Editing Nanomedicine (section)

==Drug delivery==
{{main|Nanoparticle drug delivery}}
{{Multiple image|direction = vertical |width=220 |image1 = Nanoparticles biomolecule interaction.svg|image2 = Liposome.jpg|footer = [[Nanoparticle]]s ''(top)'', [[liposome]]s ''(middle)'', and [[dendrimer]]s ''(bottom)'' are some [[nanomaterials]] being investigated for use in nanomedicine.|image3 = Graphs.jpg}} Nanotechnology has provided the possibility of delivering drugs to specific cells using nanoparticles.<ref name="ijn2012">{{cite journal | vauthors = Ranganathan R, Madanmohan S, Kesavan A, Baskar G, Krishnamoorthy YR, Santosham R, Ponraju D, Rayala SK, Venkatraman G | title = Nanomedicine: towards development of patient-friendly drug-delivery systems for oncological applications | journal = International Journal of Nanomedicine | volume = 7 | pages = 1043–60 | year = 2012 | pmid = 22403487 | pmc = 3292417 | doi = 10.2147/IJN.S25182 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Patra JK, Das G | title = Nano based drug delivery systems: recent developments and future prospects | journal = Journal of Nanobiotechnology | date=September 2018 | doi = 10.1186/s12951-018-0392-8 | volume = 16 | issue = 71 | page = 71 | pmid = 30231877| pmc = 6145203 | doi-access = free }}</ref> This use of drug delivery systems was first proposed by Gregory Gregoriadis in 1974, who outlined liposomes as a drug delivery system for chemotherapy.<ref name=":22" /> The overall drug consumption and side-effects may be lowered significantly by depositing the [[Active pharmaceutical ingredient|active pharmaceutical agent]] in the diseased region only and in no higher dose than needed. Targeted drug delivery is intended to reduce the side effects of drugs in tandem decreases in consumption and treatment expenses. Additionally, targeted drug delivery reduces the side effects of crude or naturally occurring drugs by minimizing undesired exposure to healthy cells. [[Drug delivery]] focuses on maximizing [[bioavailability]] both at specific places in the body and over a period of time. This can potentially be achieved by molecular targeting by nanoengineered devices.<ref>{{cite journal | vauthors = LaVan DA, McGuire T, Langer R | title = Small-scale systems for in vivo drug delivery | journal = Nature Biotechnology | volume = 21 | issue = 10 | pages = 1184–91 | date = October 2003 | pmid = 14520404 | doi = 10.1038/nbt876 | s2cid = 1490060 }}</ref><ref>{{cite journal | vauthors = Cavalcanti A, Shirinzadeh B, Freitas RA, Hogg T |title=Nanorobot architecture for medical target identification |journal= Nanotechnology |volume=19 |issue=1 |pages=015103(15pp) |date=2008 |doi=10.1088/0957-4484/19/01/015103 |bibcode=2008Nanot..19a5103C |s2cid=15557853 }}</ref> A benefit of using nanoscale for medical technologies is that smaller devices are less invasive and can possibly be implanted inside the body, plus biochemical reaction times are much shorter. These devices are faster and more sensitive than typical drug delivery.<ref>{{cite journal |last1=Boisseau |first1=Patrick |last2=Loubaton |first2=Bertrand |title=Nanomedicine, nanotechnology in medicine |journal=Comptes Rendus Physique |date=September 2011 |volume=12 |issue=7 |pages=620–636 |doi=10.1016/j.crhy.2011.06.001 |bibcode=2011CRPhy..12..620B |url=https://hal.archives-ouvertes.fr/hal-00598930/file/Boisseau_nanomedicine_CRAS.pdf }}</ref> The efficacy of drug delivery through nanomedicine is largely based upon: a) efficient encapsulation of the drugs, b) successful delivery of drug to the targeted region of the body, and c) successful release of the drug.<ref>{{cite journal | vauthors = Santi M, Mapanao AK, Cassano D, Vlamidis Y, Cappello V, Voliani V | title = Endogenously-Activated Ultrasmall-in-Nano Therapeutics: Assessment on 3D Head and Neck Squamous Cell Carcinomas | journal = Cancers | volume = 12 | issue = 5 | pages = 1063 | date = April 2020 | pmid = 32344838 | pmc = 7281743 | doi = 10.3390/cancers12051063 | doi-access = free }}</ref> Several nano-delivery drugs were on the market by 2019.<ref>{{cite journal |last1=Farjadian |first1=Fatemeh |last2=Ghasemi |first2=Amir |last3=Gohari |first3=Omid |last4=Roointan |first4=Amir |last5=Karimi |first5=Mahdi |last6=Hamblin |first6=Michael R |title=Nanopharmaceuticals and nanomedicines currently on the market: challenges and opportunities |journal=Nanomedicine |date=January 2019 |volume=14 |issue=1 |pages=93–126 |doi=10.2217/nnm-2018-0120 |pmid=30451076 |pmc=6391637 }}</ref>

Drug delivery systems, lipid-<ref>{{cite journal |last1=Rao |first1=Shasha |last2=Tan |first2=Angel |last3=Thomas |first3=Nicky |last4=Prestidge |first4=Clive A. |title=Perspective and potential of oral lipid-based delivery to optimize pharmacological therapies against cardiovascular diseases |journal=Journal of Controlled Release |date=November 2014 |volume=193 |pages=174–187 |doi=10.1016/j.jconrel.2014.05.013 |pmid=24852093 |url=https://unisa.alma.exlibrisgroup.com/view/delivery/61USOUTHAUS_INST/12142893230001831 }}</ref> or polymer-based nanoparticles, can be designed to improve the [[pharmacokinetics]] and [[biodistribution]] of the drug.<ref>{{cite journal | vauthors = Allen TM, Cullis PR | title = Drug delivery systems: entering the mainstream | journal = Science | volume = 303 | issue = 5665 | pages = 1818–22 | date = March 2004 | pmid = 15031496 | doi = 10.1126/science.1095833 | bibcode = 2004Sci...303.1818A | s2cid = 39013016 }}</ref><ref>{{cite journal | vauthors = Walsh MD, Hanna SK, Sen J, Rawal S, Cabral CB, Yurkovetskiy AV, Fram RJ, Lowinger TB, Zamboni WC | title = Pharmacokinetics and antitumor efficacy of XMT-1001, a novel, polymeric topoisomerase I inhibitor, in mice bearing HT-29 human colon carcinoma xenografts | journal = Clinical Cancer Research | volume = 18 | issue = 9 | pages = 2591–602 | date = May 2012 | pmid = 22392910 | doi = 10.1158/1078-0432.CCR-11-1554 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Chu KS, Hasan W, Rawal S, Walsh MD, Enlow EM, Luft JC, Bridges AS, Kuijer JL, Napier ME, Zamboni WC, DeSimone JM | display-authors = 6 | title = Plasma, tumor and tissue pharmacokinetics of Docetaxel delivered via nanoparticles of different sizes and shapes in mice bearing SKOV-3 human ovarian carcinoma xenograft | journal = Nanomedicine | volume = 9 | issue = 5 | pages = 686–93 | date = July 2013 | pmid = 23219874 | pmc = 3706026 | doi = 10.1016/j.nano.2012.11.008 }}</ref> However, the pharmacokinetics and pharmacodynamics of nanomedicine is highly variable among different patients.<ref>{{cite journal | vauthors = Caron WP, Song G, Kumar P, Rawal S, Zamboni WC | title = Interpatient pharmacokinetic and pharmacodynamic variability of carrier-mediated anticancer agents | journal = Clinical Pharmacology and Therapeutics | volume = 91 | issue = 5 | pages = 802–12 | date = May 2012 | pmid = 22472987 | doi = 10.1038/clpt.2012.12 | s2cid = 27774457 }}</ref> When designed to avoid the body's defense mechanisms,<ref name=":0">{{cite journal | vauthors = Bertrand N, Leroux JC | title = The journey of a drug-carrier in the body: an anatomo-physiological perspective | journal = Journal of Controlled Release | volume = 161 | issue = 2 | pages = 152–63 | date = July 2012 | pmid = 22001607 | doi = 10.1016/j.jconrel.2011.09.098 }}</ref> nanoparticles have beneficial properties that can be used to improve drug delivery. Complex drug delivery mechanisms are being developed, including the ability to get drugs through cell membranes and into cell [[cytoplasm]]. Triggered response is one way for drug molecules to be used more efficiently. Drugs are placed in the body and only activate on encountering a particular signal. For example, a drug with poor solubility will be replaced by a drug delivery system where both hydrophilic and hydrophobic environments exist, improving the solubility.<ref>{{cite journal | vauthors = Nagy ZK, Balogh A, Vajna B, Farkas A, Patyi G, Kramarics A, Marosi G | display-authors = 6 | title = Comparison of electrospun and extruded Soluplus®-based solid dosage forms of improved dissolution | journal = Journal of Pharmaceutical Sciences | volume = 101 | issue = 1 | pages = 322–32 | date = January 2012 | pmid = 21918982 | doi = 10.1002/jps.22731 }}</ref> Drug delivery systems may also be able to prevent tissue damage through regulated drug release; reduce drug clearance rates; or lower the volume of distribution and reduce the effect on non-target tissue.  However, the biodistribution of these nanoparticles is still imperfect due to the complex host's reactions to nano- and microsized materials<ref name=":0" /> and the difficulty in targeting specific organs in the body. Nevertheless, a lot of work is still ongoing to optimize and better understand the potential and limitations of nanoparticulate systems. While advancement of research proves that targeting and distribution can be augmented by nanoparticles, the dangers of nanotoxicity become an important next step in further understanding of their medical uses.<ref>{{cite journal | vauthors = Minchin R | title = Nanomedicine: sizing up targets with nanoparticles | journal = Nature Nanotechnology | volume = 3 | issue = 1 | pages = 12–3 | date = January 2008 | pmid = 18654442 | doi = 10.1038/nnano.2007.433 | bibcode = 2008NatNa...3...12M }}</ref> The toxicity of nanoparticles varies, depending on size, shape, and material. These factors also affect the build-up and organ damage that may occur. Nanoparticles are made to be long-lasting, but this causes them to be trapped within organs, specifically the liver and spleen, as they cannot be broken down or excreted. This build-up of non-biodegradable material has been observed to cause organ damage and inflammation in mice.<ref>{{cite journal | vauthors = Ho D |title=Nanodiamonds: The intersection of nanotechnology, drug development, and personalized medicine |journal=Science Advances |year=2015 |volume=1 |issue=7 |pages=e1500439 |doi=10.1126/sciadv.1500439 |pmid=26601235 |pmc=4643796 |bibcode=2015SciA....1E0439H}}</ref> Delivering [[Iron oxide nanoparticle|magnetic nanoparticles]] to a tumor using uneven stationary [[magnetic fields]] may lead to enhanced tumor growth. In order to avoid this, alternating [[electromagnetic fields]] should be used.<ref>{{cite journal |last1=Orel |first1=Valerii E. |last2=Dasyukevich |first2=Olga |last3=Rykhalskyi |first3=Oleksandr |last4=Orel |first4=Valerii B. |last5=Burlaka |first5=Anatoliy |last6=Virko |first6=Sergii |title=Magneto-mechanical effects of magnetite nanoparticles on Walker-256 carcinosarcoma heterogeneity, redox state and growth modulated by an inhomogeneous stationary magnetic field |journal=Journal of Magnetism and Magnetic Materials |date=November 2021 |volume=538 |pages=168314 |doi=10.1016/j.jmmm.2021.168314 |bibcode=2021JMMM..53868314O }}</ref>

Nanoparticles are under research for their potential to decrease [[antibiotic resistance]] or for various antimicrobial uses.<ref>{{cite journal | vauthors = Banoee M, Seif S, Nazari ZE, Jafari-Fesharaki P, Shahverdi HR, Moballegh A, Moghaddam KM, Shahverdi AR | display-authors = 6 | title = ZnO nanoparticles enhanced antibacterial activity of ciprofloxacin against Staphylococcus aureus and Escherichia coli | journal = Journal of Biomedical Materials Research Part B: Applied Biomaterials | volume = 93 | issue = 2 | pages = 557–61 | date = May 2010 | pmid = 20225250 | doi = 10.1002/jbm.b.31615 | url = http://www.lib.ncsu.edu/resolver/1840.2/2635 }}</ref><ref>{{cite journal | vauthors = Seil JT, Webster TJ | title = Antimicrobial applications of nanotechnology: methods and literature | journal = International Journal of Nanomedicine | volume = 7 | pages = 2767–81 | date = 2012 | pmid = 22745541 | pmc = 3383293 | doi = 10.2147/IJN.S24805 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Eslamian L, Borzabadi-Farahani A, Karimi S, Saadat S, Badiee MR | title = Evaluation of the Shear Bond Strength and Antibacterial Activity of Orthodontic Adhesive Containing Silver Nanoparticle, an In-Vitro Study | journal = Nanomaterials | volume = 10| issue = 8 | pages = 1466| date = July 2020| pmid = 32727028 | doi = 10.3390/nano10081466 | pmc =7466539| doi-access = free }}</ref><ref>{{cite journal | vauthors = Borzabadi-Farahani A, Borzabadi E, Lynch E | title = Nanoparticles in orthodontics, a review of antimicrobial and anti-caries applications | journal = Acta Odontologica Scandinavica | volume = 72 | issue = 6 | pages = 413–7 | date = August 2014 | pmid = 24325608 | doi = 10.3109/00016357.2013.859728 | s2cid = 35821474 }}</ref> Nanoparticles might also be used to circumvent [[multidrug resistance]] (MDR) mechanisms.<ref name=ijn2012/>

=== Systems under research ===
Advances in lipid nanotechnology were instrumental in engineering medical nanodevices and novel drug delivery systems, as well as in developing sensing applications.<ref>{{cite journal | vauthors = Mashaghi S, Jadidi T, [[Gijsje Koenderink|Koenderink G]], Mashaghi A | title = Lipid nanotechnology | journal = International Journal of Molecular Sciences | volume = 14 | issue = 2 | pages = 4242–82 | date = February 2013 | pmid = 23429269 | pmc = 3588097 | doi = 10.3390/ijms14024242 | doi-access = free }}</ref> Another system for [[microRNA]] delivery under preliminary research is [[nanoparticles]] formed by the self-assembly of two different microRNAs to possibly shrink [[Neoplasm|tumors]].<ref>{{cite journal | vauthors = Conde J, Oliva N, Atilano M, Song HS, Artzi N | title = Self-assembled RNA-triple-helix hydrogel scaffold for microRNA modulation in the tumour microenvironment | journal = Nature Materials | volume = 15 | issue = 3 | pages = 353–63 | date = March 2016 | pmid = 26641016 | pmc = 6594154 | doi = 10.1038/nmat4497 | bibcode = 2016NatMa..15..353C }}</ref> One potential application is based on small electromechanical systems, such as [[nanoelectromechanical system]]s being investigated for the active release of drugs and sensors for possible cancer treatment with iron nanoparticles or gold shells.<ref name="pubs.rsc.org">{{cite journal | vauthors = Juzgado A, Soldà A, Ostric A, Criado A, Valenti G, Rapino S, Conti G, Fracasso G, Paolucci F, Prato M | display-authors = 6 | title = Highly sensitive electrochemiluminescence detection of a prostate cancer biomarker | journal = Journal of Materials Chemistry B | volume = 5 | issue = 32 | pages = 6681–6687 | date = August 2017 | pmid = 32264431 | doi = 10.1039/c7tb01557g }}</ref> Another system of drug delivery involving nanoparticles is the use of [[Aquasome|aquasomes]], self-assembled nanoparticles with a [[Nanocrystalline material|nanocrystalline]] center, a coating made of a polyhydroxyl [[oligomer]], covered in the desired drug, which protects it from [[Dehydration reaction|dehydration]] and [[conformational change]].<ref name=":22">{{Cite journal |last1=Jagdale |first1=Sachin |last2=Karekar |first2=Simran |date=August 2020 |title=Bird's eye view on aquasome: Formulation and application |url=https://doi.org/10.1016/j.jddst.2020.101776 |journal=Journal of Drug Delivery Science and Technology |volume=58 |pages=101776 |doi=10.1016/j.jddst.2020.101776 |issn=1773-2247}}</ref>