ABSTRACT

Nanomedicine is a rapidly growing field that applies nanotechnology principles to improve healthcare, with a focus on the diagnosis, treatment, and prevention of diseases. Nanoparticles offer unique properties that make them useful in medicine, including a high surface area-to-volume ratio and specific targeting capabilities. The article explores the different types of nanomedicines used in the pharmaceutical industry and their potential benefits, as well as targeted drug delivery mechanisms. While nanomedicine has led to the development of globally marketed therapies such as Doxil and Abraxane, regulatory and ethical considerations must be addressed to ensure safety and efficacy. Limitations of nanomedicines in targeted drug delivery, such as limited drug payload capacity and lack of specificity, must also be addressed. Despite challenges, the prospects for nanomedicine are promising, with the potential to revolutionize personalized medicine, improve disease detection and treatment, and support tissue regeneration and repair. Integration with artificial intelligence can lead to more precise and efficient drug delivery and disease diagnosis. Continued investment and collaboration between researchers, healthcare providers, and industry partners can help overcome obstacles and unlock the full potential of nanomedicine. Overall, nanomedicine is an exciting and promising field that has the potential to significantly improve healthcare outcomes.

Key Words: Nanomedicine, Targeted drug delivery system, Treatment, Healthcare, FDA (food and drug administration)

INTRODUCTION

Nanomedicine is an interdisciplinary field that applies the principles of nanotechnology to the diagnosis, treatment, and prevention of diseases. It involves the use of nanoparticles, which are typically between 1 and 100 nanometres in size, to develop new and innovative therapies that can improve patient outcomes [1]. The unique properties of nanoparticles, such as their high surface area to volume ratio, unique optical and magnetic properties, and ability to target specific cells, make them useful in medicine [2]. The objective of studying nanomedicine is to develop more effective and personalized treatments for a range of diseases, from cancer to infectious diseases to neurological disorders [3]. By engineering nanoparticles to selectively accumulate in diseased tissues, release drugs in a controlled manner, and enhance the efficacy and safety of existing therapies, researchers aim to overcome many of the limitations of conventional drugs [4, 5]. Nanomedicine offers a promising approach to improve the diagnosis and treatment of diseases and has the potential to revolutionize healthcare in the coming years. However, regulatory and ethical challenges must be addressed to ensure the safety and efficacy of nanomedicine therapies [6].

Types of nanomedicines used in the pharmaceutical industry

Multiple sclerosis (MS) is a multifaceted autoimmune Nanomedicines are a class of medical interventions that involve the use of nanoparticles or nanoscale materials for diagnosing, treating, or preventing diseases. They offer unique advantages due to their small size, large surface area, and potential for targeted drug delivery [7, 8]. In the pharmaceutical industry, various types of nanomedicines have been developed and studied. Some of the prominent types include:

• Nano-emulsions: Nano-emulsions are thermodynamically stable systems composed of oil, water, and surfactants. They are used to encapsulate both hydrophobic and hydrophilic drugs, offering improved solubility and bioavailability. Nano-emulsions are used for various routes of administration, including oral, topical, and parenteral [9].
• Polymeric nanoparticles: As mentioned before, polymeric nanoparticles are made from biodegradable polymers and can carry drugs within their matrix. They are versatile and can be designed for targeted drug delivery, sustained release, and improved stability [10].
• Solid-Lipid nanoparticles (SLNs): SLNs are lipid-based nanoparticles that offer enhanced drug stability, controlled release, and improved bioavailability. They consist of a solid lipid core that can encapsulate both hydrophobic and hydrophilic drugs [11].
• Quantum dots: Quantum dots are nanoscale semiconductor crystals that emit specific wavelengths of light based on their size. They have applications in imaging and diagnostics due to their tunable optical properties and high brightness [12].
• Colloidal gold: Colloidal gold nanoparticles have unique optical properties and are used in diagnostic assays, imaging, and targeted drug delivery. They can be conjugated with ligands for specific cell targeting [13].
• Dendrimers: Dendrimers are highly branched polymers with a well-defined structure. They can be used to encapsulate drugs within their interior and can be functionalized for targeted drug delivery, gene delivery, and imaging [14].
• Nanocrystals: Nanocrystals are crystalline particles with nanometer-scale dimensions. They improve drug solubility and dissolution rate, enhancing the bioavailability of poorly water-soluble drugs [15].
• Liposomes: Liposomes, as described earlier, are vesicles composed of lipid bilayers that can encapsulate drugs. They are widely used for drug delivery, particularly for improving the pharmacokinetics and targeting of drugs [16].
• Carbon nanotubes: Carbon nanotubes have been explored for drug delivery, imaging, and even as carriers for gene therapy due to their unique structural and surface properties [17].

Targeted drug delivery by nanomedicines

Targeted drug delivery using nanomedicines is a strategy that aims to deliver therapeutic agents specifically to the site of action within the body while minimizing their exposure to healthy tissues. This approach enhances the therapeutic efficacy of drugs and reduces potential side effects [18]. Here's how targeted drug delivery by nanomedicines works:

• Design and functionalization: Nanoparticles are designed and engineered to have specific properties that enable them to target certain cells, tissues, or organs. Surface modifications, such as attaching targeting ligands (antibodies, peptides, aptamers) or coatings, allow nanoparticles to interact selectively with receptors on the target cells [19].
• Active targeting: Active targeting involves nanoparticles binding to specific molecules or receptors on the surface of target cells. This binding can be facilitated by the functionalized nanoparticle ligands or antibodies, ensuring a higher concentration of the therapeutic agent at the desired site [20].
• Passive targeting (Enhanced Permeability and Retention, EPR): Tumors and inflamed tissues often have leaky blood vessels and compromised lymphatic drainage. Nanoparticles can exploit this phenomenon by accumulating at these sites due to their size and charge. This passive accumulation is known as the enhanced permeability and retention (EPR) effect [21].
• Responsive targeting: Some nanoparticles are designed to respond to specific environmental cues at the target site, such as changes in pH, temperature, or enzymatic activity. This responsiveness can trigger drug release only when the nanoparticles are close to the target, further enhancing the selectivity of drug delivery [22].
• Internalization and drug release: Once the nanoparticles reach the target site and bind to the target cells, they are often internalized by the cells. The nanoparticles then release the therapeutic agent in a controlled manner, either due to the local environment or through an external trigger (e.g., light, magnetic field) [23].
• Avoiding the immune system: Nanoparticles can be designed to evade recognition and clearance by the immune system, allowing them to circulate in the bloodstream and reach their target more effectively [24].
• Reduced systemic toxicity: Targeted drug delivery reduces the exposure of healthy tissues to the drug, minimizing off-target effects and toxicity [25, 26].

This targeted approach is particularly advantageous in the treatment of diseases like cancer, where conventional chemotherapy can damage healthy tissues and cause severe side effects. By concentrating the therapeutic effect at the tumor site, targeted nanomedicines enhance the effectiveness of treatment while mitigating harm to healthy tissues [27]. However, it's important to note that achieving successful targeted drug delivery involves complex factors, including nanoparticle design, choice of targeting ligands, understanding the target's molecular characteristics, and ensuring safety and regulatory approval. The field of nanomedicine continues to advance, refining these techniques and pushing the boundaries of targeted drug delivery for a wide range of medical applications.

Applications of nanoparticles in medicine: targeted therapies and beyond

Nanoparticles have found diverse applications in medicine, extending beyond targeted therapies to encompass a wide range of innovative approaches. These versatile nanoscale materials are being harnessed for various purposes that have the potential to revolutionize diagnostics, treatment, and disease management [28].

Nanoparticles revolutionize medicine with applications like targeted therapies (oncology), improved diagnostics (MRI, CT, PET), regenerative medicine (tissue repair), enhanced vaccines (antigen delivery), gene therapy (genetic disorders), antimicrobial agents (infections), personalized medicine (individualized treatment), blood-brain barrier penetration (neurological disorders), wound healing (growth factors), organ transplantation (immunosuppression), drug combinations (synergy), theranostics (visualization and treatment), neurological disorders (Alzheimer's, Parkinson's), cardiovascular health (atherosclerosis), and organ imaging (precision surgeries) [29-43].

Globally marketed nanomedicines

Pharmaceutical nanomedicine products have achieved remarkable prominence within the global healthcare landscape. With over 70 nanomedicine products securing approval from the FDA and EMA since 1995, and an even larger number progressing through clinical trials, nanomedicine's trajectory is one of robust growth. This surge is driven by the pursuit of elevated drug effectiveness coupled with diminished toxicity, effectively showcasing nanotechnology's prowess in revolutionizing drug delivery [44].

Since 1989, the global market has welcomed 78 nanomedicines, with the FDA granting 66 approvals and the EMA endorsing 31. Among these, 20 have earned the coveted joint approval of both agencies, while others have secured the backing of either the FDA (43) or the EMA (12) individually. The dynamic focus on nanomedicine development, fortified by its transformative healthcare advantages, has precipitated a substantial upswing in market presence post-2010. This diverse array of nanomedicines encompasses an assortment of nanocrystals, lipid-based and polymer-based nanoparticles, dendrimer-based nanoparticles, protein-based nanoparticles, and inorganic nanoparticles [6]. Inorganic nanoparticles constitute a particularly intriguing facet, offering a dual role encompassing diagnostics and therapy. Ranging from metal and carbon nanotubes to calcium phosphate, iron oxide, silica, and quantum dot nanoparticles, these agents adeptly serve as stable and biocompatible carriers for therapeutic agents [45]. However, the journey is not without challenges, as their gradual dissolution and lack of biodegradation present obstacles to sustained, long-term utilization [46]. Conversely, organic carriers encompassing lipid-based vectors, polymer-based vectors, and dendrimers act as protective envoys for therapeutic agents, boosting drug-loading capacity and fine-tuning pharmacokinetic profiles. As nanomedicine's transformative journey unfolds, it continues to redefine the boundaries of pharmaceutical methodologies [47].

In tandem with this, numerous exemplars of globally marketed nanomedicines accentuate the substantial potential of this field. Noteworthy instances include Doxil (liposomal doxorubicin), Abraxane (nanoparticle-bound paclitaxel), Onivyde (liposomal irinotecan), and other innovations spanning nanocrystal-based formulations, iron replenishment therapies, and precision-targeting antibody-drug conjugates. Collectively, these pioneering nanomedicines underscore the diversified applications of nanotechnology in amplifying therapeutic outcomes and elevating overall patient well-being [48-51].

Regulatory and ethical considerations in nanomedicine

Nanomedicine has the potential to transform healthcare, but with this potential comes a need for responsible and ethical development, as well as stringent regulation to ensure safety and efficacy [1]. The unique properties of nanoparticles raise concerns about their potential toxicity and long-term effects on human health and the environment. Thus, it is crucial to evaluate and minimize potential risks associated with nanomedicine development and application [52]. Regulatory bodies such as the FDA have developed guidelines for the evaluation and approval of nanomedicine products. These guidelines include recommendations for testing and evaluation of the safety and efficacy of nanomedicine products. Furthermore, ethical considerations are crucial, including issues related to patient consent, privacy, and informed decision-making. Ensuring the safety and efficacy of nanomedicine requires collaboration between regulatory agencies, researchers, healthcare providers, and patients. Additionally, clear communication and education about nanomedicine development and its potential risks and benefits are necessary to establish public trust and facilitate responsible and ethical development [53].

Limitations of nanomedicines in targeted drug delivery

While nanomedicines hold great promise for targeted drug delivery, they are not without limitations. One significant challenge is their limited drug payload capacity, which can restrict the number of therapeutic agents that can be loaded onto nanoparticles [7]. Moreover, the lack of absolute specificity in targeting can lead to off-target effects, potentially affecting healthy tissues and diminishing the desired precision [25]. The efficiency of targeting is another concern, as successful delivery to specific cells or tissues may not always be achieved, reducing the therapeutic impact [54]. The variability in biological responses among individuals can also influence the effectiveness of nanomedicines, making it challenging to predict uniform outcomes [6]. Navigating regulatory challenges poses another hurdle, as the approval process for novel nanomedicines involves demonstrating their safety, efficacy, and manufacturing consistency [55]. Additionally, the cost considerations associated with developing and producing nanomedicines can be substantial, potentially limiting their accessibility to a wider population [6]. These limitations underscore the need for ongoing research and development efforts to overcome these challenges, optimize nanomedicine designs, and unlock their full potential for revolutionizing targeted drug delivery in healthcare.

Future prospects of nanomedicine in targeted drug delivery

The prospects for nanomedicine are exciting, with the potential to revolutionize personalized medicine, improve disease detection and treatment, and support tissue regeneration and repair. One important direction in nanomedicine is the development of nanorobots and nanosensors that can perform complex tasks within the body, such as drug delivery, disease detection, and tissue repair. Nanoparticles can also be used to deliver multiple drugs or therapies simultaneously, leading to more effective treatments for complex diseases. Additionally, nanoparticles can be used as non-invasive diagnostic tools to detect diseases in their early stages. The integration of artificial intelligence and nanomedicine can also lead to more precise and efficient drug delivery and more accurate disease detection and diagnosis. However, there are still challenges to address, such as safety and toxicity concerns, regulatory issues, and cost-effectiveness. Continued investment and collaboration between researchers, healthcare providers, and industry partners can help to overcome these challenges and unlock the full potential of nanomedicine [56-58].

CONCLUSION

Nanomedicine is a rapidly growing field with promising applications in drug delivery, disease detection, and tissue regeneration. Targeted therapies with nanoparticles have shown the potential in improving patient outcomes and quality of life. However, there are also limitations and challenges to address, including safety and toxicity concerns, regulatory issues, and cost-effectiveness. Despite these challenges, the future of nanomedicine is promising, and continued investment and collaboration between researchers, healthcare providers, and industry partners can help to overcome these obstacles and realize the full potential of this exciting field.

Acknowledgments: I would like to thank Staffs and Management of N. N. Sattha College of Pharmacy for their Support.

Conflict of interest: None

Financial support: None

Ethics statement: None

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