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Author Interview: Medical Nanotechnology and Nanomedicine

by nanoscienceworks — last modified September 01, 2010 - 11:21 talks with the Dr. H. F. Tibbals, Director of the Bioinstrumentation Resource Center for the University of Texas Medical Center, and author of Medical Nanotechnology and Nanomedicine.

Author Interview: Medical Nanotechnology and Nanomedicine

This long-awaited research volume, scheduled for publication September 2010, reviews nanotechnology uses across a wide range of medical applications, including imaging, diagnosis, monitoring, drug delivery, surgery, tissue regeneration, and even prosthetics. 

Unlike many technology-only volumes, Medical Nanotechnology and Nanomedicine is a practical reference book that investigates the impact of nanotechnology on medicine and biomedical sciences, as well as the broader societal and economic effects. Dr. Tibbbal's intent is that the book provide researchers, business, regulatory, and administrators a balanced, assessment of current and future nanomedicine developments to help all these professionals plan and make decisions. What is the difference between medical nanotechnology and nanomedicine?

Tibbals: Nanomedicine and medical nanotechnology have come to be used in slightly different meanings:

Nanomedicine refers to programs for application of newly emerging nanotechnologies for medical treatment, based on molecular processes at the cellular level and nanoparticle fabrication for drug delivery and image enhancement.   Medical nanotechnology is a broader term, which includes a wide array of nanoscale technologies directly and indirectly applied to medicine, many of which pre-date the new paradigm and recent popularization of nanotechnology. These include areas of biotechnology, bionanotechnology, and application of nanotechnology to areas like prosthetics and tissue engineering.  Almost all areas of nanotechnology are directly relevant to medicine because of the importance of nanoscale phenomena to cellular signaling, enzyme action and the cell cycle. What is your specialty, and how did you become interested in this area?

Tibbals: My education was in the basic sciences, mathematics, and languages. I have always been interested in biology and nature. My first research experience was in electrochemistry, and in graduate school I got to work with radiologists and pathologists, getting a PhD in physical and analytical chemistry.

I was very interested in computers and semiconductor technology, in the enhancement of chemical sensors by surface nanostructure, and especially in Smalley's discoveries and vision in carbon nanostructures. After a period of working in instrumentation and semiconductor technology, I took the first opportunity to apply my experience towards environmental and medical applications, joining UT Southwestern (The University of Texas Southwestern Medical Center) and getting support from Zyvex, Alcon, and NASA.  I believe that the highest purpose of science is its application to reduce human suffering. There is a great deal of interest in your book. Why do you think now is the right time to bring Medical Nanotechnology and Nanomedicine out on the market?

Tibbals: The past decade has been marked by a maturing of nanomedicine. The U. S. National Science and Technology Council brought out a report on vision for Nanotechnology in the Next Decade in 2000, the NIH initiated its nanomedicine programs, and similar nanotechnology and nanomedicine initiatives have been launched around the world.

Nanoscience and nanotechnology are now recognized as exciting new frontier areas with enormous opportunities. Nanotechnology is now creating more applications in medicine, and the possibilities are growing faster than ever. The availability of the human genome has opened up new areas for application of nanotechnology in proteomics, theragnostics, and regenerative medicine.

Nanotechnology is driving major improvements in capability, cost, power requirements, and flexibility of distributed processing, sensing, and control for personalized medical monitoring, prosthetics, and minimally invasive surgery.

As we prepare for the second decade of major nanotechnology development, it is important for everyone to be aware of the possibilities for medical advancements based on nanoscience. Can you give us some examples of what medical nanotechnology and nanomedicine are doing for us now? How can we be helped by the nanotechnology of today?

Tibbals: Nanoscience is producing powerful tools for elucidation of cellular processes and for drug discovery and formulation. Nanomedicine is already being applied in the form of approved treatments and techniques for diagnostic image enhancement and drug delivery, most notably for cancer and chronic inflammatory diseases- areas in which traditional biochemical drugs are reaching diminishing returns.

There are dozens of nanoparticle enhanced drug formulations now available for treatment of cancer, inflammatory diseases, and degenerative diseases, as well as for overcoming drug resistance in pathogens such as staph and tuberculosis. Nanomedical technology is being applied for new surgical glues, tissue scaffolding, and devices for minimally invasive imaging and surgery in the body. In the public health area, nanotechnology is providing new methods for water purification and environmental monitoring. Which kinds of doctors are using the applications of Nano in their surgeries and daily practice?

Tibbals: Doctors who face the greatest challenges of intractable diseases, major debilitating injuries and conditions, and difficulty in diagnosing and monitoring patient health have been among the first to apply new nanotechnologies, in areas such as cancer, cardiovascular disease, and degenerative diseases. In the book every major section (on imaging, drugs, surgery, devices) lists the medical specialties and diseases that are currently using some form of nanomedicine and medical nanotechnology.

They include practically every medical specialty, as well as nursing and public health. Current leading areas for nano-applications are cancer treatment (benefiting from nano-enhanced imaging, targeted nano-drug delivery, and nanoparticle phototherapies) and difficult surgeries (benefiting from nano-sensors for endoscopy and intra-surgical monitoring). How do you see that nanotechnology is changing our lives globally?

Tibbals: Nano is a disruptive technology and economic force that opens new possibilities. Nano is changing the way healthcare is being delivered - it is changing the paradigm of medicine from treatment towards prevention, and merging the previously separate areas of diagnostics and therapeutics.

The capabilities of nanomedical technology coupled with widespread distributed wireless communication is taking healthcare from the hospital and clinic into our daily lives, with medical monitoring and consultation available through wearable sensors coupled with cell phones and personal digital assistants.

Pilot programs and products are already appearing to make this scenario a reality. Nano is allowing developing countries to leapfrog older ways of doing things. Similar developments are being driven by nanotechnology in communication, manufacturing, distribution, education, and social interactions, as nano introduces new types of intelligent devices and materials and drives down their costs. What can we expect to see in the future for medical nanotechnology?

Tibbals: Many of the medical technologies discussed in the book are just now at the "proof of concept" stage. We are seeing them move into prototyping of drugs and devices for medical application, followed by clinical trials which may take several years. Those that pass the tests of safety and effectiveness will rapidly appear in medical practice.

Several new areas are especially exciting for their future potential to regenerate tissue affected by brain and nerve injury, cardiovascular ischemia, and degenerative diseases such as Alzheimer’s and ALS.

One is the application of protein nanoscience to the epigenetic reprogramming of cells. As discussed in the chapter on regenerative medicine, nanotechnology is being applied to create stem cells from a person's own mature cells, eliminating problems associated with immune rejection, embryonic stem cells and genetic engineering of cells for medical treatments. Another promising area is the application of nanotechnology to the guidance of cell growth, differentiation, and migration; this will be important in making stem cell therapy more successful than it is currently, by providing nano-engineered tissue scaffolding to support stem cell implants.

Another area that is just beginning to appear is the generation of live tissue surgical implants on demand in the operating room, by three dimensional tissue printing with nano-engineering rapid prototyping systems that assemble tissue scaffolding with biopolymers and cells to fit the shape, size, and structural requirements of a specific surgical operation while it is taking place.

Still another area is the increase in use of low-cost wearable and implantable intelligent nano-sensors to give early warning of incipient health conditions, to monitor the progress of treatment, and to apply therapies by nano-activation of energy or chemical medications in the body, either automatically in response to embedded control systems, or on command from healthcare providers who can monitor the patient remotely.

These and many other examples discussed in the book are already represented by actual examples of experimental systems and prototypes. In the book I avoided discussion of purely speculative examples. Are the applications of this book appropriate for all areas of the globe? We have a lot of international representatives reading this now thinking "what is in it for my country?"

Tibbals: One of the remarkable and inspiring aspects of nanotechnology its global relevance and impact. Nano is truly a disruptive technology - it bypasses older established ways of doing things.

In medicine, just as in energy, manufacturing, agriculture, water management, resource extraction, transportation, financial transactions, distribution, communications, and social interactions, nanotechnology is making radical new approaches available and affordable.

In Medical Nanotechnology and Nanomedicine there are examples of how nano is accelerating treatments and vaccine development for neglected diseases which afflict developing countries, but which also will become global if left unchecked. There are examples of new nano-based diagnostic methods and instruments that are faster, simpler, less expensive, and use less energy than conventional standard methods currently the standard in western medicine.

And nano-targeted drug delivery is providing a means to overcome acquired drug resistance in many endemic diseases such as malaria, while lowering the cost of therapies and making drugs that are more stable to environmental challenges.

The availability of medical monitoring and remote consultation via wireless communications will have a major global impact. Just as developing countries largely by-passed major investments in fixed wired telephone installations and went directly to cellular phones, the whole world will benefit from the economies of healthcare innovations provided by the wireless network. Obstacles such as energy are being met by nano-engineering for cheaper, more efficient solar and wind power, coupled with nano-energy harvesting and nano-scale electronics that operates on a small fraction of the power required for older technologies.

If the world merely follows the obsolete energy- and materials-intensive path that was historically taken by developed counties, the way to sustainable development looks very difficult. But nanotechnology and biomimetics are revolutionizing the approach to solving engineering and materials challenges. And the barriers to adopting the new alternatives are sometimes stronger in the developed countries where legacy investments and established practices are entrenched.

One thing which everyone today must be aware of is that science and technology, along with the economy and cultural aspects such as music and sports, are truly global. Telecommunications, transportation, and travel have made many former boundaries irrelevant. We are entering an age of interaction in which a dynamic new global mindset is replacing the regional and national preoccupations of the past several hundred years. Progress will belong to those who are open to the best that is offered globally. Which countries are leading in nanomedicine and medical nanotechnology?

Tibbals: There are many different measures of leadership in technology, varying depending upon whether you focus on basic research, application and development, or delivery of results in the economy.

In basic research and patents the most industrialized economies such as the United States, Europe, and Japan are being joined in the lead by China, India, and smaller countries such as Korea, Singapore, Thailand, Australia, Canada, and others. In the book I point out examples of strong and innovative nanomedicine developments from South America, Africa, the Middle East, and elsewhere.

One thing to keep in mind is that the community of scientific and medical research is global. No matter where they are located, the leading centers of research draw the brightest and most creative minds from all over the world. Examination of the resumes of the management and boards of leading and newly emerging biomedical firms and research faculties will show diverse origins, and a typical leader will have spanned the globe in obtaining education, doctoral, postdoctoral, and research experience.

Today is similar in its global interchanges to other times where human knowledge and innovation have flourished, the classical period, the Renaissance, the Age of Enlightenment, and many other examples.

Industrial and commercial development is increasingly global and trans-national, and will follow markets and economic incentives. Increased co-operation between countries and market communities is allowing governments to respond to the rise of global trans-national business. Interesting and developments are the initiative for common markets among African countries, and for development cooperation between Brazil and African nations, as well as major investments and joint developments between China and places such as Australia and Africa. The leadership in technology will be affected by economic developments, and is far from static.

The recent economic disruptions are accelerating globalization trends. Basic research and education are still differentiated among nations and economic communities, and the countries which maintain commitment to investments in knowledge will be the future leaders.

Medicine is ultimately about service to those in need. In this respect there is a growing realization that nanomedicine and nanotechnology provide opportunities for more economical and enhanced healthcare for populations, marked by increased international cooperating in fighting disease and by the recent expansion of a national healthcare policy in the United States.