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Explore the potential clinical applications of nanotechnology such as surface modifications of medical devices, gene therapy, drug delivery, and neural regeneration. Identify barriers and opportunities for advancing nanomedicine. Discuss possible action items for the Texas Medical Center.
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Defining the right clinical problems for nanotechnology Table 2 John S. Oghalai, MD
1. Nanotechnology to change the surface of implanted devices • Premise: on the nanoscale, adhesion properties of surfaces may be different • To decrease biofilm formation of pathogenic organisms • To increase the ability of beneficial organisms to form biofilms • Examples: vascular stents, indwelling catheters, cochlear implants, pacemakers
2. Mechanical modulation of biologic components • Premise: carbon nanotubes are stiff and may cross-link collagen fibers • Examples • To stiffen the eardrum for the treatment of cholesteatoma or atelectasis • To stiffen the basilar membrane within the cochlea and alter the frequency sensitivity of hearing • To stiffen the skin in patients with chronic skin disorders and ulcerations • Tendon and/or bone strengthening
3. Topical Gene Therapy • Premise: carbon nanotubes can be used to transport exogenous DNA into a cell and could be applied locally with minimal risk • Examples of potential use for gene delivery: • To the cochlea for the treatment of hearing loss • To the eye for visual loss • To the skin • To blood vessels, via endovascular application
4. Neural Regeneration & Repair • Premise: Nanotubes conduct electricity and can be fabricated in parallel matrices • Examples: • To repair the facial nerve after planned surgical sacrifice • To repair the spinal cord after traumatic injury • To repair or restore function in long nerves to extremities in diabetics or other patients with peripheral nerve disease
5. Drug delivery • Premise: Nanotubes can transport drugs • Examples: • Deliver alpha radiation to cancer micrometastases • Deliver compounds to areas of vascular stenosis or occlusion (heart, brain, etc.) • Deliver growth factors to chronic wounds • Deliver substances across the blood-brain and blood-perilymph (inner ear) barriers • Delivery of anti-HIV therapies to T-cells
6. Imaging • Premise: Nanotubes can carry contrast agents • Examples: • Transportation of gadolinium to improve MRI sensitivity
Technical barriers • Toxicities of nanomaterials are unknown • How to best target the nanomaterials so that systemic administration can be used • How to uncage the drug so it gets out at the desired location • Is there a way to “re-cage” the drug when it is no longer desired • How are nanoparticles removed from the body • Mathematical modeling of nanostructures is in its infancy
Other barriers • Identifying potential collaborators between institutions, departments, and backgrounds • Obtaining seed grant funds to start novel projects • Obtaining large amounts of funding to be able tp translate successful results from animal studies into clinical phase 1 trials.
Action Items • Make the Collaborative Research Center (CRC) the hub for nanomedicine interactions • Weekly or bi-weekly seminar series dedicated to nanotechnology research • Increase number of Rice graduate students and post-docs working in collaborations with biological labs within the Texas Medical Center