Nanotechnology in Medicine and Public Health

Microscopic robotic surgeries, artificial skeletons and muscles, noninvasive imaging devices; the promises of nanotechnology are seemingly endless. But what exactly is this emerging field, and how can it become a major influence in medicine? Perhaps only time will tell if nanotechnology lives up to its promise, but it is nevertheless important to look at some of the effects that the introduction of this technology can have on our society. Medicine based on nanotechnology is expensive: perhaps even more so than many of the other current and extremely expensive technologies available today [1]. This cost could have dramatic effects on the already large gap between the health problems that are widespread in wealthy countries compared to those that are prevalent in poorer countries. Even if we were able to completely understand the medical benefits of nanotechnology, we would still need to closely examine possible social effects.

Nanotechnology is the study of materials whose measurements in at least one dimension are smaller than a nanometer, which is a billionth of a meter [2]. Molecules at this scale act differently than macroscopic molecules; the effects of quantum mechanics must be taken into account [3]. These effects are not entirely understood and are part of the reason that nanotechnology is such a difficult but exciting field of research.

How can tiny molecules be made into useful structures? There are two basic approaches used to design nanomolecules: top-down and bottom-up. In the top-down approach, scientists start with macroscopic material and then modify the material using ultra-precise instruments [4]. Alternatively in the bottom-up approach, researchers try to design and synthesize molecules that will self-assemble given a change in the surrounding environment, such as a change in pH, the concentration of the solute, or the electric charge [4].

Once made, these nanomolecules have a wide range of potential applications within the medical field.  For example, researchers could make drugs with far fewer side effects by developing nanomaterials that affect desired biological targets with incredible accuracy. Cancer medications using nanomolecules would be better able to selectively kill tumor cells rather than indiscriminately killing both cancerous and healthy cells. For example, a buckyball, a very small sphere of carbon atoms with a cage-like structure, provides a useful example. The cage-like structure allows other molecules, such as a drug, to be encased inside. Independently, these encased molecules are potentially dangerous if they come into contact with certain molecules or tissues, but buckyballs ensure that the drug is safely delivered where it needs to go [2].

Clearly, the potential applications of nanotechnology in medicine, especially in cancer treatment, are enormous.  But what are the possible downsides? There has been some debate over the environmental effects of nanomolecules, mainly that no one knows exactly what nanoparticles will do to a biological ecosystem once released, but there are other policy-related issues that ought to be considered as well [2].

And the conversation around these policy-related issues begins with the enormous cost associated with the development of new drugs and technologies. Studies conducted in 2003 reflect an average cost of about $800 million to devise a single new drug and to put it on the market [5].  Developing nanotechnology requires even more specialized equipment and a greater level of precision than developing most other drugs, leading to larger costs and longer development timelines [1]. Furthermore, given that nanotechnology is still a developing field, it is unclear exactly what effects a specific nanomolecule will have on the body or the environment. This fact leads to the greater regulation imposed on nanotechnology-associated developments by the FDA, making the process of drug development even more expensive and time-consuming [1]. These factors will greatly increase the costs of drug development in nanotechnology, and might subsequently increase the prices at which these drugs are sold.

The high cost of drugs, including those developed using nanotechnology, widens the gap between the disease burden of more developed countries, including the United States and those of less developed countries. This gap is already obvious: the most widespread diseases of the developing world are rarely encountered in developed countries.  The gap is especially obvious when considering communicable diseases; it is unsurprising to hear that around 80% of HIV/AIDS related deaths and 90% of malaria deaths occur in sub-Saharan Africa, however, the disparity is not restricted to the spread of communicable diseases; there is also an increasing discrepancy between the life expectancies of people diagnosed with chronic diseases in developed versus developing countries [6].

For example, there is a large difference in cancer survival rates between developed and developing countries. This difference is restricted to those types of cancers such lymphoma and melanoma that have drastically better survival ratings if detected early and properly treated [7]. This fact implies that the different life expectancies for people with cancer is dependent on the quality of treatment available. Nanotechnology holds promise for treating cancer and many other diseases, but it is an expensive technology that will be available only to those who can afford it, at least at first, and most likely for the long term as well [2]. The development of nanotechnology raises a difficult question: is it morally acceptable to spend so much money developing technologies for our world when halfway around the globe, people are dying for lack of medicines we now take for granted? The problem that we face, then, is not only how to develop new technologies for our medical arsenal in the war against chronic disease, but even more importantly, to develop policies and systems that allow these technologies to be available on a large scale and to truly raise the global standard of living.

 References

  1. Morigi, Valentina et al. “Nanotechnology in Medicine: from Inception to Market Domination. Journal of Drug Delivery (2012): 1-7
  2. Tareen, T. Nanotechnology in Medicine. http://www.medlink-uk.org/Site/documents/Nano2011/TareenT.pdf
  3. Karunaratne, D. “Nanotechnology in Medicine.”  Journal of the National Science Foundation of Sri Lanka 35 (2007):149-152.
  4. Silva, G. “Introduction to Nanotechnology and Its Applications to Medicine.” Surgical Neurology 61 (2004):216-2220.
  5. Koprowski E. Nanotechnology in Medicine: Emerging Applications. New York: Momentum Press, 2012.
  6. “Health Financing.” World Bank http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf
  7. Sankaranarayanan R. et al. “An Overview of Cancer Survival in Developing Countries.” Lyon: IARC Scientific Publications  145 (1998).

Image Credit: Nanomedicine Blog

Image Credit: Nanotechnology Now

Rebekka is studying bioengineering at Harvard and is particularly interested in the effect that bioengineered technologies can have on the future of public health, especially at the global level.  She is particularly interested in the difficulties associated with providing widespread access to healthcare. Follow The Triple Helix Online on Twitter and join us on Facebook.

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  • Interesting article!!
    I’ve worked in nanomedical research for some time, and I think that this technology is truly the future of healthcare. Not only are many bio-materials becoming easy and cheap to produce (such as PHVB, a polyester compound that can be produced by genetically engineered bacteria), but the efficacy of many of our current drugs can be drastically improved by encapsulation by these compounds.

    One of the major means that nanomedicine has found success is with the advent of targeting capacities. Adding targeting ligands that are specific to the type of cancerous tissue being targeted (as easily determined by tissue biopsy and processing) allows chemotherapeutic drugs to seek out and be taken by the cancer cells, where the biomaterial outer polymer will degrade, giving a controlled time release of the agent to successfully destroy the cancer cell, and only the cancer cell. Targeting ligands can also stimulate cellular receptors to allow for specific responses, such as increased permeability of the nanoparticles through the blood brain barrier or through the pores of bones to the marrow.
    Targeting ligands with nanomedicine appear to have finally given us the ‘Magic Bullet’ that Erlich first imagined in the late 1800’s by Paul Ehrlich.

    With PEGYLATION (a nanocoating that disguises the nanoparticle from the immune system), more advanced forumations (such as nanoprecipitation, single emulsion, double emulsion) to control size, and drug delivery nanodevices, a nanocapsule can be made to go nearly anywhere in the body, stay in circulation for a chosen amount of time, and maintain utmost safety of the patient and ultimately improving his or her clinical outcome by receiving nanotherapy.