Heart nanotechnology is the "Engineering of functional systems at the molecular scale" ("Nanotechnology Research"). [1]
Nanotechnology deals with structures and materials that are approximately one to one-hundred nanometers in length. At this microscopic level, quantum mechanics take place and are in effect, resulting in behaviors that would seem quite strange compared to what humans see with the naked eye (regular matter). Nanotechnology is used for a wide variety of fields of technology, ranging from energy to electronics to medicine. In the category of medicine, nanotechnology is still relatively new and has not yet been widely adopted by the field. It is possible that nanotechnology could be the new breakthrough of medicine and may eventually be the solution and cure for many of the health problems that humans encounter. Nanotechnology may lead to the cure for illnesses such as the common cold, diseases, and cancer. It is already starting to be used as a treatment for some serious health issues; more specifically it is being used to treat the heart and cancer.[ citation needed ]
Nanotechnology in the field of medicine is more commonly referred to as nanomedicine. Nanomedicine that deals with helping the heart is really starting to take off and gain in popularity compared to most of the other fields that nanomedicine currently has to offer. There are several heart problems that nanotechnology has promising evidence of being effective in the treatment of heart disease in the near future.
It should hopefully be able to treat heart valves that are defective; and detect and treat arterial plaque in the heart ("Nanotechnology Made Clear"). Nanomedicine should be able to help heal the hearts of people that have already been victims of heart disease and heart attacks. On the other hand, it will also play a key role in finding people with a high risk of having heart disease, and will be able to help prevent heart attacks from happening in the first place. Nanotechnology of the heart is a lot less invasive than surgery because everything is occurring at a minuscule level in the body compared to relatively large tissues that are dealt with in surgery. With our technology today, heart surgeries are performed to treat the damaged heart tissue that resulted from a heart attack. This is a major surgery that usually takes a couple of months to recover from ("WebMD - Better Information. Better Health"). During this period, patients are extremely limited in the activities that they can do. This long recovery process is an inconvenience to the patients, and with the growth of medicine it most likely won't be very long before a more efficient method for treating heart attack patients will be developed and used.[ citation needed ] The method that is the frontrunner to replace major heart surgery is the use of nanotechnology. There are a couple alternate ways to heart surgery that nanotechnology will potentially be able to offer in the future.
With people that have heart disease or that have suffered a heart attack, their hearts are often damaged and weakened. The more minor forms of heart failure do not require surgery and are often treated with medications ("WebMD - Better Information. Better Health"). The use of nanotechnology on treating damaged hearts will not replace these milder heart problems, but rather the more serious heart problems that currently require surgery or sometimes even heart transplants.
A group of engineers, doctors and materials scientists at MIT and Children's Hospital Boston have teamed together and are starting the movement of finding a way to use nanotechnology to strengthen the weakened heart tissue ("MIT - Massachusetts Institute of Technology"). The first method uses nanotechnology combined with tissue engineering, and gold nanowires are placed and woven into the damaged parts of the heart, essentially replacing the non-functioning or dead tissues. [2]
The other approach would potentially use minuscule nanoparticles that would travel through the body and find dying heart tissue. The nanoparticles would be carrying objects such as "stem cells, growth factors, drugs and other therapeutic compounds,". [2] Then the nanoparticles would release the compounds and inject them into the damaged heart tissue. This would theoretically lead to the regeneration of the tissue. [2]
Being able to fix cardiac tissue that has been damaged from a heart attack or heart disease is not very simple and it is one of the major challenges today in the field of tissue engineering ("Popular Science"). This is because heart cells are not the easiest objects to create in a lab. It takes an enormous amount of special care and work to develop the cells so that they beat in sync with one another ("Popular Science"). Even after the heart cells have finally been made, it is also a large task to insert the cells into the inoperable parts of the heart and to get them working in unison with the tissues that were still working properly ("Popular Science").
There have been several successful examples of this with the use of a "stem-cell- based heart patch developed by Duke University researchers," ("Popular Science"). The biomaterials that make up the patch are usually made of either biological polymers like alginate or synthetic polymers such as polylactic acid ("Nature Nanotechnology"). These materials are good at organizing the cells into functioning tissues; however they act as insulators and are poor conductors of electricity, which is a major problem especially in the heart ("Nature Nanotechnology"). Since the electrical signals that are sent between calcium ions are what control when the cardiomyocytes of the heart contract, which makes the heart beat, the stem-cell heart patch is not very efficient and not as effective as doctors would like it to be ("Popular Science"). The results of the patch not being very conductive is that the cells are not able to attain a smooth, continuous beat throughout the entire tissue containing the stem cells. This results in the heart not functioning properly, which in turn could mean that more heart problems might arise due to the implanting of the stem cells.
Recently[ when? ] there have been some new developments in the field of nanotechnology that will be more efficient than the poorly conducting stem-cell-based patch ("Nature Nanotechnology"). Scientists and researchers found a way for these stem cell patches (also known as tissue scaffolds) to be conductive and therefore become exponentially[ citation needed ] more effective ("Nature Nanotechnology"). They found that by growing gold nanowires into and through the patches, they were able to greatly increase the electrical conductivity. [2] The nanowires are thicker than the original scaffold and the cells are better organized as well. [2] There is also an increase in production of the proteins needed for muscle calcium binding and contraction. [2] The gold nanowires poke through the stem cell's scaffolding material, which strengthens the electrical communication between surrounding heart cells. [2] Without the nanowires, the stem cell patches produced a minute current and the cells would only beat in small clusters at the stimulation origin. [2] With the nanowires, the cells seem to contract together even when they are clustered far away from the source of stimulation. [2] The use of gold nanowires with the stem cell heart patches is still a relatively new concept and it will probably be awhile before they will be used in humans. It is hoped that the nanowires will be tested in live animals in the near future. [2]
Another way that nanotechnology will potentially be used to help fix damaged heart tissues is through the use of guided nanoparticle "missiles". [2] These nanoparticles can cling to and attach to artery walls and secrete medicine at a slow rate ("MIT-Massachusetts Institute of Technology"). The particles, known as nanoburrs due to the fact that they are coated with little protein fragments that stick to and target certain proteins. The nanoburrs can be made to release the drug that is attached to them over the course of several days ("MIT-Massachusetts Institute of Technology"). They are unique compared to regular drugs because they can find the particular damaged tissue, attach to it, and release the drug payload that is attached to it ("MIT-Massachusetts Institute of Technology"). What happens is the nanoburrs are targeted to a certain structure, known as the basement membrane; this membrane lines the arterial walls and is only present if the area is damaged. Nanoburrs could be able to carry drugs that are effective in treating the heart, and also potentially carry stem cells to help regenerate the damaged heart tissue ("MIT-Massachusetts Institute of Technology").
The particles are made up of three different layers and are sixty nanometers in diameter ("MIT-Massachusetts Institute of Technology").The outer layer is a coating of polymer called PEG, and its job is to protect the drug from disintegrating while it is traveling through the body. The middle layer consists of a fatty substance and the inner core contains the actual drug along with a polymer chain, which controls the amount of time it will take before the drug is released ("MIT-Massachusetts Institute of Technology").
In a study done on rats, the nanoparticles were injected directly into the rat's tail and they still were able to reach the desired target (the left carotid artery) at a rate that was twice the amount of the non-targeted nanoparticles ("MIT-Massachusetts Institute of Technology"). Because the particles can deliver drugs over a long period of time, and can be injected intravenously, the patients would not need to have multiple repeated injections, or invasive surgeries on the heart which would be a lot more convenient. The only downside to this is that the existing delivery approaches are invasive, requiring either a direct injection into the heart, catheter procedures, or surgical implants. [2] There is no question, however, that the future of heart repairs and heart disease/attack prevention will definitely involve the use of nanotechnology in some way.[ citation needed ]
Polyketal nanoparticles are pH-sensitive, hydrophobic nanoparticles formulated from poly(1-4-phenyleneacetone dimethylene ketal). [3] They are an acid-sensitive vehicle of drug delivery, specifically designed for targeting the environments of tumors, phagosomes, and inflammatory tissue. [3] In such acidic environments, these nanoparticles undergo accelerated hydrolysis into low molecular weight hydrophilic compounds, consequently releasing their therapeutic contents at a faster rate. [3] Unlike polyester-based nanoparticles, polyketal nanoparticles do not generate acidic degradation products following hydrolysis [3] [4]
Post-myocardial infarction, inflammatory leukocytes invade the myocardium. Leukocytes contain high amounts of Nicotinamide adenine dinucleotide phosphate (NADPH) and Nox2. [5] [6] Nox2 and NADPH oxidase combine to act as a major source of cardiac superoxide production, which in excess can lead to myocyte hypertrophy, apoptosis, fibrosis, and increased matrix metalloproteinase-2 expression. [5] In a mouse-model study by Somasuntharam et al. 2013, polyketal nanoparticles were used as a delivery vehicle for siRNA to target and inhibit Nox2 in the infarcted heart. [7] Following intramyocardial injection in vivo, Nox2-siRNA nanoparticles prevented upregulation of Nox2-NADPH oxidase, and improved fractional shortening. [7] When taken up by macrophages in the myocardium following a MI, the nanoparticles degraded in the acidic environment of the endosomes/phagosomes, releasing Nox2-specific siRNA into the cytoplasm. [7]
Polyketal nanoparticles have also been used in the infarcted mouse heart to prevent ischemia-reperfusion injury caused by reactive oxygen species (ROS). [8] Levels of the antioxidant Cu/Zn-superoxide dismutase (SOD1), which scavenges harmful ROS, decrease following MI. [9] SOD1-enacapsulated polyketal nanoparticles are able to scavenge reperfusion-injury induced ROS. [8] Furthermore, this treatment improved fractional shortening, suggesting the benefit of targeted delivery by polyketals. One of the key advantages of polyketal use is that they do not exacerbate the inflammatory response, even when administered at concentrations exceeding therapeutic limits. [10] In contrast to commonly used poly(lactic-co-glycolic acid) (PLGA) nanoparticles, polyketal nanoparticle administration in mice instigates little recruitment of inflammatory cells. [10] Additionally, intramuscular injection of polyketals into the leg of rats shows no significant increases in inflammatory cytokines such as IL-6, IL-1ß, TNF-α and IL-12. [10]
Nanomedicine is the medical application of nanotechnology. Nanomedicine ranges from the medical applications of nanomaterials and biological devices, to nanoelectronic biosensors, and even possible future applications of molecular nanotechnology such as biological machines. Current problems for nanomedicine involve understanding the issues related to toxicity and environmental impact of nanoscale materials.
Troponin, or the troponin complex, is a complex of three regulatory proteins that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle. Measurements of cardiac-specific troponins I and T are extensively used as diagnostic and prognostic indicators in the management of myocarditis, myocardial infarction and acute coronary syndrome. Blood troponin levels may be used as a diagnostic marker for stroke or other myocardial injury that is ongoing, although the sensitivity of this measurement is low.
The endocardium is the innermost layer of tissue that lines the chambers of the heart. Its cells are embryologically and biologically similar to the endothelial cells that line blood vessels. The endocardium also provides protection to the valves and heart chambers.
Stem-cell therapy uses stem cells to treat or prevent a disease or condition. As of 2024, the only FDA-approved therapy using stem cells is hematopoietic stem cell transplantation. This usually takes the form of a bone marrow or peripheral blood stem cell transplantation, but the cells can also be derived from umbilical cord blood. Research is underway to develop various sources for stem cells as well as to apply stem-cell treatments for neurodegenerative diseases and conditions such as diabetes and heart disease.
Targeted drug delivery, sometimes called smart drug delivery, is a method of delivering medication to a patient in a manner that increases the concentration of the medication in some parts of the body relative to others. This means of delivery is largely founded on nanomedicine, which plans to employ nanoparticle-mediated drug delivery in order to combat the downfalls of conventional drug delivery. These nanoparticles would be loaded with drugs and targeted to specific parts of the body where there is solely diseased tissue, thereby avoiding interaction with healthy tissue. The goal of a targeted drug delivery system is to prolong, localize, target and have a protected drug interaction with the diseased tissue. The conventional drug delivery system is the absorption of the drug across a biological membrane, whereas the targeted release system releases the drug in a dosage form. The advantages to the targeted release system is the reduction in the frequency of the dosages taken by the patient, having a more uniform effect of the drug, reduction of drug side-effects, and reduced fluctuation in circulating drug levels. The disadvantage of the system is high cost, which makes productivity more difficult, and the reduced ability to adjust the dosages.
Cardiomyoplasty is a surgical procedure in which healthy muscle from another part of the body is wrapped around the heart to provide support for the failing heart. Most often the latissimus dorsi muscle is used for this purpose. A special pacemaker is implanted to make the skeletal muscle contract. If cardiomyoplasty is successful and increased cardiac output is achieved, it usually acts as a bridging therapy, giving time for damaged myocardium to be treated in other ways, such as remodeling by cellular therapies.
A coronary stent is a tube-shaped device placed in the coronary arteries that supply blood to the heart, to keep the arteries open in patients suffering from coronary heart disease. The vast majority of stents used in modern interventional cardiology are drug-eluting stents (DES). They are used in a medical procedure called percutaneous coronary intervention (PCI). Coronary stents are divided into two broad types: drug-eluting and bare metal stents. As of 2023, drug-eluting stents were used in more than 90% of all PCI procedures. Stents reduce angina and have been shown to improve survival and decrease adverse events after a patient has suffered a heart attack—medically termed an acute myocardial infarction.
A biointerface is the region of contact between a biomolecule, cell, biological tissue or living organism or organic material considered living with another biomaterial or inorganic/organic material. The motivation for biointerface science stems from the urgent need to increase the understanding of interactions between biomolecules and surfaces. The behavior of complex macromolecular systems at materials interfaces are important in the fields of biology, biotechnology, diagnostics, and medicine. Biointerface science is a multidisciplinary field in which biochemists who synthesize novel classes of biomolecules cooperate with scientists who have developed the tools to position biomolecules with molecular precision, scientists who have developed new spectroscopic techniques to interrogate these molecules at the solid-liquid interface, and people who integrate these into functional devices. Well-designed biointerfaces would facilitate desirable interactions by providing optimized surfaces where biological matter can interact with other inorganic or organic materials, such as by promoting cell and tissue adhesion onto a surface.
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction to the heart muscle. The most common symptom is retrosternal chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. The pain may occasionally feel like heartburn. This is the dangerous type of Acute coronary syndrome.
Nano-scaffolding or nanoscaffolding is a medical process used to regrow tissue and bone, including limbs and organs. The nano-scaffold is a three-dimensional structure composed of polymer fibers very small that are scaled from a Nanometer scale. Developed by the American military, the medical technology uses a microscopic apparatus made of fine polymer fibers called a scaffold. Damaged cells grip to the scaffold and begin to rebuild missing bone and tissue through tiny holes in the scaffold. As tissue grows, the scaffold is absorbed into the body and disappears completely.
Amniotic stem cells are the mixture of stem cells that can be obtained from the amniotic fluid as well as the amniotic membrane. They can develop into various tissue types including skin, cartilage, cardiac tissue, nerves, muscle, and bone. The cells also have potential medical applications, especially in organ regeneration.
Arginylglycylaspartic acid (RGD) is the most common peptide motif responsible for cell adhesion to the extracellular matrix (ECM), found in species ranging from Drosophila to humans. Cell adhesion proteins called integrins recognize and bind to this sequence, which is found within many matrix proteins, including fibronectin, fibrinogen, vitronectin, osteopontin, and several other adhesive extracellular matrix proteins. The discovery of RGD and elucidation of how RGD binds to integrins has led to the development of a number of drugs and diagnostics, while the peptide itself is used ubiquitously in bioengineering. Depending on the application and the integrin targeted, RGD can be chemically modified or replaced by a similar peptide which promotes cell adhesion.
Myocardial infarction complications may occur immediately following a myocardial infarction, or may need time to develop. After an infarction, an obvious complication is a second infarction, which may occur in the domain of another atherosclerotic coronary artery, or in the same zone if there are any live cells left in the infarct.
Human HGF plasmid DNA therapy of cardiomyocytes is being examined as a potential treatment for coronary artery disease, as well as treatment for the damage that occurs to the heart after MI. After MI, the myocardium suffers from reperfusion injury which leads to death of cardiomyocytes and detrimental remodelling of the heart, consequently reducing proper cardiac function. Transfection of cardiac myocytes with human HGF reduces ischemic reperfusion injury after MI. The benefits of HGF therapy include preventing improper remodelling of the heart and ameliorating heart dysfunction post-MI.
Human engineered cardiac tissues (hECTs) are derived by experimental manipulation of pluripotent stem cells, such as human embryonic stem cells (hESCs) and, more recently, human induced pluripotent stem cells (hiPSCs) to differentiate into human cardiomyocytes. Interest in these bioengineered cardiac tissues has risen due to their potential use in cardiovascular research and clinical therapies. These tissues provide a unique in vitro model to study cardiac physiology with a species-specific advantage over cultured animal cells in experimental studies. hECTs also have therapeutic potential for in vivo regeneration of heart muscle. hECTs provide a valuable resource to reproduce the normal development of human heart tissue, understand the development of human cardiovascular disease (CVD), and may lead to engineered tissue-based therapies for CVD patients.
Regeneration in humans is the regrowth of lost tissues or organs in response to injury. This is in contrast to wound healing, or partial regeneration, which involves closing up the injury site with some gradation of scar tissue. Some tissues such as skin, the vas deferens, and large organs including the liver can regrow quite readily, while others have been thought to have little or no capacity for regeneration following an injury.
Eosinophilic myocarditis is inflammation in the heart muscle that is caused by the infiltration and destructive activity of a type of white blood cell, the eosinophil. Typically, the disorder is associated with hypereosinophilia, i.e. an eosinophil blood cell count greater than 1,500 per microliter. It is distinguished from non-eosinophilic myocarditis, which is heart inflammation caused by other types of white blood cells, i.e. lymphocytes and monocytes, as well as the respective descendants of these cells, NK cells and macrophages. This distinction is important because the eosinophil-based disorder is due to a particular set of underlying diseases and its preferred treatments differ from those for non-eosinophilic myocarditis.
Tissue engineered heart valves (TEHV) offer a new and advancing proposed treatment of creating a living heart valve for people who are in need of either a full or partial heart valve replacement. Currently, there are over a quarter of a million prosthetic heart valves implanted annually, and the number of patients requiring replacement surgeries is only suspected to rise and even triple over the next fifty years. While current treatments offered such as mechanical valves or biological valves are not deleterious to one's health, they both have their own limitations in that mechanical valves necessitate the lifelong use of anticoagulants while biological valves are susceptible to structural degradation and reoperation. Thus, in situ (in its original position or place) tissue engineering of heart valves serves as a novel approach that explores the use creating a living heart valve composed of the host's own cells that is capable of growing, adapting, and interacting within the human body's biological system.
Erin Baker Lavik is an American bioengineer serving as the deputy director and chief technology officer of the National Cancer Institute's Division of Cancer Prevention (DCP) since 2023. She was previously a professor of chemical, biochemical, and environmental engineering at the University of Maryland, Baltimore County. Lavik develops polymers and nanoparticles that can protect the nervous system. She is a fellow of the American Institute for Medical and Biological Engineering.
Milica Radisic is a Serbian Canadian tissue engineer, academic and researcher. She is a professor at the University of Toronto’s Institute of Biomaterials and Biomedical Engineering, and the Department of Chemical Engineering and Applied Chemistry. She co-founded TARA Biosystems and is a senior scientist at the Toronto General Hospital Research Institute.