopulmonology, offers NP-based drug and gene delivery for treatment of lung diseases as well as a route for delivery of systemic therapy. Delivery of exogenous genes to the airway epithelium in vivo has been limited by several physiological barriers, resulting in the low success rate of these systems. NP-based drug delivery systems have revolutionized the field of pharmacotherapy by presenting the ability to alter the pharmacokinetics of the conventional drugs to extend the drug retention time, reduce the toxicity and increase the half-life of the drugs (Swai et al. 2009).

Kewal K. Jain

Chapter 12. Nanoorthopedics

Abstract

Nanoorthopedics means the application of nanobiotechnology in orthopedics, the medical specialty dealing with disorders of bones and joints. Two important areas of application are bone implants and joint injuries involving cartilage.

Kewal K. Jain

Chapter 13. Nanoophthalmology

Abstract

Nanotechnology has many applications in disorders of eye, which could be included under the heading of nanoophthalmology. These include drug delivery, study of pathomechanism of eye diseases, regeneration of the optic nerve and counteracting neovascularization involved in some degenerative disorders. Nanoparticles enable delivery of ocular drugs to specific target sites and results to date strongly suggest that ophthalmology will benefit enormously from the use of this nanometric scale technology.

Kewal K. Jain

Chapter 14. Nanomicrobiology

Abstract

Microbiology plays an important role in practice of medicine. Nanodiagnostics have refined the detection of infectious diseases and many new nanotechnology-based therapies, particularly of viral diseases, are in development.

Kewal K. Jain

Chapter 15. Miscellaneous Healthcare Applications of Nanobiotechnology

Abstract

Nanobiotechnology impacts nearly all aspects of healthcare. Separate chapters were devoted to major therapeutic areas. Role of nanotechnology in delivery of vaccines for infectious diseases, nanovaccines, was discussed in Chap. 6. Other areas which are not well defined or specialties where the use of nanobiotechnology is still limited are all included in this chapter.

Kewal K. Jain

Chapter 16. Nanobiotechnology and Personalized Medicine

Abstract

Personalized medicine simply means the prescription of specific therapeutics best suited for an individual. It is usually based on pharmacogenetic, pharmacogenomic, transcriptomic, pharmacoproteomic and pharmacometabolomic information. Other individual variations in patients and environmental factors are also taken into consideration (Jain 2015). Personalized medicine means improving healthcare by incorporating early detection of disease, preventive medicine, rational drug discovery and development, and monitoring of therapy. Concept of personalized medicine as systems medicine is the best way of integrating new technologies and translating them into clinical application for improving healthcare. Application of nanobiotechnology is described for personalized management of cancer and cardiovascular disorders. Advances in nanobiotechnology will facilitate the development of personalized medicine by:

• Nanodiagnostics will improve the sensitivity and extend the present limits of molecular diagnostics/molecular imaging of CNS disorders.
• Nanotechnology can be integrated in detection of biomarkers, POC devices, biochips and biosensors.
• Biomarkers discovered by use of nanodiagnostics will facilitate the development of new personalized drugs for various disorders.
• Nanobiotechnology will facilitate integration of diagnosis and therapy, which is an important part personalized medicine.

Kewal K. Jain

Chapter 17. Nanotoxicology

Abstract

Toxicology is the branch of medicine that deals with the study of the adverse effects of chemicals and biological agents on the human body. It is the study of symptoms, mechanisms, treatments and detection of poisoning. The broad scope of toxicology covers not only the adverse effects of therapeutics but also environmental agents and poisons. Nanotoxicology covers safety issues relevant to nanomaterials.

Kewal K. Jain

Chapter 18. Ethical and Regulatory Aspects of Nanomedicine

Abstract

Ethical and regulatory aspects are important in practice of medicine and the same applies to nanomedicine. As has happened with introduction of all new technologies, in healthcare, these issues need to be considered. The FDA is formulating specific regulations relevant to nanobiotechnology products. The development of pharmaceuticals containing nanoparticles and methods of drug delivery, however, will be regulated by the FDA like any other biopharmaceutical product.

Kewal K. Jain

Chapter 19. Research and Future of Nanomedicine

Abstract

Research is an important activity in nanobiotechnology both in the academic and commercial sectors. Major portion of the research activity is in the commercial sector and is focused on translation into clinical applications as the number of products in the market is still limited. Two important segments of research in the commercial sector are nanodiagnostics and nanoparticle-based drug delivery. Whereas most of the academic research in the US is funded by government agencies, research in the commercial sector is funded by venture capital and other private sources. Research activities at various companies involved in nanobiotechnology are described. There are numerous collaborations between the academia and the industry and many discoveries made in universities are commercialized by the companies.

Kewal K. Jain

Backmatter