domingo, abril 01, 2007

Nanomed

Nanomedicine

by Gregor Wolbring

March 30, 2007

Some people envision nanomedicine -- by itself or in convergence with BICS -- as providing answers to global problems of disease and ill medical health. Others pursue extreme lifespan extension and immortality under the umbrella of nanomedicine, and argue for the pursuit of ‘morphological freedom’ (1) (a future column) and enhancement medicine, where body modification beyond species typical functioning is seen as a therapeutic intervention.

Nanomedicine is sometimes referred to as “medical intervention at the molecular scale for curing disease or repairing damaged tissues, such as bone, muscle, or nerve” (2) or as “the preservation and improvement of human health using molecular tools and molecular knowledge of the human body." (3)

The nanomedicine glossary at ‘Nanotechnology Now' describes nanomedicine as: “the comprehensive monitoring, control, construction, repair, defense, and improvement of all human biological systems, working from the molecular level, using engineered nanodevices and nanostructures; (2) the science and technology of diagnosing, treating, and preventing disease and traumatic injury, of relieving pain, and of preserving and improving human health, using molecular tools and molecular knowledge of the human body; (3) the employment of molecular machine systems to address medical problems, using molecular knowledge to maintain and improve human health at the molecular scale." (4)

According to Nanowerk News, “A novel discipline is emerging in medicine: nanoscopic medicine. Based on the premises that diseases manifest themselves as defects of cellular proteins, these proteins have been recently shown to form specific complexes exerting their functions as if they were nanoscopic machines. Nanoscopic medicine refers to the direct visualization, analysis (diagnosis) and modification (therapy) of nanoscopic protein machines in life cells and tissues with the aim to improve human health.”

The journal Nanomedicine: Nanotechnology, Biology and Medicine was launched in March 2005. (5)

According to Frost and Sullivann, nanotechnological processes in medicine will reach a sales volume of about $180 billion by 2015. (6) According to the Freedonia group, (7) “demand for nanotechnology health care products in the US is projected to increase nearly 50 per cent per year to $6.5 billion in 2009 and by 2020, demand for nanotechnology health care products is projected to exceed $100 billion.” (7) Nanotechnology is seen to have great potential in health care.

Many nanomedicine taxonomies exist. One was developed for a 2003 workshop entitled, “NanoMedicine-NanoHealth: Establishing an Innovative Research Agenda for Canada,” funded by CIHR, the Natural Science and Engineering Research Council, and the National Research Council of Canada. (8)

Another was published in 2005, in the first issue of the journal Nanomedicine: Nanotechnology, Biology and Medicine. (9)

Many of the anticipated nanomedicine products can be found in recent reports by me (10) and others (2;11-14) and a variety of products are already on the market. I covered nanocancer therapies in a recent column

Nanomedicine is expected to improve drug delivery, increasing drug solubility and potency, allowing controlled release over longer time periods, and enabling molecules to be targeted to individual organs or diseased cells for drug delivery or imaging purposes. (I will cover nanodrugs and nanodelivery systems in upcoming columns.) Commercialization timelines for cancer therapy and drug delivery applications can be found here.

A variety of nanomedicine roadmaps exist (2) (11) (15). Europe has a Technology Platform for Nanomedicine. The European Nanomedicine roadmap (11) looks at:

  • “the level of development of the nanomaterials and a prognosis of its evolution in the next 15 years”;
  • “the timeframe of possible industrial applications in this domain at short (0-2 years), middle (3-5 years) and long term (6-10 years)”;
  • “nanomaterial costs and its possible evolution at short, middle and long term (when available)”;
  • “the market size of the nanomaterials (when available).”

It identifies the following main domains of application of nanomaterials in the Health and Medical Systems sector:

  • Drug discovery
  • Drug delivery
  • Diagnostics
  • Imaging
  • Implants
  • Active implants
  • Tissue engineering
  • Surgery
  • Cosmetics
  • Food
  • Genomics
  • Proteomics

One of the key points of the USA National Institute of Health Nanomedicine roadmap (2) is the establishment of Nanomedicine Development Centers.

“The National Institutes of Health (NIH) has announced four Nanomedicine Development Centers awards that will share approximately $42 million over five years. The four advanced centers in nanomedicine are part of the NIH's New Pathways to Discovery. The four centers are: The Center for Protein Folding Machinery at Baylor College of Medicine; The National Center for Design of Biomimetic Nanoconductors at the University of Illinois, Urbana-Champaign; Engineering Cellular Control: Synthetic Signaling and Motility Systems at the University of California, San Francisco; and the NanoMedicine Center for Mechanical Biology at Columbia University in New York.”

The book Nanomedicine by Robert Freitas (3;16) gives more ideas as to the future of nanomedicine, as does a recent report by ETC Group. (17)

The Choice is Yours

How does the vision of nanomedicine impact community health; public health; health promotion; medical faculties in universities and their interaction, relationship with other departments and faculties in universities, on regulations and funding? How does it impact on marginalized groups and global health?

Will it by itself lead to solutions for neglected diseases? Does nanomedicine prevail where non nanomedicine failed? Who will have access to it? How will nanomedicine be influenced by the changes in the concept of health? (10) Will nanomedicine be more used for medical health or also the social well being component of health?

These are just a few questions and how useful nanomedicine will be depends on the answers to these questions.

Gregor Wolbring is a biochemist, bioethicist, science and technology ethicist, disability/vari-ability studies scholar, and health policy and science and technology studies researcher at the University of Calgary. He is a member of the Center for Nanotechnology and Society at Arizona State University; Member CAC/ISO - Canadian Advisory Committees for the International Organization for Standardization section TC229 Nanotechnologies; Member of the editorial team for the Nanotechnology for Development portal of the Development Gateway Foundation; Chair of the Bioethics Taskforce of Disabled People's International; and Member of the Executive of the Canadian Commission for UNESCO. He publishes the Bioethics, Culture and Disability website, moderates a weblog for the International Network for Social Research on Diasbility, and authors a weblog on NBICS and its social implications.

Resources

  1. Anders Sandberg. Morphological Freedom -- Why We not just Want It, but Need It. 2001.

  2. The National Institute for Health (NIH) U. Roadmap for Nanomedicine. 2005.

  3. Robert Freitas. Nanomedicine, Volume I: Basic Capabilities. 1999.

  4. Nanotechnology Now. Nanomedicine Glossary. 2005.

  5. International Journal of Nanomedicine.

  6. Nanoroadmap, 2005, 6.

  7. Infoshop. US Nanotechnology Health Care Product Demand to Reach $6.5 billion in 2009. 2005.

  8. Neil Gordon & Uri Sagman. Nanomedicine Taxonomy. Canadian Institute for Health Research (CIHR). 2003.

  9. Freitas, R. Nanomedicine: Nanotechnology, Biology and Medicine Nanomedicine: Nanotechnology, Biology and Medicine 1, 1 2-9. 2005.

  10. Wolbring, G. HTA Initiative #23: The Triangle of Enhancement Medicine, Disabled People, and the Concept of Health: A New Challenge for HTA, Health Research, and Health Policy. 2005. ISBN 1-894927-36-2 (print); ISBN 1-894927-37-0 (onliine); ISSN: 1706-7855.

  11. René de Groot, Jonathan Loeffler Ulrich Sutter. Roadmap Report Concerning the Use of Nanomaterials in the Medical & Health Sector. The project was funded by theEuropean Community under the "Sixth Framework" Programme (Contract No NMP4-CT-2004-505857). 2006.

  12. Koo, O. M., Rubinstein, I., and Onyuksel, H. "Role of nanotechnology in targeted drug delivery and imaging: a concise review." Nanomedicine: Nanotechnology, Biology and Medicine 1, 3 193-212. 2005.

  13. European Science Foundation. An ESF – European Medical Research Councils (EMRC) Forward Look Report: Nanomedicine. 2-912049-52-0. 2005.

  14. Institute of Nanotechnology. Research Applications and Markets in Nanotechnology in Europe 2005. 2005.

  15. Morten Bøgedal, M. G. J.-C. G. H. H. S. L. I. M. M. M. C. N. V. W. Nanotechnology and its Implications for the Health of the EU Citizen. 2003.

  16. Robert Freitas. Nanomedicine, Volume IIA: Biocompatibility. 2003.

  17. ETC Group. Nanotech Rx-Medical Applications of Nano-scale Technologies: What Impact on Marginalized Communities. (pdf).

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