Keywords

1 Introduction

The term nanotechnology is derived from the Greek word “nano” that means “dwarf” (short man). The term “Nano” means very tiny in size, the scale 10−9 m or less. All natural materials and systems have their roots at the nanoscale. The basic material for any living organism, i.e., DNA itself has a nano size. Nanotechnology is the science that deals with materials of nano size range. The most emerging field of science and technology is nanobiotechnology that brings together biology, chemistry, physics, and many areas of engineering, biotechnology, and medicine [1]. Nanobiotechnology has been evolved as an entirely new scientific and technological area from the fusion of nanotechnology and biotechnology. It reflects the demanding importance of nanoscience and nanotools in the generation of novel biomaterials for use in tissue engineering, nanosensors used in diagnostics, nanopores that facilitate the passage of single molecules for DNA sequencing, nanomaterials for application in imaging single molecules or cells, and devices for therapeutic application [2,3,4,5]. By integrating innovative applications of nanotechnology into modern biological issues, many approaches of life sciences are being developed by nanobiotechnology [6].

One of the most elegant emerging fields of applied nanobiotechnology is nanomedicine. Nanobiotechnology has its vast application in different branches of medical science. Tissue engineering, advance medical imaging, clinical diagnosis, nano drug formulation, nanobiosensors are some of the important areas where nanobiotechnology plays a leading role (Fig. 1.1).

Fig. 1.1
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Emerging of nanomedicine by application of nanobiotechnology

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The use of nanobiotechnology to revolutionize the medical fields is being highly focused by the scientist. The basic physiological mechanisms of an organism occur at molecular level, i.e., in the nano scale. Understanding different molecular level mechanisms related to physiological changes leads to development of new ideas in the medical perspectives. Drug targeting at molecular level, use of nanosensors, nanopores, quantum dots are some of the significant examples of recent development in nanomedicine [7,8,9,10]. It plays a vital role in advanced biology and medical analysis notably within the development of potential targeted delivery systems with lower drug toxicities and higher efficiencies. It has applications in almost each medical branch like neurological disorders (nanoneurology), eye diseases (nanoophthalmology), cardiovascular disorders (nanocardiology), cancer (nanooncology), diseases of skeletal system (nanoorthopedics), and infectious diseases. Although the application of engineering to drugs seems to be a comparatively recent trend, the basic nanotechnology approaches for medical application dates back to several decades [11,12,13,14,15]. Nanomedicine can likewise be viewed as a refinement of sub-atomic medication and coordinates in genomics and proteomics to encourage the improvement of customized medication. Nanobiotechnology affects the advancement of nanomedicine both legitimately just as by improving different trains, for example, the delivery of nanopharmaceuticals and atomic diagnostics. Similar advancements encourage the improvement of personalized medication corresponding to nanomedicine [7]. Nanotechnologies can expand the limits of current molecular diagnostics and empower purpose of care diagnostics, theranostics, and advancement of personalized medication [16, 17].

1.1 Advantages of Nanomedicine

Nanomedicine is being applied to design site specific drug delivery, new techniques for diagnosis and imaging. The advantages of nanomedicine can be categorized into the benefits of nanotherapeutics, nanodiagnostics, and nanotheranostics [16,17,18,19] (Table 1.1). This chapter highlights the application of nanobiotechnology in different fields of nanomedicines. Diagnostic, therapeutic, and clinical application of nanomedicines including recent patents are also discussed.

Table 1.1 Advantages of nanomedicine
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2 Application of Nanobiotechnology in Nano Medicine

2.1 Diagnosis

Conventional diagnoses for most of the diseases are done by physical examination of symptoms. As the symptom may take time to appear, treatment for those illnesses may have lost their effectiveness. It would be convenient and effective if a disease can be detected at the earliest state of its occurrence. Molecular diagnosis plays a notable role to identify pathogens and diseased cells at very early stage of disease with no symptoms. Nanobiotechnology alters the way of diagnosis by improving sensitivity and better efficacy. Major nanodiagnostics application of nanobiotechnology includes nanobiosensors, biochips and microarrays, nanopore technology, biobarcode, nanoparticle based imaging and labeling, nanoproteomic based diagnosis [20]. Most of the nanodiagnostics technologies are in clinical use and still many are at their development phase.

2.1.1 Nanobiosensors

It is one of the most hopeful, concise systems consisting of a biological element (responsible for sampling), and a physical element or transducer (transmitting sampling results for further processing). Detecting an analyte using a transducer by utilizing biochemical reaction to quantify the amount of analyte is the working principle of biosensors [21]. For instance, carbon nanotubes (CNTs) show appropriate electrochemical properties for label-free and multiplexed point-of-care biosensitivity. These were effectively utilized to identify ions, metabolites, and protein biomarkers [22, 23]. They had been used for detection of prostate cancer [24]. CNT-based optical nanobiosensors have been effectively utilized for the determination of immunoglobulins, surface-enhanced Raman spectroscopy (SERS) based biomedical imaging, and phototherapy [25, 26]. Aptamer-AuNPs hybrid frameworks have been showed useful for the identification of specific tumor cells [27, 28]. Comparable hybrid frameworks have been used for combined in vitro imaging and photothermal treatment in oral cancer epithelial cells [29]. Quantum dots (QDs) based lab-on-chip, multiplexed sandwiched immunoassay has been utilized to recognize various lung cancer related biomarkers, for example, carcinoembryonic antigen (CEA), cytokeratin 19 pieces (CYFRA21-1), and neuron-explicit enolase (NSE) in biological fluid [30]. QD based nanosensor was in a nuclease-enzyme-based amplification approach for fluorescence resonance energy transfer (FRET)-based detection of femtomolar concentrations of miRNA [31]. Electrochemical molecularly bioimprinted siloxane biosensor has been utilized for ultra-sensing of gemcitabine as a lung cancer chemotherapy medication [32]. AuNRs modified by ssDNA probes of cadF gene have been developed for precise detection of Campylobacter jejuni and Campylobacter coli [33]. AuNPs conjugated mesoporous silica-graphene oxide nanoconstructs were effectively utilized for optical bioimaging in colorimetric tumor cell diagnosis [34]. Silicon nanowires (SiNWs) were utilized in sensors as field effect transistors (FETs). FET-SiNWs have been appeared to detect numerous prostate cancer biomarkers, for example, PSA (prostate-specific antigen) at very early stage [35].

2.1.2 Biochips/Microarray

These are nanoscale devices (normally made of glass or silicon base) to coordinate various processes for DNA/protein analysis. These chips are highly sensitive to interact with cellular constituents. Receptor-functionalized nanomotors are capable to isolate biological targets, for example, pancreatic cancer cells and E. coli from biological samples [36, 37]. Protein microarrays have been used in analysis of protein level in colon carcinoma cells with exposure to ionizing radiation [38, 39]. This protein analysis helps in the differentiation of the protein level in normal cells compared to premature and metastatic cancer cells [40]. Protein microarray-based analyses of protein–protein interaction and IgE immunoassay for allergy diagnosis have been reported [38, 41, 42].

2.1.3 Nanopore Technology

A nanopore is a pore of nanometer size. It comprises a pore-forming protein or as a pore in silicon or graphene. It has been well reported to be used in DNA sequencing. Working principle is the detection of the ionic current passing through it as a voltage is applied across the membrane [43, 44]. Label-free detection of post-translational modifications of protein has been achieved by using single-cell biological nanopore and has tremendous potential for disease diagnosis and cell biology [45]. Bacterial lower respiratory tract infections using nanopore sequencing has been reported as rapid and potential clinical diagnosis tool to replace culture diagnosis [46]. It is applied for cancer diagnosis and treatment through the identification and accurate estimation of MicroRNA (miRNA—cancer biomarkers) and the determination of aberrant DNA methylation as a robust biomarker in cancer. It offers, utilizing MinION stage (Oxford Nanopore Technologies), a viable technique for quick, genome-wide screening of salmonoid RNA virus, with significant potential applications for diagnostics and details investigation concerning the origins and spread of disease outbreaks [47].

2.1.4 Biobarcode

Nanoparticle based biobarcode assay is an ultrasensitive and powerful strategy for the determination of biological targets, for example, proteins and nucleic acids. It works on two target specific probes: Magnetic micro beads (MMB) bearing biological probe to identify the target and the second gold nanoparticles (AuNPs) bearing target binding molecule, called biobarcode (an oligonucleotide) [48,49,50,51]. The biobarcode method has been successfully used for rapid and reliable detection of amyloid-derived diffusible ligands (ADDL) in cerebrospinal liquid (CSF) for the clinical diagnosis of Alzheimer’s disease [52], E. coli O157:H7 microbes by means of AuNP labeling and inductively coupled plasma mass spectrometry (ICP-MS) [53], hepatitis C virus (HCV) core antibodies utilizing a TaqMan probe [54]. This method was reported to be potential diagnostic tool for the detection of PSA [55], the Vibrio cholerae O1 OmpW gene [56], and Staphylococcus aureus protein A [57].

2.1.5 Nanoparticle Based Imaging and Labeling

Nanotechnologies offer various opportunities for improving existing and designing of new imaging methods. Nanoparticles of perfluorohydrocarbons coated with a lipid layer have been reported as an ultrasonic contrast agent [58]. Iron oxide NPs have been clinically applied as MRI contrast agent, for example, superparamagnetic nanoparticles [59], ultra-small SPIO improves MRI for imaging cerebral ischemic injuries and dextran-coated iron oxide nanoparticle improves MRI visualization of intracranial tumors [60, 61]. The fluorescent in situ hybridization (FISH) combined with conventional fluorescence microscopy and fluorescence confocal microscopy have been successfully used to localize abnormal gene related to a disease and to diagnose and differentiate infected erythrocytes from normal erythrocytes [9, 62, 63]. Surface-enhanced Raman scattering (SERS) is generally applied in the detection of small quantity of circulating tumor cells, RNA, nucleic acid, lipids, and proteins present in blood samples [64,65,66,67,68,69]. It is also used in cancer diagnosis. The single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been reported for radiotracer-based targeted in vivo imaging [70].

2.1.6 Nanoproteomic Based Diagnosis

Nanoproteomics can reveal critical information related to rare cell populations, hard-to-obtain clinical specimens, the cellular heterogeneity of pathological tissues, and disease biomarkers. These information help in early diagnosis of a disease and monitoring of disease progression. Magnetic nanospherical probes functionalized with antibodies were utilized to recognize anti-HSA antibody [71]. Identification of target autoantibody GDC glutamate decarboxylase (Type 1 diabetes) was successfully accomplished by utilizing supramolecular nanoprobes [72]. AuNP or europium NP-based bio-barcode identification approach utilized for signal intensification of HIV-1 p24 immunoassay [73]. Sol–gel immobilized nanostructure zinc film was utilized for Neisseria gonorrhoeae identification [74]. Serum small extra vesicles proteome of tuberculosis patients showed typical deregulation and consequently, could be helpful for designing alternate host-directed therapeutic interventions [75]. The sputum proteomics study helps to separate active TB from non-TB patients with moderate accuracy [76].

2.2 Therapeutics

Today nanoformulation plays a leading role in drug delivery and development. Due to several advantages like high efficacy, site specific delivery over conventional drug therapy, nanotherapeutics is now highly focused for achieving health benefits. Polymeric nanoparticles, liposomes, nanogels, siRNA, dendrimers, and gene drug delivery are some of the highly anticipated nanobiotechnology used in therapeutic nanomedicine application. Over the past few decades, the US FDA has approved 100 nanomedicine formulations [77]. This shows that nanotechnology is playing an immense role in today’s biomedical science [78, 79].

2.2.1 Polymeric Nanoformulation

The polymeric nanoparticles are fabricated from synthetic and/or natural polymers. The synthetic polymers are preferred over natural one due to their good availability with higher purity, batch to batch reproducibility, and controlled release behavior for the entrapped drug(s) [80]. Some examples of biodegradable and non-biodegradable polymers commonly used in the preparation of polymeric nanoparticles are polylactide (PLA), poly lactide-co-glycolide, copolymers (PLGA) and poly (ε-caprolactone), polyacrylates, and poly (methyl methacrylate) [81]. Both hydrophilic and hydrophobic drugs can be encapsulated into polymeric nanoparticles by emulsion solvent evaporation, double emulsion solvent evaporation technique, or other suitable methods. A few of the popularly marketed polymeric nanoparticles are Decapeptyl®, Gonapeptyl Depot®, Enantone Depot®, and Abraxane [82, 83].

2.2.2 Liposomes

Liposome based drug delivery systems enhance the therapeutic indices of various drugs through alterations in their pharmacokinetics and pharmacodynamics. A few liposome products have become commercially available for the management of various cancer and fungal infections. For examples, Doxil® for the treatment of ovarian cancer and AIDS-related Kaposi’s sarcoma [84], DaunoXome® for the management of advanced HIV-associated Kaposi’s sarcoma [85]. A few more commercial liposome products are Depocyt® by SkyPharma Inc., Myocet® by Elan Pharmaceuticals, Mepact® by Takeda Pharmaceutical, Marqibo® by Talon Therapeutics [86,87,88], and Onivyde™ by Merrimack Pharmaceuticals, Inc. [86,87,88,89]. For fungal infections, the US FDA approved Amphotec® and Ambisome® in 1996 and 1997, respectively [90, 91].

2.2.3 Nanogels

A nanogel is a nanoparticle composed of a hydrogel—a crosslinked hydrophilic polymer network. Various bioactive compounds such as DNA, proteins, and drugs can be encapsulated in polymeric mesh for drug delivery for various biomedical applications [92, 93]. The preparation methods include micro-molding and photolithographic methods, continuous microfluidics, and free radical polymerization techniques [94]. Chitin nanogel based clobetasol (anti-psoriatic drug) exhibited strong cytotoxicity towards THP-1 and HaCaT cell lines by MTT assay [95]. Sane Care Nanogel, Zyflex Nanogel, Augen Nanogel Eye-care Gel, Skin Perfect Brightening Nanogel, and Oxalgin Nanogel formulation are commercially available [96].

2.2.4 siRNA

Small interfering RNA (siRNA), sometimes known as short interfering RNA or silencing RNA, is a class of double-stranded RNA. It is an exciting new tool in molecular biology and the next frontier in molecular medicine [97,98,99]. The therapeutic advantages of siRNAs for treatment of viral infection, dominant disorders, cancer, and neurological disorders show great promise. Gold nanorod and trimer of N-acetylgalactosamine (GalNAc) have been reported as carrier for the delivery of siRNA [100,101,102,103]. In another study, siRNA targeting Beclin1 was conjugated to ferric–cobalt electro-magnetic nanomaterial (CoFe2O4@ BaTiO3; MENP-siBeclin1) to deliver siRNA into the brain. This novel drug delivery system was effective against HIV-1 infection following on-demand release of siRNA using an in vitro human BBB model [104]. Anticancer siRNA therapeutics has no or negligible side effects as compared to chemotherapeutics. Scientists have tried to target undruggable oncogenes like k-RAS or c-MYC siRNA in mouse model to develop RNAi based therapeutics [105]. siRNAs have been used against BCR/ABL transcripts induced apoptosis [106]. siRNAs have also been used to target K-RAS transcripts carrying the valine-112 oncogenic mutation (K-RASV112) [107]. SphK1 siRNA or JSI-124 showed strong pro-inflammatory effects on the progression of ulcerative colitis, which may be the therapeutic target for its treatment [108].

2.2.5 Dendrimers

Dendrimers are three-dimensional, globular hyper branched polymeric nanoarchistructures. Arginine terminated peptide dendrimers, along with sonophoresis improved the transdermal penetration of ketoprofen [109]. The most widely used dendrimers for pharmaceutical uses are poly-propyleneimine (PPI, AstromolR, DAB) [110] and polyamidoamine (PAMAM; Starburst) dendrimers [111]. The multifunctional dendrimers can carry cancer cell specific molecule, anticancer drug and molecule that recognizes the signals of cell death. Dendrimers are also capable for on-demand drug release within the cancer microenvironment [112,113,114].

2.2.6 Gene Drug Delivery

Gene delivery is the process of introducing foreign genetic material, such as DNA or RNA, into host cells. Genetic material must reach the nucleus of the host cell to induce gene expression. It is essential in gene therapy of human genetic diseases. The gene therapy is a promising therapy for inherited disorders, viral infection, and cancers. DNA-based gene delivery systems have been carried out for lentivirus, poxvirus, adenovirus, adeno-related virus, retrovirus, human foamy virus (HFV), and herpes virus [115]. RNA-based gene delivery systems have been done for HIV with lenti-viral vectors-adjusted CD 34(+) cells in patients experiencing transplantation for AIDS-related lymphoma [116]. In case of cancer, the cytokine immune-gene therapy is a promising strategy [117,118,119]. The previous literatures report on the development of gene delivery carriers. For examples, the cationic non-viral lipid-based gene carriers “lipoplexes” [120, 121], biodegradable poly (ethyleneimine) for plasmid DNA delivery [122], branched poly (ethyleneimine)-cholesterol water-soluble lipo-polymers [123], and polyethylene glycol-grafted poly (L-lysine) as polymeric gene carriers [124, 125] have been developed.

2.2.7 Other Nanoformulations

Nanoparticulate drug delivery systems can alter the PK/PD of poorly soluble drugs by increasing their solubility and bioavailability. Drugs loaded in NPs can be protected against external environment making them less sensitive to physical/chemical changes due to photo-oxidation [126,127,128]. US FDA approved nanocrystal drug formulations for target specific delivery, dose reduction, and enhanced safety profile. For examples, Tricor (fenofibrate, AbbVie), Emend (Aprepitant, Merck), and MAT2501 nanocrystal (Amikacin) [129,130,131]. Drugs can also be encapsulated into lipid and/or polymer core to alter their PK/PD properties [132, 133]. For examples, resveratrol loaded lipid-core nanocapsules (RSV-LNC) for targeting colon cancer [134] and ciprofloxacin loaded SLNs for better antibacterial activity [135]. Various delivery routes such as oral, dermal, pulmonary, ocular, and rectal routes have been investigated for the administration of nanocapsules [136,137,138,139,140,141]. Some iron oxide nanodrugs have been approved by US FDA for iron replacement therapies. For examples, Venofer (iron sucrose infusion, American Regent, Inc.), Ferrlecit (sodium ferric gluconate complex in sucrose infusion, Sanofi-Aventis U.S.), Infed (iron dextran infusion, Actavis Pharma), and Dexferrum (iron dextran infusion, American Regent, Inc.) indicated for anemia associated with chronic kidney disease [130]. There are also colloidal gold bound tumor necrosis factor and TNF-bound colloidal gold for anticancer effects [131].

2.2.8 Nano Surgery

Nanobiotechnology has significant application in the field of surgery. The development of surgical nanorobot is a significant achievement in the field of surgery. It can act as a semi-autonomous on-site surgeon inside the body guided by a human surgeon. Surgical procedures are performed through various functions such as pathology, diagnosing and correcting lesions by nanomanipulation via coded ultrasound signals, coordinated by an on-board computer and a human surgeon [142]. In femtosecond laser surgery, femtolaser is considered as a pair of nanoscissors by vaporizing tissue locally while leaving adjacent tissue unharmed [143]. Proteolytic liposomal NPs of collagenase were reported to enhance periodontal remodeling of the oral connective tissues that replaced surgical blades [144]. Nanorobotic microbivores have been developed for spying and removing unwanted pathogens from bloodstream [145].

2.2.9 Medical Implants

Medical implants are devices or tissues that are placed inside or on the surface of the body as prosthetics or for drug delivery or to control physiological functions or for giving support to body parts. Previous literatures showed that a significant development has been done in the field of medical implants using nanobiotechnology. Titanium spinal implants with surface modification through the addition of titanium oxide/zirconium nanoparticles have shown increased bone formation compared to conventional smooth implants [146]. Cervical cages modified with silicon nitride nanoparticles have shown multiple biomechanical advantages and commercially available [147]. The nanoLOCK™ by Titan Spine technology has been found to induce a higher osteogenic and angiogenic growth factors than with traditional titanium polyether-ether-ketone cages [148]. Additionally, arthroplasty implants [149], orthodontic implants [150], dental nanorobots [151], and dental implants [152] have also been reported in the literatures. Some commercially available medical implants include Nano TiteTM (Bicon LLC, Boston, USA), Nano TiteTM (Biomet 3i, Palm Beach Gardens, USA), OSSEANTM (IntraLock International, Boca Raton, FL, USA), and Osseo SpeedTM (Astra Tech, AB, Mӧlndal, Sweden) [153].

2.3 Clinical Advances and Patents

Currently, the approval process for nanomedicines in humans is regulated by the US FDA, and is essentially the same as that for any other regulated drug, device, or biologic [77]. As of October 2019, 68 clinical trials including the term “nano” were listed as “recruiting” or “active” on ClinicalTrials.gov. Likewise, 165 clinical trials including the term “liposome” were listed [154]. Both diagnostic and therapeutic nanomedicine those are in clinical trials or recently patented are listed in Tables 1.2 and 1.3.

Table 1.2 Recent nanomedicines in clinical development [154]
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Table 1.3 Recent US FDA approved nanomedicines [155]
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3 Challenges for Nanobiotechnology in Nanomedicine

The use of nanobiotechnology to nanomedicines is being expanding and developed day by day. However, numerous difficulties have also been faced by the researcher, industry, and regulators for doing as such [156]. Characterization of novel nanocompounds for their safety and toxicity is one of the major difficulties in nanomedicine development. Huge efforts have been given to discover how structure of nanoparticles and their properties like charge, size, shape, surface coats, and so on interact with living body system [129]. Lack of specific protocols for assessing of nanomedicines at the physicochemical and biological level influence their development [157]. US FDA has published guidelines regarding the importance of nanomaterial characterization [129]. The Nanotechnology Characterization Laboratory (NCL), set up by the National Cancer Institute, has additionally published guidelines about innovative platforms for the development of nanodrugs for cancer treatment [156]. Reports have been released in regard to the tendency of certain NPs to show toxicity at molecular, cellular, and tissue level [158]. Biological toxicities of NPs include oxidative stress, inflammation, immunotoxicity, genotoxicity, neurotoxicity, and carcinogenicity [159]. The harmful properties of NPs might be used positively for surgical removal of diseased tissues and cancer immunotherapy. Additionally, the toxicity of NPs can be reduced through surface coating with hydrophilic polymers to improve cell viability [160]. Cost for the development and regulatory approval of nanoformulations is other challenge, which is difficult to compensate for low selling nanomedicine. The withdrawal of nanomedicines from the market post FDA approval may be due to the toxicity issues. For examples, Feruglose and Resovist. Hence, phase 4 post-marketing pharmacovigilance is the major concern to further assess the safety of nanomedicine [161].

4 Conclusion and Future Aspects

Nanotechnology provides innovative nanodevices and nanosystems those are much smaller than a human cell. Such tools can be used at molecular and cellular levels to kill cancer cells or take over the function of subcellular organelles. Nanodiagnostics will enable routine detection of single particles of viruses or bacteria in minuscule samples. Nanobiotechnology will give nanodevices to look at tissues in minute details. Biosensors those are smaller than a cell would provide us an interior check out of cellular operation. With lab-on-chip utility using nanobiochips, routine check of diagnostic parameters of patients will come to a precise and fast effective theranostic measure. Research is increasing daily to find out newer drug delivery options, newer targeting strategies for medicinal products by the use of nanobiotechnology. Successful implementation of liposomal carrier system, DoxilR, in drug market is a land mark of nanomedicine that inspires industry and regulators to bring forward many more nanodrug formulations for human use. Increasing scenario of the clinical trials and FDA approved nanoformulation represent the growth of awareness utility and knowledge in this area. Such trends in nanoverse will lead to hand to hand use of medical application in the near future.

Nanomedicines have shown nice potential to handle clinical needs in various diseases. However, toxicity and ethical problems with nanomedicine are the major challenges. Fortunately, with the outburst of public and scientific awareness of nanobiotechnology, there is a detail discussion on these ethical and toxicological issues. The potential applications provided by nanotechnology for diagnosis, prevention, and treatment of diseases are presently terribly broad. Therefore, to pursue the sensible application of nanomedicine, there is a demand of straightforward approaches, and systematic development in conjunction with creativeness and visionary power.