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5 Big Advances in Small Clinical Technology

 |  By gshaw@healthleadersmedia.com  
   August 10, 2010

From a tiny eye telescope to microscopic health data on the surface of contact lenses to advances in cancer treatments, medical devices continue to get smaller and smaller. And the smallest of the small fields—nanotechnology—is expected to get bigger (so to speak) over the coming years. 

The global market for nanotechnology was worth $11.6 billion in 2007 and could reach $27.0 billion by the end of 2013, according to India-based market research firm Bharatbook in a report released this month. Biomedical applications has the highest projected growth rate (56%) compared to other applications over the next 5 years.

A report published by the same company in June found:

  1. US demand for nanotechnology medical products will rise more than 17 percent per year to $75.1 billion in 2014.
  1. The total market for nanomedicines will command strong growth over the long term, rising to almost $59 billion in 2014 and sustaining a strong upward pace through 2019.
  1. Among nanodiagnostic products, nanosized monoclonal antibody labels and DNA probes are greatly enhancing the speed, accuracy, capabilities and costeffectiveness of in vitro diagnostic testing, drug discovery and medical research procedures.
  1. Within the medical supplies and devices segment, nanomaterials are already gaining significant demand as active ingredients of burn dressings, bone substitutes, and dental repair and restoration products. In the long term, advances in nanotechnology will lead to the introduction of new, improved medical supply and device coatings as well as a new, diverse group of medical implants.
  1. The greatest near-term impact of nanotechnology in health care by indication will be in therapies and diagnostics for cancer and central nervous system disorders.

Here are just five of the many ways smaller medical technology is getting better.

1. Nanomaterials
Engineered nanomaterials—about 100,000 times smaller than a single strand of hair—represent a significant breakthrough in material design and development for industry and consumer products, including diagnosis, imaging and drug delivery technologies. So much so that the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, has put $13 million in grants over a two-year period to increase understanding the potential health, safety, and environmental issues related to the tiny particles The NIEHS awards are funded through the American Recovery and Reinvestment Act to develop better methods to assess exposure and health effects associated with nanomaterials and develop reliable tools and approaches to determine the impact on biological systems and health outcomes of engineered materials, according to NIEHS.

There’s still plenty to learn about nanomaterials and gauging their safety will also be a priority of the grants. “We currently know very little about nanoscale materials' effect on human health and the environment," said Linda Birnbaum, PhD, director of the NIEHS and the National Toxicology Program (NTP), an interagency program for the U.S. Department of Health and Human Services. "Nanomaterials come in so many shapes and sizes, with each one having different chemical properties and physical and surface characteristics. They are tricky materials to get a handle on. The same properties that make nanomaterials so potentially beneficial in drug delivery and product development are some of the same reasons we need to be cautious about their presence in the environment."

2. Particle toxicology
Can nano-sized particles travel from the nose to the brain? That’s one of the questions that The Society of Toxicology (SOT) researchers are exploring. Particle toxicology has come a long way from revealing the prominent role for coal and silicainduced diseases in the early 20th century, according to SOT. Investigations have gone from asbestos fibers to manmade mineral fibers, ambient particulate matter, and engineered nanoparticles. The focus too has grown from the traditional target organ, the respiratory system, to extra-pulmonary organs such as the heart, vascular system, and the brain. The connection between the nose and the brain and the transport, in particular, of nanosized particles to the olfactory bulb, was described early on to explain how poliovirus infection progressed. Research that is more recent suggests that man-made nanosized particles can access the same pathway.

Ongoing research seeks to better understand if and how nanosized poorly soluble particles get into the brain, the properties of the particles that accumulate in the brain (e.g. size, solubility, and reactivity), how the particles get cleared from brain tissue, and how particles might induce adverse effects such as neurodegenerative disease.

3. Microscopic sensors
Just this month, University of Washington researchers used nanotechnology to integrate microscopic optical, electronic, and biosensing devices into contact lenses to continuously monitor a patient’s health through the biochemistry of the eye surface—displaying the information through symbols right on the lens  That sound distracting? In the future, the information could also be sent via text message or e-mail.

In July, Food and Drug Administration approved a new treatment that could help millions of older adults who are nearly blinded by macular degeneration—a miniature telescope implanted directly into the eye that magnifies images to more than twice their size. One problem? Although it can sit comfortably atop a fingertip, the device is still relatively large—and it’s not for everybody.

4/5. Nanotechnology and tumors
In July, at a meeting of the American Association of Physicists in Medicine (AAPM), researchers talked about nano-coated “gold bullets” that help destroy tumors and improve radiation therapy.

Image-guided radiation therapy targets tumors in organs that tend to move during treatment, such as the prostate gland or the lungs, as well as tumors near vital organs. Often, inert markers are implanted into the body to help radiation oncologists pinpoint the cancerous tissue.

Researchers say they want to use these markers to deliver drugs that will combat cancer and make the tumor more sensitive to radiation. The drugs can be tailored to different tumor types, the researchers say.

“Right now, these markers are just passive implants that are inserted into the tumor,” says Srinivas Sridhar, a physics professor at Northeastern University and director of the university’s Electronic Materials Research Institute. “We’re making them active and smart using nanotechnology,” he said.

While researchers are already developing nanotechnology capsules that deliver a cancer drug to tumors with precision, researchers at Baylor College of Medicine in Houston, TX, have developed a targeted nanocapsule system that delivers two cancer therapies simultaneously: the chemotherapy agent doxorubicin and heat therapy (hyperthermia).

The system is based on nanoparticle-assembled capsules (NACs), structures that form themselves as a result of their chemical properties. The capsules contain the chemotherapy agent doxorubicin. An external magnetic field passed over the nanocapsule releases doxorubicin and also heats up the NAC solution, heating the tumor cells to kill them.

"The great thing about our magnetic, nanoparticle-assembled capsule is that it's a multifunctional device that can be used simultaneously to release the desired drug concentration at the tumor site while heating up the tumor cells," says lead researcher John McGary.

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