nanomedicine

nanomedicine, branch of medicine that seeks to apply nanotechnology—that is, the manipulation and manufacture of materials and devices that are roughly 1 to 100 nanometres (nm; 1 nm = 0.0000001 cm) in size—to the prevention of disease and to imaging, diagnosis, monitoring, treatment, repair, and regeneration of biological systems.

Although nanomedicine remains in its early stages, a number of nanomedical applications have been developed. Research thus far has focused on the development of biosensors to aid in diagnostics and vehicles to administer vaccines, medications, and genetic therapy, including the development of nanocapsules to aid in cancer treatment.

An offshoot of nanotechnology, nanomedicine is an emerging field and had garnered interest as a site for global research and development, which gives the field academic and commercial legitimacy. Funding for nanomedicine research comes both from public and private sources, and the leading investors are the United States, the United Kingdom, Germany, and Japan. In terms of the volume of nanomedicine research, these countries are joined by China, France, India, Brazil, Russia, and India.

Working at the molecular-size scale, nanomedicine is animated with promises of the seamless integration of biology and technology, the eradication of disease through personalized medicine, targeted drug delivery, regenerative medicine, as well as nanomachinery that can substitute portions of cells. Although many of these visions may not come to fruition, some nanomedicine applications have become reality, with the potential to radically transform the practice of medicine, as well as current understandings of the health, disease, and biology—issues that are of vital importance for contemporary societies. The field’s global market share totalled some $78 billion dollars in 2012, driven by technological advancements. By the end of the decade, the market is expected to grow to nearly $200 billion.

Development

Nanomedicine derives much of its rhetorical, technological, and scientific strength from the scale on which it operates (1 to 100 nm), the size of molecules and biochemical functions. The term nanomedicine emerged in 1999, the year when American scientist Robert A. Freitas Jr. published Nanomedicine: Basic Capabilities, the first of two volumes he dedicated to the subject.

Extending American scientist K. Eric Drexler’s vision of molecular assemblers with respect to nanotechnology, nanomedicine was depicted as facilitating the creation of nanobot devices (nanoscale-sized automatons) that would navigate the human body searching for and clearing disease. Although much of this compelling imagery still remains unrealized, it underscores the underlying vision of doctors being able to search and destroy diseased cells, or of nanomachines that substitute biological parts, which still drives portrayals of the field. Such illustrations remain integral to the field, being used by scientists, funding agencies, and the media alike.

Attesting to the field’s actuality are numerous dedicated scientific and industry-oriented conferences, peer-reviewed scientific journals, professional societies, and a growing number of companies. However, nanomedicine’s identity, scope, and goals are a matter of controversy. In 2006, for instance, the prestigious journal Nature Materials discussed the ongoing struggle of policy makers to understand if nanomedicine is a rhetorical issue or a solution to a real problem. This ambivalence is reflected in the numerous definitions of nanomedicine that can be found in scientific literature, that range from complicated drugs to the above mentioned nanobots. Despite the lack of a shared definition, there is a general agreement that nanomedicine entails the application of nanotechnology in medicine and that it will profoundly impact medical practice.

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A further topic of debate is nanomedicine’s genealogy, in particular its connections to molecular medicine and nanotechnology. The case of nanotechnology is exemplary: on one hand, its potential—in terms of science but also in regard to funding and recognition—is often mobilized by nanomedicine proponents; on the other, there is an attempt to distance nanomedicine from nanotechnology, for fear of being damaged by the perceived “hype” that surrounds it. The push is then for nanomedicine to emerge not as a subdiscipline of nanotechnology but as a parallel field.

Research, applications, and key concepts

Although nanomedicine research and development is actively pursued in numerous countries, the United States, the EU (particularly Germany), and Japan have made significant contributions from the field’s outset. This is reflected both in the number of articles published and in that of patents filed, both of which have grown exponentially since 2004. By 2012, however, nanomedicine research in China grew with respect to publications in the field, and the country ranked second only to the United States in the number of research articles published.

In 2004, two U.S. funding agencies—the National Institutes of Health and the National Cancer Institute—identified nanomedicine as a priority research area allocating $144 million and $80 million, respectively, to its study. In the EU meanwhile, public granting institutions did not formally recognize nanomedicine as a field, providing instead funding for research that falls under the headers of “nanotechnology” and “health.” Such lack of coordination had been the target of critiques by the European Science Foundation (ESF), warning that it would result in lost medical benefits. In spite of this, the EU ranked first in number of nanomedicine articles published and in 2007 the Seventh Framework Programme (FP7) allocated €250 million to nanomedicine research. Such work has also been heavily funded by the private sector. A study led by the European Science and Technology Observatory found that over 200 European companies were researching and developing nanomedicine applications, many of which were coordinating their efforts.

Much of nanomedicine research is application oriented, emphasizing methods to transfer it from the laboratory to the bedside. In 2005 the ESF pointed to four main subfields in nanomedicine research: analytical tools and nanoimaging, nanomaterials and nanodevices, novel therapeutics and drug delivery systems, and clinical, regulatory, and toxicological issues. Research in analytical tools and nanoimaging seeks to develop noninvasive, reliable, cheap, and highly sensitive tools for in vivo diagnosis and visualization. The ultimate goal is to create fully functional mobile sensors that can be remotely controlled to conduct in vivo, real-time analysis. Research on nanomaterials and nanodevices aims to improve the biocompatibility and mechanical properties of biomaterials used in medicine, so as to create safer implants, substitute damaged cell parts, or stimulate cell growth for tissue engineering and regeneration, to name a few. Work in novel therapeutics and drug delivery systems strives to develop and design nanoparticles and nanostructures that are noninvasive and can target specific diseases, as well as cross biological barriers. Allied with very precise means for diagnosis, these drug delivery systems would enable equally precise site-specific therapeutics and fewer side effects. The area of drug delivery accounts for a large portion of nanomedicine’s scientific publications.

Finally, the subfield of clinical, regulatory, and toxicological issues lumps together research that examines the field as a whole. Questions of safety and toxicology are prevalent, an issue that is all the more important given that nanomedicine entails introducing newly engineered nanoscale particles, materials, and devices into the human body. Regulatory issues revolve around the management of this newness, with some defending the need for new regulation, and others the ability of systems to deal with it. This subfield should also include other research by social scientists and humanists, namely on the ethics of nanomedicine.

Combined, these subfields build a case for preventive medicine and personalized medicine. Building upon genomics, personalized medicine envisions the possibility of individually tailored diagnostics and therapeutics. Preventive medicine takes this notion further, conjuring the possibility of treating a disease before it manifests itself. If realized, such shifts would have radical impacts on understandings of health, embodiment, and personhood. Questions remain concerning the cost and accessibility of nanomedicine and also about the consequences of diagnostics based on risk propensity or that lack a cure.