INTRODUCTION:

Nanomedicine is a subfield of medicine that aims to use nanotechnology—that is, the manipulation and production of materials and devices with a size of approximately 1 to 100 nanometers (nm; 1nm = 0.0000001cm)—for disease prevention as well as for biological system imaging, diagnosis, monitoring, treatment, regeneration, and repair. Several nanomedical applications have been created, despite the fact that nanomedicine is still in its infancy. The development of biosensors for use in diagnostics, as well as delivery systems for vaccinations, drugs, and genetic therapy—including the creation of nanocapsules to help treat cancer—has dominated research to far.¹

Operating at the molecular level, nanomedicine holds out hope for the smooth fusion of biology and technology, the eradication of disease by tailored treatment, precise medication administration, regenerative medicine, and the development of nanomachinery capable of replacing entire cells. While many of these dreams may never come true, some applications of nanomedicine have been realized and have the potential to drastically alter medical practice and our current understanding of biology, illness, and health—issues that are crucial to modern societies.

A major contributing factor to the rise in mortality in developing countries is the prevalence of infectious diseases like tuberculosis (TB), which is spread by the Mycobacterium tuberculosis bacteria. One of the challenges in achieving therapeutic benefits of medications is getting them to the location of sickness. Therefore, efforts have been made to enhance medications and use lipid-based nanoscale drug delivery systems (NDDS) to make them available at the location of the disease. Therapeutics based on nanocarriers assist in overcoming the toxicity and low solubility of a number of medications used to produce tuberculosis treatment approaches. This article discusses the various types of nanoscale carriers that are used in the administration of drugs and vaccines, as well as how these carriers have developed to address issues with stability, durability, efficacy, and biodistribution.

Nanomedicine has appeared noteworthy potential in treating irresistible illnesses, advertising inventive arrangements through nanocarriers. These nanoscale materials can provide drugs absolutely to disease locales, progressing restorative adequacy and minimizing side impacts. Nanocarriers, such as liposomes, polymeric nanoparticles, and dendrimers, secure the dynamic pharmaceutical fixing and empower focused on conveyance, upgrading its steadiness and retention. Moreover, nanocarriers can co-deliver numerous drugs, giving a synergistic approach that upgrades the antimicrobial impact whereas minimizing the potential for resistance. Their flexibility in plan and functionalization offers a promising future for more viable and personalized treatment procedures in the battle against irresistible diseases.²

The key advantages of nanomedicines:

There can be a few focal points in utilizing nanomedicines over conventional little atom drugs, including:

Targeted drug delivery²

The capacity of nanomedicines to target particular bodily cells is one of their primary benefits. Conventional non-targeted medications spread throughout the body and may cause serious adverse effects. The majority of nanomedicines are made up of drug-carrying nanoparticles. Therapeutics can be made more potent and less hazardous by engineering these nanoparticles to improve medication delivery to the target cells.

Longer half-life:

The duration required for the body to excrete half of a substance is known as its half-life. Because small molecule medications usually have short half-lives, frequent administration is necessary to keep the body's levels of the drug at the optimal levels. Nanomedicines can be given less often since they can be made to have longer half-lives.

Enhanced solubility²

Certain medications may not dissolve as well in water, which can lessen their effectiveness. These medications can be made more soluble and effective by using nanoparticles.

What are the most used nanoparticles in medicine?

There are a few sorts of nanoparticles commonly utilized to make nanomedicines, such as

Lipid nanoparticles:

Liposomes are the most often utilized lipid nanoparticles. A liposome is a spherical structure consisting of cholesterol and phospholipids, among other lipidic substances. Liposomes have the ability to accommodate both hydrophilic and hydrophobic medications. Hydrophilic drugs can be encapsulated in the inner aqueous area, whilst hydrophobic substances can be encapsulated in the lipid bilayer. By adding ligands like peptides, proteins, carbohydrates, aptamers, antibodies, and polymers, one can alter the liposome surface. Surface alterations enable liposome-based nanomedicines to be delivered more precisely and to be more effective.

Polymeric nanoparticles:

Therapeutic substances, which can be contained in the polymeric core or directly conjugated to the polymer, and biocompatible/biodegradable polymers make up polymeric nanomedicines. Natural polymers including chitosan, starch, and dextran, as well as synthetic ones like polyethylene glycol (PEG), polylactic acid (PLA), polyglycolide (PGA), and poly (lactic-co-glycolic acid) (PLGA) can be found among the polymers. Small compounds, proteins, antibodies, and nucleic acid aptamers can all be used as medicinal agents. But the medicinal substance itself, like glatiramer acetate, can also be a polymer. Pharmaceuticals conjugated to or encapsulated in polymers have better regulated release and enhanced bioavailability as benefits.

Inorganic nanoparticles:

Nanoscale materials include silica and many inorganic materials like metals. Among them, iron, gold, and silver nanoparticles are the subjects of extensive research to create novel nanomedicines. For instance, tissue regeneration and wound healing are enhanced by the use of nanosized gold and silver. Additionally, gold nanoparticles have special optical qualities that help with imaging and diagnostics. There are numerous uses for iron oxide nanoparticles in diagnostic contexts. Moreover, they can be applied to cancer therapy involving hyperthermia. For the treatment of iron deficiency anemia, iron-carbohydrate nanocomplexes are frequently utilized as iron replacement therapy.

Albumin-based nanoparticles:

The production of novel nanomedicines has found a strong platform in the serum protein albumin. In fact, medications coated with albumin become more stable and extend their bloodstream circulation. This is because the medication is "invisible" to the immune system due to the albumin coating, which slows down its clearance. Additionally, for many cancer types, the albumin coating permits targeted drug delivery. Albumin-based nanoparticles can potentially be employed for diagnostic purposes. Indeed, to improve the visibility of particular organs in imaging modalities, albumin-coated contrast agents are often utilized in diagnostic contexts.⁹

What diseases are currently treated with nanomedicines?

A number of nanomedicines are being developed and licensed to treat a range of illnesses. A few instances of nanomedicines being used in clinical settings to treat infectious diseases and cancer are shown below.

Cancer:

Treatment of various forms of cancer is arguably the most well-known use of nanomedicines. Chemotherapy medications can be delivered to cancer cells via nanoparticles with minimal harm to healthy cells that are multiplying. Liposomes, albumin- and polymer-based nanoparticles, and other nanoparticles are commonly employed in cancer treatment.

Infectious diseases:

The potential of nanoparticles to cure bacterial, fungal, and viral infections is being studied. These are a few instances of clinically used nanoparticles for the treatment of infectious diseases.

Liposomal amphotericin B:

Amphotericin B is an antifungal drug with a broad range of activity against yeasts and molds, as well as the parasite Leishmania spp. However, scientists working in the pharmaceutical industry have been forced to create new, less lethal formulations because to the severe dose-limiting toxicity of Amphotericin B. Amphotericin B in a special lipid nanoformulation called liposomal amphotericin B has been used for more than 20 years to treat leishmaniosis and systemic fungal infections. It has been demonstrated that this liposomal formulation is less nephrotoxic than free Amphotericin B. Amphotericin B is, in fact, encapsulated in the liposome in the lipid nanoformulation and is not available for interaction with the renal distal tubules. The drug's inability to be glomerulofiltered because to the liposomes' big size may account for the decreased renal

The potential of nanoparticles to cure bacterial, fungal, and viral infections is being studied. These are a few instances of clinically used nanoparticles for the treatment of infectious diseases.¹¹

Nanomedicine: Modernizing antibiotics:

By using nano-scale carriers, a contemporary method to antimicrobial therapy will solve the numerous drawbacks and restrictions of conventional antibiotics. Antibiotics added to nanoparticles have a number of possible benefits. It is possible to design particles such that they directly target germs, organs, tissues, or cell types. One advantage of targeting is that it can concentrate strong antibiotic concentrations at the exact location where bacterial death is required.⁴

Infection treatment targets beyond bacterial killing:

Antimicrobial drugs have not been the only treatments for infections that aim to eradicate germs. Antivirals, biofilm disruption, bacterial toxin sequestration, and modification of the human response to infection are further areas of study.

Shifting focus to targeted drug delivery systems:

The administration of small molecules, which can change an antibiotic's pharmacokinetics, volume of distribution, efficacy, and off-target consequences, will undoubtedly be the focus of future antibiotic innovation. There is now study on many various delivery targets: to organ tissues, to individual cells, and directly to microorganisms.

Market innovation:⁵

It is evident that the infection treatment industry has a number of unmet demands, but it is less certain that market forces will encourage such development. The antibiotic market is unappealing to investors and major pharmaceutical corporations for a number of reasons. Initially, since the majority of bacterial infections are transient, prescribing patients does not yield the same substantial income as patients with persistent illnesses. Secondly, most people can benefit from low-cost generic medications.

Growing relevance of nanomedicine in infectious diseases:

For many years, nanomedicine has been the general term for materials at the nanoscale that are employed for medication delivery, diagnosis, and treatment. Over the past five years, its use has increased dramatically, and it is essential for targeted administration and diagnostics for infectious, neurological, and oncological conditions.

Since nanoparticles (NPs) may be readily modified to change their physicochemical and functional characteristics, nano formulations are helpful for creating vaccinations and treatments for infectious diseases. Lipid and polymer-based carriers have been used to nano-form a number of FDA-approved antiviral medications (for HIV and Herpes), and lipid nanoparticles (LNPs) were also used to make the first commercially available mRNA vaccine for COVID-19.

Long-term treatment is necessary for a number of IDs, including HIV and TB, and these long-term dose regimes frequently lead to poor patient adherence and treatment outcomes. This is more common in nations with low sociodemographic indices (SDIs), where treatment compliance is lower and the disease burden is higher. Active research has been done on developing nano-based therapies that could make the dosage schedule simpler. These could be nanostructured medications with improved solubility or nano-encapsulated antimicrobials and antivirals (lipid or polymer). Furthermore, in order to elicit cell-based immune responses, nanoparticles can enhance the effectiveness of currently available medications and vaccinations. In addition to preventative vaccinations, nanotechnology may play a key role in the creation of immunomodulatory treatments for persistent infections and multidrug-resistant bacteria.

Application:⁶

Clinical medicine challenges can be addressed with new diagnostic and therapeutic capabilities made possible by nanomedicine. Nanomedicines have the potential to completely transform therapeutic approaches because they are multifunctional agents with programmable features.

This promise is especially clear for infectious disease applications, for which the ongoing emergence, re-emergence, and evolution of pathogens has proven challenging to counter by conventional means. This article presents a conceptual framework that outlines potential paths for the advancement of nanomedicines as better, all-around antiviral medications that target encapsulated viruses. The life cycle of medically significant enveloped viruses, such as HIV, influenza, and Ebola, depends heavily on lipid membranes, making cellular and viral membrane interfaces perfect components to include in broad-spectrum antiviral treatments.

Examples are given to show how lipid membrane-inspired nanomedicine tactics provide a broad variety of targeting options to take control of important viral life cycle stages by direct or indirect methods involving membrane interfaces. Through the use of nanotechnology-enabled technologies, the potential can be realized by opening up novel inhibitory functions or enhancing the performance of currently available medications. The clinical translation of nanomedicines for applications in infectious diseases is receiving adequate attention in light of these attractive potential, particularly as pharmaceutical drug-discovery pipelines require fresh avenues for innovation.

Challenges and Future Perspective:¹⁷

With their special benefits in improving biological, mechanical, and electrical qualities, as well as their antimicrobial properties, gene delivery capabilities, and ease of creating engineered tissues, nanomaterials are important in therapeutic engineering. Notwithstanding these developments, a number of significant challenges still need to be addressed before broad clinical adoption can be achieved. The requirement for reliable instruments and processes to evaluate the safety profiles of nanomaterials is one of the main obstacles to their use in therapeutic applications. Even though the majority of NPs have far better safety profiles and fewer adverse effects, it is still necessary to carefully assess their toxicity, carcinogenicity, and teratogenicity because NPs may interact intricately with biological systems.

Long-term treatment for diseases like HIV and TB often leads to poor adherence, especially in countries with low sociodemographic indices. Research is focusing on nano-based therapies to simplify dosage regimens. These therapies include nanostructured drugs or nano-encapsulated antimicrobials and antivirals. Nanotechnology may also improve vaccines and create treatments for persistent infections and multidrug-resistant bacteria.

1. Micro-/nanorobots can deliver nanomedicines effectively due to their small size, enabling them to penetrate deep tissues and cross the blood-brain barrier. However, their drug-carrying capacity is limited, especially for large molecules, requiring further research to overcome biological barriers and enhance multi-drug delivery.

2. The choice of nanomaterials is critical in developing micro-/nanorobots. For microorganism-based robots, challenges include supporting microbial life and supplying nutrients. Artificially engineered robots must prioritize materials' toxicity, degradability, and applicability, ensuring suitability for widespread use.

3. Nanomedicine release must match lesion severity, with timely feedback mechanisms to confirm efficacy. After drug delivery, the nanorobots should be safely eliminated from the body.

4. Cross-disciplinary collaboration remains inadequate, and foundational research on nanomedicines requires further exploration to address key theoretical challenges.

CONCLUSION:

There are countless ways that nanomedicine might advance health. Expertise in public health must be included to optimize improvements in both individual and population health. This impact on the advancement of nanomedicine will aid in identifying the most pressing areas requiring technical innovation, deciding how best to distribute funds, and formulating environmental and public health policies.

Enhancing cross-disciplinary training for scientists, physicians, and public health professionals employed in business, government, and higher education is crucial to the advancement of nanomedicine. Research and education in nanomedicine will advance more quickly if collaboration is taken, which will increase public health's return on investment. Human health will be transformed by research and development of innovative nanomedicine applications combined with public health concepts.

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Received on 09.10.2024 Revised on 06.12.2024

Accepted on 15.01.2025 Published on 28.02.2025

Available online from March 03, 2025

Asian J. Pharm. Res. 2025; 15(1):60-64.

DOI: 10.52711/2231-5691.2025.00010

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