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Nanotechnology and Heart Disease

Author and Curator:  Tilda Barliya PhD

Cardiovascular disease is the most common cause of death worldwide and will become even more prevalent as the population ages. New therapeutic targets are being identified as a result of emerging insights into disease mechanisms, and new strategies are also being tested, possibly leading to new treatment options. Improving diagnosis is also crucial, because by detecting disease early, the focus could be shifted from treatment to prevention (1).

Mortality rates for cardiovascular disease have improved, but there are inequalities across the UK

The World Health Organization estimates that more than 17 million people died from cardiovascular diseases in 2008. In the U.S., about 785,000 people will have new heart attacks this year and 470,000 will suffer recurrent ones. While more patients are surviving such events, about two-thirds don’t make complete recoveries and are vulnerable to heart failure (2).

Heart and vascular disease is the number one killer in most industrialized nations, and costs countries billions in health care, and lost wages. Nanotechnology, biotechnology, robotics, and stem cells are reinvigorating the development of artificial components of the cardiovascular system. We’ve seen hearts grown from stem cells in labs, artificial mechanical hearts, companies spending millions to develop artificial blood, and now even artificial vascular tubes which act more like the real thing. Combined with upcoming advances in robotic and micro-surgery, medicine could be on the path to conquering its public enemy number one.

Nanotechnology offers several tools and advantages in cardiovascular science which are in the areas of diagnosis, imaging, and tissue engineering.

including:

  • treating defective heart valves
  • detecting and treat arterial plaque
  • understanding at a sub-cellular level how heart tissue functions in both healthy  and damaged organs, which can help researchers design better treatments

Examples:

Robert Langer, Omid Farokhzad and colleagues have developed nanoparticles that can cling to artery walls and slowly release medicine, an advance that potentially provides an alternative to drug-releasing stents in some patients with cardiovascular disease. The particles, dubbed “nanoburrs” because they are coated with tiny protein fragments that allow them to stick to target proteins, can be designed to release their drug payload over several days (3, 4). The nanoburrs are targeted to a specific structure, known as the basement membrane, which lines the arterial walls and is only exposed when those walls are damaged. Therefore, the nanoburrs could be used to deliver drugs to treat atherosclerosis and other inflammatory cardiovascular diseases. In the current study, the team used paclitaxel, a drug that inhibits cell division and helps prevent the growth of scar tissue that can clog arteries

Prof. Erkki Ruoslahti and other researchers from UC Santa Barbara have developed a nanoparticle that can attack plaque –– a major cause of cardiovascular disease (5).  These lipid-based micelles target the p32 receptors known to overexpress in plaques. To accomplish the research, the team induced atherosclerotic plaques in mice by keeping them on a high-fat diet. They then intravenously injected these mice with the micelles, which were allowed to circulate for three hours.

Clinical Trials:

Nanotechnology creates artificial artery for clinical trials

Researchers at London Royal Free Hospital are hoping to save limbs and lives with the creation of their new artificial artery. Unlike current artery replacements, this grafting substance was created using nanotechnology and can pulse with the natural movements of the body. That pulsing will allow the polymer tube to be used in very small grafts (<8mm), giving hope that damaged arteries which would normally lead to amputations or heart attacks can now be treated (6). The clinical study should have started by the end of 2010. No further information is currently available on this clinical trial.

The new artificial artery material was developed by Professors George Hamilton (vascular surgery) and Alexander Seifalian (nanotechnology and tissue repair). The substance is a polymer which has been embedded with different types of special molecules. Some of these molecules aid circulation, others encourage stem cells to coat its walls. That coating is very important and may allow the artificial tissue to bond better with the body and promote long term health. Most importantly though, the design of the artificial vascular tissue is resistant to clotting and can pulse.

Summary:

Research of heart disease is progressing on several levels simultaniously. It is believed that nanotechnology may offer several advantages in detecting and treating several heart conditions, however, they have yet to progressed into the clinical trials.

Quoting Dr. Tal Dvir: ” Many current experimental approaches to heart attack involve supplying growth factors, drugs, stem cells and other therapeutic agents to the scarred, dying tissue. Some of these compounds, such as periostin and neuregulin, have been shown in animal models to enhance heart regeneration and improve cardiac function. But the existing delivery approaches are all invasive, involving direct injections into the heart, catheter procedures, or surgical placement of implants that release the necessary factors.

The ultimate goal is to have the particles release compounds that promote regeneration. One approach is to release factors that attract the patient’s own stem cells, avoiding the need for tissue-engineered patches. But to date, no one’s gotten stem cells to differentiate efficiently into cardiomyocytes”

REFERENCES

1. http://www.nature.com/nature/supplements/insights/cardiovascular/index.html

2. Novel Cure for Ailing Hearts. http://online.wsj.com/article/SB10000872396390443537404577577002440205144.html

3. Chan JM., Zhang L., Tong R., Ghosh D., Gao W., Liao G., Yuet KP., Gray D., Rhee JW., Cheng J., Golomb G., Libby P, Langer R and Farokhzad OC. Spatiotemporal controlled delivery of nanoparticles to injured vasculature. Proc Natl Acad Sci U S A. 2010 Feb 2;107(5):2213-8.  http://www.pnas.org/content/107/5/2213.long

4. Chan JM., Rhee JW., Drum CL., Bronson RT., Golomb G., Langer R and Farokhzad OC. In vivo prevention of arterial restenosis with paclitaxel-encapsulated targeted lipid-polymeric nanoparticles. Proc Natl Acad Sci U S A. 2011 Nov 29;108(48):19347-52.

http://www.pnas.org/content/108/48/19347.long

5. Hamzah J., Kotamraju VR., Seo JW., Agemy L., Fogel V., Mahakian LM., Peters D., Roth L., Gagnon MK., Ferrara KW and Ruoslahti E. Specific penetration and accumulation of a homing peptide within atherosclerotic plaques of apolipoprotein E-deficient mice. Proc Natl Acad Sci U S A. 2011 Apr 26;108(17):7154-9http://www.pnas.org/content/108/17/7154.long

6. Written By: http://singularityhub.com/2010/01/05/nanotechnology-creates-artificial-artery-for-clinical-trials/

7. Ikaria® Commences Global Registration Trial for Bioabsorbable Cardiac Matrix. http://www.prnewswire.com/news-releases/ikaria-commences-global-registration-trial-for-bioabsorbable-cardiac-matrix-136581753.html.

8. Posted by: Prof. Lev-Ari :”Arteriogenesis and Cardiac Repair: Two Biomaterials – Injectable Thymosin beta4 and Myocardial Matrix Hydrogel” http://pharmaceuticalintelligence.com/2013/02/27/arteriogenesis-and-cardiac-repair-two-biomaterials-injectable-thymosin-beta4-and-myocardial-matrix-hydrogel/

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