36 Autumn-winter 2009/HesaMag #01 Special report 25/30 Nanos in the human body – Medical perspectives and ethical concerns Healthcare is a priority focus of nanotechnology research, where the convergence of nanosciences, molecular and cell biology, and medicine can act to deliver improvements in human health and quality of life. It is an appealing prospect; but as with any new technology, there are both ethical and health and safety issues to be addressed, especially where applications in human bodies are concerned. Aída Maria Ponce Del Castillo ETUI Researcher Nanotechnologies can be seen as a Other developments are the generation “tool-kit” that enables different life sciences of nanomaterials that could be applied to im- to work together to produce new tools for di- prove tissue regeneration, like restoring car- agnosis and treatments. tilage function to overcome arthritis, in vitro Advances in nanotechnology harbour engineered organ patches or biomaterials for many potential uses in medicine. They will in situ regeneration of bones. Nanotechnol- help increase our understanding of the hu- ogy could also help in the fight against cancer, 1. National Nanotechnology man body, its mechanisms and diseases, and by developing nanomaterial systems to attack Initiative 2003, how to restore it to health. and destroy tumours. Workshop Report on One possible application will be to cus- Their multiple properties give nanoma- Nanobiotechnology, tomise medical treatment through personal- terials a wide spectrum of medical uses; some Virginia, p. 39. Liposomes for drug delivery ised medicine delivery, where patients will have a biocidal activity used in self-cleaning in some cases of cancer be given the precise, controlled dose of their surfaces. Recent research has investigated the therapy; nano-magnetic 2 specific medication at the right time. Nan- properties of fullerene compounds as antivi- particles for magnetic otechnologies will enable the development ral agents to eliminate pathogens and bacteria resonance imaging and of nanostructures to deliver drug molecules in place of long-term antibiotic treatments3. nanomaterials for void filler directly into the cells. Nanoparticles can act Nano-tool kits are also being developed and dental restoration have as drug-carriers or Trojan horses by encap- that will use nano-robots to monitor health been recently approved sulating the medication, travelling around inside a patient or to act at the sub-cellular in the USA. Engineering and Physical Sciences the body indiscriminately and delivering the level where a disease occurs. Nano-robots Research Council 2008, medication to the patient at the molecule lev- could be introduced through the vascular sys- Nanotechnology for el at the required dose when it is needed1. tem, and could be programmed and guided Healthcare, p. 3. by a surgeon to identify the molecular origins of severe diseases like Alzheimer’s or Parkin- 2. Fullerene is one of the son’s, or to perform intra-cellular surgery4. four types of naturally- Behind this ostensibly rosy prospect, occurring forms of carbon. Its architectural structure however, loom ethical and health and safety Nanotechnology could resembles a football, or the issues that any new technology raises, and geodesic domes designed also help in the fight which must be addressed to make a reasoned by the architect and assessment of what is in view. philosopher R. Buckminster against cancer, by On ethical aspects, there is a wide-rang- Fuller; C60 is the most ing discussion of the potential risks of nano- common, and consists of 60 developing nanomaterial materials and nanotechnologies for humans, carbon atoms. Fullerenes as little is still known about how they interact were discovered as recently as 1985, and their most with the human body in terms of toxicity and systems to attack and striking properties ― high carcinogenicity. This lack of knowledge is one symmetry, stability and destroy tumours. reason why specific regulations are needed to versatility ― give them a control the use of nanotechnologies. wide range of applications. 37 Autumn-winter 2009/HesaMag #01 Special report 26/30 What is a nano-device? Very tiny objects could be manufactured and inserted in the organs of the body for a specific purpose. They are small enough to enter the body, travel around, enter the cells and interact with DNA and proteins. Some examples of nano-devices or nano-implants are the so-called smart pills, organ replace- ments, neural interfaces, and brain implants. They would offer a good way to treat neurological dysfunctions, cancers and other diseases and disabilities. Nano-devices might help to cure some diseases or deliver treatments; they could provide drug delivery, photodynamic therapy, or read the genetic code and detect errors. Other examples are titanium-bases micro-needles to control drug delivery, carbon nanotubes that trace the shape of the DNA and make a map, and quantum dots as sensors. Their ability to penetrate cell membranes allows some nanoparticles to enter the human body, travel easily through the bloodstream and deposit in organs. Skin, lungs and the in- testine are likely to be the first entry route for such nanomaterials into the human body. Nano-applications, by contrast, are tiny devices deliberately inserted into the human body as a tool for tracking, diagnosis or treat- ment delivery without handling or exposure Nanomedicine opens up of the patient. untold prospects, but A big aim is to develop a single, multi- at what price for the integrity of humankind, purpose nano-device that will be able to as- personal free agency sist in imaging inside the body, recognize pre- and respect for privacy? Image: © Belga, NSP cancerous or cancerous cells, release a drug that targets only those cells, and report back on the effectiveness of the treatment. Nano-applications in humans should There are two key considerations when deliver a better quality of life and health, but implementing nano-devices. One relates to there are inherent risks in the development of the individual or patient who must specifical- any new technology. The ethical issues must ly consent to having the device implanted in be considered to gain a more rounded view of their body. The other is how the nano-device what the consequences might be, and how so- itself reacts once in the organism, its effects ciety can respond to them. Ethical concerns and safety. have been raised in the sphere of health care For the individual, the risks and adverse in relation to implanting nano-devices and outcomes of agreeing to a nano-implant raise the possibility for human enhancement of- issues of autonomy – control over one’s body fered by the use of nanotechnologies. – privacy, data protection, and informed con- 3. Freitas, RA 2005, sent. It also has wider societal implications, What is nanomedicine? Nano-implants in the human body raising questions of prudence and distribu- Nanomedicine: Nanotech. tive justice. Biol. Med. 1, p. 2-9. Nanotechnology could change the face On the technical side, the small size and of medical implants by allowing miniature complexity of nano-devices means that their 4. Freitas, RA 2005, devices to be further reduced in size and in- behaviour inside the human body may be Nanotechnology, serted in the human body to cure and repair unpredictable and uncontrollable, having un- nanomedicine and nanosurgery, International damaged cells using nano-materials that known effects that could cause a health prob- Journal of Surgery, Vol. 3, have improved biocompatibility and physi- lem. Future nanomaterials used in biomedical Issue 4, p. 243-246. ological integration with human tissue. applications must be biologically compatible, 38 Autumn-winter 2009/HesaMag #01 Special report 27/30 Lab-on-a-chip inside battle suits soldiers exposed to toxic agents and biological hazards by sampling one of their cells. The results Battlefield hospitals are not easily come by, so the can be available within 10 minutes. Institute for Soldiers Technologies based in Massa- chusetts, USA, is researching ways of improving the Another battle suit project is nano-enabled survival of soldiers in combat. Its exploration of the material and devices to far-forward medical treat- use of nanomaterials, has led it to develop laborato- ment and drug delivery, like splinting wounds ries on chips that will be fitted into battle suits. or preventing adverse movements after head or neck injury, and materials and devices to enable This lab-on-a-chip consists of nano-devices that controlled release of medication. carry out rapid, real-time medical monitoring of 5. Harris, J 2007, ment or any technology with health benefits Enhancing Evolution. The ethical case of making until we are in the position to provide equita- better people, Oxfordshire, ble and universal access. The more beneficial Princeton University Press. the technology, whether it be therapeutic or Professor John Harris, enhancing, the greater moral imperative for British philosopher at the wide and equitable access"5. The complexity University of Manchester, of the issue, however, lies in ensuring safety defends a libertarian (of treatments and effects) and universal ac- position on bioethical issues. cess, among other matters that must be ad- dressed in order to justify enhancements. Human enhancement means the aug- mentation, improvement, enrichment or addition of human functions, sensorial per- formances (physical and performance excel- as well as functional within biological fluids tions about health, life