Midterm Lesson

THE PROMISING FUTURE OF NANOMEDICINE
AND PROPER USE OF NANOTECHNOLOGY IN

MEDICINE
LESSON 1: MIDTERM
INTRODUCTION TO NANOMEDICINE
• Nanomedicine is the medical application of

nanotechnology, encompassing a wide range of
applications, including drug delivery, diagnosis, imaging,
and sensing. It leverages the unique properties of
nanoscale materials to create novel solutions for the
prevention, diagnosis, and treatment of diseases.
• Potential and Scope: The intersection of
nanotechnology and medicine offers unprecedented
opportunities to advance healthcare, from creating
more effective therapies to developing non-invasive
diagnostic tools.
Targeted Drug Delivery:
• Nanotechnology enables the development of targeted drug
delivery systems, which can direct therapeutic agents
specifically to diseased cells. This specificity reduces the
drug's impact on healthy cells, minimizing side effects and
increasing the therapeutic efficacy.
• For example, nanoparticles can be engineered to recognize
and bind to specific tumor cells, releasing the drug directly
into the tumor, thereby enhancing the effectiveness of
cancer treatments.
Regenerative Medicine:
¡ In the field of regenerative medicine, nanotechnology
is used to create materials that mimic the body's
natural tissue, promoting healing and tissue
regeneration. Nanofibers and hydrogels can serve as
scaffolds for tissue engineering, supporting the growth
of new cells.
¡ These materials can be designed to degrade
harmlessly in the body once their job is done, making
them ideal for repairing organs and tissues, including
heart muscle, nerves, and bones.
¡ Early Disease Detection:
¡ Nanomedicine offers revolutionary approaches to early disease
detection by employing nanoparticles and nanodevices capable
of identifying molecular changes even before symptoms appear.
¡ For instance, nanosensors can detect biomarkers at much lower
levels than traditional methods, enabling the early diagnosis of
diseases such as cancer,Alzheimer's, and cardiovascular diseases.
¡ Early detection is crucial for effective treatment and can
significantly improve patient outcomes.
PROPER USE OF NANOTECHNOLOGY
IN MEDICINE
ETHICS, SAFETY, AND INNOVATION IN HEALTHCARE
ETHICAL CONSIDERATIONS
¡ Informed Consent: Full disclosure of treatment
risks and benefits.
¡ Privacy and Confidentiality: Safeguarding
patient data.
¡ Equitable Access: Ensuring all populations
benefit from nanomedicine advancements.
SAFETY AND RISK MANAGEMENT
¡ Toxicity Assessment:
Comprehensive testing for
biocompatibility and long-term
effects.
¡ Environmental Impact: Assessing the
ecological safety of nanomaterials.
THERAPEUTIC EFFECTIVENESS
¡ Targeted Delivery: Improving drug
delivery specificity to minimize side
effects.
¡ Dosage Optimization: Utilizing
nanocarriers for controlled release
rates.
PRECISION DIAGNOSIS AND TREATMENT
¡ Early Detection: Utilizing

nanotechnology for molecular-level
disease detection.
¡ Personalized Medicine: Tailoring
treatments to the individual’s genetic
profile.
RESEARCH AND DEVELOPMENT
¡ Ongoing Research: Advancing
understanding of nanomaterial-biological
interactions.
¡ Cross-Disciplinary Collaboration:
Encouraging innovation through diverse
expertise.
REGULATORY COMPLIANCE
¡ Standards and Regulations: Adhering to

guidelines for safety and efficacy.
¡ Transparency and Reporting: Promoting
trust through open communication.
NANOPARTICLES FOR IMAGING AND
DRUG DELIVERY
ETHICS, SAFETY, AND INNOVATION IN HEALTHCARE
IMAGING
¡ The second step in the diagnosis of a disease involves in vivo
imaging, which searches for the symptoms of the disease
within the live tissue suspected of being infected without the
need to perform surgery.
¡ Nanotechnologies are having a very important impact in this
area, particularly by developing molecular imaging agents.
¡ The latest improvements in the area of imaging deal with the
capability of tracking changes at the cellular and molecular
level through the analysis of some specific biological markers
(a technique called ‘targeted molecular imaging’ or ‘nano-
imaging’).
IMAGING
¡ A biomarker is an indicator of a biological process or
state, such as a disease, or the response to a therapeutic
intervention.
¡ This can be an altered gene, or a change in protein
production, or even a physical feature of a cell.
¡ The aim is to detect biomarkers of disease and diagnose
illnesses before, or at the onset of, the first symptoms, in
this way making in vivo imaging a tool for the early
detection of a disease.
IMAGING
¡ Biomarkers could also be used as early indicators of the
success of a treatment, thus reducing treatment time and cost.
¡ Targeted molecular imaging is important not only for
diagnostic purposes, and for monitoring the progress of a
therapy, but also for research in controlled drug release, in
assessing the distribution of a drug within the patient’s body,
and for the early detection of unexpected and potentially
toxic drug accumulations.
¡ The ability to trace the distribution of a drug leads to the
possibility of activating it only when and where needed, thus
reducing potential drug toxicity.
DIAGNOSTICS IMAGING
¡ GADOLIUM complexes
have been incorporated into
emulsion nanoparticles for
the molecular imaging of
thrombi, resulting in a
dramatic enhancement of the
signal compared to
conventional MRI contrast
agents.
DIAGNOSTICS IMAGING
signal compared to
agents.
DIAGNOSTICS IMAGING
signal compared to
agents.
DIAGNOSTICS IMAGING
signal compared to
agents.
DIAGNOSTICS IMAGING
signal compared to
agents.
DIAGNOSTICS IMAGING
¡ FULLERENES are also
used in magnetic resonance
imaging research, filled with
smaller molecules that act as
contrast-enhancement
agents.
¡ Metals and silicon
nanoparticles are also used
to enhance MRI.
DIAGNOSTIC IMAGING
¡ An example of nanoparticles used
in research for imaging is
PERFLUOROCARBON
NANOPARTICLES employed
as contrast agents for nuclear
imaging, magnetic resonance
imaging and ultrasound, with
applications in the imaging of
blood clots, angiogenesis, cancer
metastases and other pathogenic
changes in blood vessels.
DIAGNOSTIC IMAGING
¡ In X-ray imaging, to enhance the signal, an agent must

deliver a detectable number of heavy atoms into targeted
tissue without toxic effects.
¡ Nanoparticles of heavy metals have the highest density of
surface atoms but they must be inert and stable.
¡ Nanoparticles of inert metals like silver and gold are too
expensive and would render the technique not cost-
effective.
IMAGING
¡ A solution has been proposed by General Electric in the form of
nanoparticles made of heavy metal compounds encapsulated in
GOLD SHELLS.
¡ The added advantage is that organic compounds with sulphide (-S-
H) groups (thiols) can easily be attached to the gold surface
through the thiol end (forming an S-Au bond).
¡ The thiol molecule can be functionalized at the other end with
groups that act as receptors for specific binding of antigens,
antibodies or even target compounds on the surface of the cell.
¡ By targeting receptors unique to a certain type of cancer cell, gold
nanoparticles can enhance an X-ray image of a suspected cancer
tissue by many orders of magnitude.
IMAGING
GOLD SHELLS.
IMAGING
GOLD SHELLS.
THERAPY
¡ A therapy normally involves a pharmaceutical route (drugs) to treat the disease
from the inside of the body, or, when a pharmaceutical therapy is not possible or
not effective, other routes to fight the disease from the ‘outside’ of the body, such
as radiative therapies.
¡ In some circumstances, surgery is required, and an organ-substitute is inserted
into the body in the form of an implant or a donated organ.
¡ In all these approaches, which are often used in combination, the aim is always
the same: to eliminate selectively the source of the disease in a long-lasting way.
¡ Nanotechnologies are making a tremendous impact in this field, with new drugs
and new types of treatments under development, some of which have already
proven clinically effective and have entered the market.
DRUG DEVELOPMENT AND
TARGETED DRUG DELIVERY
¡ Advances in the field of pharmacology stem from two main concepts: the
development of new biologically active drugs (drug discovery) and the
development of new drug delivery systems able to reach the specific site of the
disease.
¡ Drug delivery systems (DDS) are not a new concept: research in this field started
in the mid 1960s and resulted in the type of drugs used today (i.e. medicines
where the active ingredient is encapsulated and released inside the body by
gradual dissolution, osmotic effects, or other mechanisms).
¡ Drug delivery systems are in the same form as the ‘pills’ that are frequently taken
and that release their active component gradually in time (slow release drugs) or
that dissolve based on some physiological conditions (e.g. acidity of the
environment).
¡ Drug delivery systems also exist in the form of implants, inserts or other drug-
releasing systems.
TARGETED DRUG DELIVERY
¡ Targeted drugs and targeted DDS could allow the creation of drug
formulations with optimal loading, which deliver to the body only
the necessary amount of the drugs and reduce side effects for the
patients.
¡ Together with the possibility of having nano-DDS that are
biodegradable inside the body, this will help to reduce drug toxicity.
¡ Drug safety can be further enhanced by the possibility of
introducing inside the drug formulation a label that changes color
when the drug reaches its expiry date or is no longer functioning.
This will allow for the improvement of drug shelf life and better
monitoring of drug safety.
IN DRUG TARGETING, THE DRUG MAY BE
DELIVERED TO:
¡ The capillaries of the target site.

¡ The specific type of cells as in the case of
cancer cells.
¡ Specific tissues or organs which recognize
the drug carrier.
CAUSES OF USING THE TARGETED DRUG
DELIVERY SYSTEMS:
1. Low drug stability.

2. Poor drug absorption.
3. The short half-life of the drug.
4. The large volume of distribution of the drug.
5. Low drug specificity.
6. Narrow therapeutic index of the drug.
THE ADVANTAGES OF DRUG TARGETING:
1. The protocol of drug administration becomes simpler.

2. The toxicity of the drug is decreased by targeting a specific
site.
3. The desired drug response can be reached by a small dose.
4. Avoid the first-pass effect.
5. Improvement in the drug absorption from the target site.
6. Drug targeting resulted in no peak and valley plasma
concentration.
DIFFERENT TYPES OF CARRIERS APPLIED FOR
DRUG TARGETING
NANOTUBES are a type of drug delivery system

which is a hollow cylindrical tube made of carbon
that can be easily filled and sealed with the required
drug. They are usually used for delivering the drug
to the cancer cell.
DRUG TARGETING
NANOWIRES it is a wire with a very small
diameter made of metal or other organic
compounds.
It possesses a large surface area, so the surface can
be treated to allow the nanowire to bind with
specific biological molecules when inserted inside
the body.
It can be used for detecting the causes and
treatment of brain diseases, such as seizures,
Parkinson and similar diseases.
This system can treat Parkinson’s and similar
diseases.
Also, it can be used for the detection and
localization of tumors.
¡ A NANOWIRE is a wire of NANOWIRES
diameter of the order of nm.
¡ Photo: A light-conducting silica
nanowire wraps a beam of light
around a strand of human hair.
The nanowires are flexible and
can be as slender as 50
nanometers in width, about one-
thousandth the width of a hair.
¡ This is far smaller than the
smallest capillary in the body!
That means nanowires could, in
principle, be threaded through
the circulatory system to any
point in the body without
blocking the normal flow of
blood or interfering with the
exchange of gases and nutrients
through the blood-vessel walls
NANOWIRES: MEDICAL APPLICATIONS –
¡ BRAIN
Bunch STUDIES
of nanowires AND
being guided THERAPY
through the
circulatory system to the brain. Once there, the - FANTASY
nanowires would spread out branching into tinier
and tinier blood vessels.
¡ Each nanowire would then be used to record the
electrical activity of a single nerve cell, or small
groups of nerve cells (better than PET or fMRI!)
giving the ability to pinpoint damage from injury and
stroke, localize the cause of seizures, and other
brain abnormalities.
¡ It's long been known that people with Parkinson's
disease can experience significant improvement
from direct stimulation of the affected area of the
brain with electrical pulses. Indeed, that is now a
common treatment for patients who do not
respond to medication.
¡ But the stimulation is currently carried out by
inserting wires through the skull and into the brain,
a process that causes scarring of brain tissue. The
hope is, by stimulating the brain with nanowires
threaded through pre-existing blood vessels,
doctors could give patients the benefits of the
treatment without the damaging side effects.
DRUG TARGETING
NANOSHELLS are new strategies of
nanoparticles, consisting of a hollow
dielectric core of silica covered by a shell of
gold.
It may be used for diagnostic or
therapeutic purposes.
Nanoshells can be attached with antibodies
on their surfaces, allowing them to
conjugate certain areas such as cancer cells.
This technique is very effective in targeting
the antineoplastic drug.
DRUG TARGETING
QUANTUM DOTS are

nanocrystalline semiconductor
particles that possess distinctive
optical characters which import
them the ability to be used in
imaging of tumors.
This carrier is effectively used
for targeting cancer drugs.
DRUG TARGETING
¡ NANOPORES they have very
tiny holes that allow the passage of
DNA molecules in one strand at a
time. So, allow highly exact and
effective DNA sequencing.
¡ This technique has potential in
genetic engineering and
biotechnology.
¡ DNA translocations through
nanopores created in graphene
membranes.
DRUG TARGETING
GOLD NANOPARTICLES are

used by scientists to develop an
ultrasensitive detection system for
DNA and the protein markers
associated with the presence of
different types of cancer, like
breast and prostate cancer.
Can used gold nanoparticles in the
diagnosis of lung cancer.
DRUG TARGETING
¡ DENDRIMERS are synthetic

nanoparticles with a specific
diameter.
¡ They consist of a control core
surrounded by layers of polymers.
¡ There are several sites at the
surface of the dendrimers to which
the drug may be attached.
¡ They are used in gene transfection
and medical imaging.
DRUG TARGETING
¡ LIPOSOMES are microscopic
bilayer structure vesicles
prepared using natural
phospholipid. They can entrap
both hydrophilic and lipophilic
drugs in the aqueous space or the
phospholipid bilayers. The
percentage of entrapped drug
depend on the physical and
chemical properties of the drug
and the composition of the lipids.
DRUG TARGETING
¡ NIOSOMES are non-ionic surfactant vesicles
which can entrap both hydrophilic and
lipophilic drug.
¡ The stability of niosomes is higher than
liposomes due to the natural properties of
phospholipid.
¡ It was found that niosomes are effective for
targeting antineoplastic drugs, anti-
inflammatory, anti-bacterial, anti-fungal and
antiviral drugs.
¡ Designed and evaluated a novel niosomal
delivery system of daunorubicin (DNR) for
targeting against acute myeloid leukemia (AML).
DRUG TARGETING
¡ PHARMACOSOMES are a neutral
molecule which carries both positive and
negative charges and possesses
both hydrophilic and lipophilic characters
with an optimum ratio of polyphenol
with phospholipids in form of a complex.
The drug is conjugated to the lipoidal
complex by electrostatic force or by
forming a hydrogen bond.
¡ The term pharmacosome is derived from
the word Pharmakon, meaning drug and
soma, meaning carrier.
DRUG TARGETING
¡ VIROSOMES are drug delivery
systems described as unilamellar
vesicles prepared from
phospholipids.
¡ The surface of virosomes contains
sites to which the virus-derived
glycoproteins are attached to
facilitate the recognition and
targeting of the virosomes to the
target site inside the body
DRUG TARGETING
¡ CUBOSOMES are
nanostructured drug
delivery systems prepared
from certain lipids.
¡ They are described as
liquid crystalline
nanoparticles having a
cubic structure suitable for
injection.
DRUG TARGETING
¡ NANOCRYSTALS are
the material having a
dimension less than 100 nm
and present in the form of
one crystalline structure.
¡ The nanocrystals differ
from nanoparticles in that
nanoparticles have a
dimension of less than 1000
nm.
NANOCRYSTALS : ANTIBACTERIAL EFFECTS
According to Thomas J. Webster from
Brown University, USA, it is possible to
use nanocrystals of titanium and zinc
oxides to modify the surface of implants -
¡ implants
nanostructuring method. effected by
nanomaterials
Its nature lies in multiple magnification of
the surface of material by applying layers and
of nanocrystals (proces of roughening),
such as in the case orthopaedic implants. nature implants
without
It helps to increase adhesion of the tissue nanomaterials
cells and accelerate the "healing".
Another important function of such a
modified surface is the antimicrobial
function, where the presence of zinc oxide
nanocrystals suppresses the formation of
microbial films.
DRUG TARGETING
¡ TRANSFEROSOMES are such a novel
vesicular drug delivery system.
¡ Transformers are specially self-optimizing,
self-regulating, ultra deformable “ultra-
flexible”. possessing an inner aqueous core
surrounded by a complex lipid bilayer with
unique properties, due to the presence of
“edge activators” into a vesicular membrane,
the surfactant has been used as edge
activators.
¡ So it can penetrate the skin efficiently by
squeezing themselves through pores from 5
to 10 times less than their diameter.
THE DISADVANTAGES OF DRUG TARGETING:
1. Rapid drug elimination from the body results in high dose frequency.
2. The carrier of the targeted drug delivery system may result in the
immune response.
3. The drug delivery system is not localized at the tumor tissue for
sufficient time.
4. The diffusion and redistribution of released drugs.
5. The manufacturing, storage and administration of the targeted drug
delivery system require high expertise in this field.
6. Toxicity may be raised from drug deposition at the target site.
7. The stability of the product will be difficult to be attained.
THE IDEAL FEATURES OF A TARGETED DRUG
DELIVERY SYSTEM:
1. It should be stable, safe (non-toxic), compatible with body fluid
and biodegradable.
2. Deliver the drug only to the target site.
3. Control the drug release at a predetermined rate.
4. The rate of drug release not affecting the pharmacological effect.
5. Minimum leakage of the drug during transportation to the target
site.
6. Using an inert, biodegradable, or easily eliminated carrier.
7. The preparation process of the drug delivery system should be
simple, easy and costless.
THERANOSTICS
¡ One of the most exciting opportunities that nanotechnologies have brought to the
therapeutic field is the possibility of integrating the diagnosis, therapy and follow-up
of a disease.
¡ This is referred to as THERANOSTICS, and could be enabled by nanoparticles
incorporated inside a drug that can change some property — such as color —
once the drug has reached the target (e.g. quantum dots).
¡ Drugs could therefore have a feedback action.
¡ Together with a slow, targeted release system, the nanoparticles could gradually
change colour during the drug action, thereby informing doctors of the progress of
a therapy.
¡ This approach is called ‘find, fight and follow’ and could become a reality as a result
of the parallel progress in the field of molecular imaging.
¡ One vision is that, one day, the entire process of diagnosis, pre-imaging, therapy and
post-imaging of a specific disease will be integrated.
¡ An example of theranostics is the use of gold nanoshells for imaging and treating
cancer cells at the same time.

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THE PROMISING FUTURE OF NANOMEDICINE

AND PROPER USE OF NANOTECHNOLOGY IN

• Nanomedicine is the medical application of

¡ Early Detection: Utilizing

¡ Standards and Regulations: Adhering to

¡ In X-ray imaging, to enhance the signal, an agent must

¡ The capillaries of the target site.

1. Low drug stability.

1. The protocol of drug administration becomes simpler.

NANOTUBES are a type of drug delivery system

QUANTUM DOTS are

GOLD NANOPARTICLES are

¡ DENDRIMERS are synthetic

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