Nanomedicine and the Cardiovascular System
Nanotechnology is having a rapidly expanding impact on all walks of life, including biology and medicine. At the basic end of the biological spectrum, nanotechnology tools such as atomic force microscopy, optical tweezers, and nanoparticle-based reporters provide unique insight into biological processes. At the clinical end of the spectrum, nanotechnology provides novel opportunities for a wide range of applications, including drug and nucleic acid delivery, diagnostic imaging, regenerative medicine, and in vitro diagnostics. Searching http://www.clinicaltrials.gov for the term nanoparticle reveals >100 studies, and more trials can be found using additional nanotechnology search terms. The majority of trials are in the oncology arena using nanoparticles as therapeutic delivery vehicles, but other trials include a broad range of diseases and applications, including cardiovascular, dental, multiple sclerosis and diabetes mellitus applications, wound dressings, antibacterial hand gels, and eye drops. This multi-author book addressing the application of nanotechnology to the cardiovascular system is thus timely, given the rapid growth in biological and medical application of nanotechnology. The book is part of a series, Nanoscience Applied to Health and Medicine, covering various clinical areas and technologies. Other books in the series have focused on diabetes mellitus, the nervous system, nanomedicine in health and disease, and diagnostics. Areas covered in this volume include in vitro diagnostics, molecular imaging, tissue engineering, and therapeutic delivery. Spanning >470 pages, and involving almost 80 contributors, the book includes 21 chapters, divided into 2 sections: “General Methods and Applications” and “Focused Areas, Treatments, and Diseases.” The preface indicates that the goal is to overcome the problem of technical writing being inaccessible to the novice by having unique sections for the novice and expert. To support this goal, each chapter includes a list of key facts, a glossary of definitions of key terms and phrases, and bulleted summary points in addition to an abstract. There are also sections on the application of the technologies to other areas of disease in each chapter, which helps to give a broader perspective.
The utility of the book for the nanotechnology novice would be helped by the provision of chapters giving an overview of each of the areas covered and the nanotechnology solutions being used. As an example, the first chapter, on nanoparticle contrast agents, provides an excellent overview of nanotechnology-based imaging agents, including the different types of agents and their use with different imaging modalities. This is complemented by chapters in the second part of the book on the use of nanoagents for detection and treatment of thromboses and the use of iron oxide nanoparticles for cardiac stem cell tracking. Similarly, the last chapter of the first section, on nanofiber-based vascular grafts, describes the fabrication techniques, the materials used, and the ways that nanotechnology can help to overcome the clinical problems that vascular grafts face, such as thrombosis and calcification. This approach is unfortunately missing for other areas, for example the engineering of cardiac tissues. Rather than an overview chapter addressing the use of different types of nanomaterials and different strategies for engineering cardiac tissues in vitro and for in vivo regeneration, there are 2 more focused chapters, one on the use of nanotechnology for cell sheet engineering, and a second on collagen scaffolds. This leaves other areas, such as the use of nanocomposites for engineering of cardiac valves and self-assembling injectable nanoscaffolds for cardiac repair after myocardial infarction, uncovered. Similarly, the coverage of biosensors is skewed toward nanowires, whereas many of the alternative nanotechnology platforms that have been developed are ignored. For example, the bio-barcode assay developed by Mirkin and colleagues,1,2 which has been commercialized for cardiovascular and other applications, is not included, and other promising nanoparticle-based systems using electrochemical or magnetic resonance approaches for cardiovascular applications are also ignored.
The chapters are generally well written, although, as would be expected, there is considerable variability in style. The book would have benefitted from better organization; the arrangement of chapters is somewhat haphazard, with no attempt to group chapters with similar themes such as imaging or regenerative medicine. Although some overlap is inevitable in a multi-author book spanning many institutions, more coordination between authors would have been helpful in avoiding, for example, 3 chapters including the principles of nanowire field effect transistors. Some of the chapter topics are very narrowly focused and perhaps not of broad general interest, such as chapters on stimulation of angiogenesis by europium nanorods and detection of nanosized blood microparticles by atomic force microscopy. In other cases, the nanotechnology content of the chapter is minimal; for example, a chapter on micro- and nanobubbles is focused almost exclusively on microbubbles, with no references citing the use of nanobubbles.
In summary, for a reader with cardiovascular interests new to the area of nanotechnology, this book will provide a mixed bag. For some areas, the reader will come away with a good overview of how nanotechnology solutions can help the field, as well as some more detailed examples of specific applications. In other cases, the reader will gain useful information about parts of the field, but will miss the bigger picture of the state of the science. Like the curate's egg it is good in parts, but misses an opportunity to give a comprehensive overview of how nanotechnology can contribute to cardiovascular sciences.
Denis B. Buxton, PhD
Division of Cardiovascular Sciences
National Heart, Lung, and Blood Institute
- © 2012 American Heart Association, Inc.