Medicine and medical technology always have been and continues to be an essential part of all life, as all life are subject to contracting diseases, ailments and various injuries and illnesses due to undesirable microorganisms, environmental conditions or trauma. However, the advancement in the understanding of pathogens, anatomy and science overall has led to better quality of life for humans in modern times than ever before, giving rise to new medicine and medical technology, from vaccines, to antibiotics and advanced surgical methods. It was however evident that humanity would reach its metaphorical last straw, and reach that we did. Though we are far more advanced in medicine than any previous generation before us, people in modern times experience many complications as a result of our own developments.1 We are in a time where pathogens such as bacteria have grown increasingly resistant to antibiotics, and in addition, non-communicable diseases such as cancers have grown increasingly common. This has pitted us in a race against time to discover new methods and establish better measures, which fuels scientists and researchers to perpetually discover something “better than before,” to combat such complications. The development and establishment of the novel smart therapeutics has been a major gear shift in this race and has allowed for healthcare professionals and researchers to effectively provide therapy and treatment for their patients in recent years, unlike ever before2.
A smart therapeutic system is a medical drug molecule in combination with one or more other molecules or materials (henceforth referred to as the smart matrix) which are engineered to change their structure or orientation based on an external stimulus. This change of structure brings about a response that allows for increased effectivity of a drug, or a therapeutic that is attached along with the smart matrix – analogically similar to a sensor. This “sensor” system is the result of the development of smart materials, where material chemists engineer materials to respond to an external change. While several uses for these exist, most prominent use for such smart therapeutic systems is in targeted and controlled drug delivery.
Targeted drug delivery involves the delivery of a drug directly to a specific locale, be it an organ, or even a set of tissues. This is in contrast to more traditional delivery methods such as oral intake and external application, where the drug takes effect upon metabolizing within the human systems. Controlled drug delivery involves the release of a drug to a specific target at a metered dosage predetermined by the smart drug as engineered. The development of both methods has been a major topic among medical experts and researchers, and is still ongoing. It is however an established system of which the effectivity is already being witnessed3. Such systems are already prominently used in the treatment of several diseases, trauma, neurological disorders and especially cancers and it has never been easier due to the many advantages they offer. A novel application of controlled drug delivery systems being actively researched relates to the treatment of asthma patients, where flavonoid-based drugs are periodically released in metered dosages into the human systems by a controlled drug delivery system within the patient’s body, that is ingested or injected initially. This has been shown to improve the effectivity of the antioxidant and anti-inflammatory properties of the used flavonoids in the human body and thus shows increased potential to aid in alleviating discomfort and providing relief to chronic asthma patients.
Targeted drug-delivery systems are significantly more favourable than traditional drug delivery methods, due to their very nature of targeting. This means that a drug would only act on its intended target organ or tissue, and thus would lead to much greater efficacy. This also means it eliminates the risk of adverse effects to other organs or organ systems, and also would require a much lower dose of drug. An example of such a drug-delivery system is the use of 177Lu-DOTA-TATE or LutatheraTM in the treatment of neuroendocrine tumours in peptide-receptor radionuclide therapy (PRRT). Lutathera consists of a radioactive isotope of lutetium (177Lu) which is bound with an organic molecule known as DOTA-TATE. This molecule helps guide the lutetium to neuroendocrine tumours based on specific cell receptors known as type-2 somastostatin receptors, which are overexpressed in neuroendocrine tumours. The radionuclide is ensured to reach the tumour directly and then it is released to do its work in tumour therapy.4 Often, a controlled drug delivery system is used in tandem with such targeted systems, so that the required drug may be released to its target at predetermined intervals and dosages. Such an example is ATRIGEL5 technology, which is a method of controlled parenteral drug delivery, where it is injected into a locale, and then the ATRIGEL continues to release its embedded drug according to a dosage. This is additionally advantageous as it eliminates the need for repeated drug intake, and significantly reduces patient discomfort.
The work of scientists and medical engineers to develop smarter therapeutics continues even now, to the development of smart vaccines, and hemostatic solutions for quick wound healing and trauma treatment. This is a testament to the great advantage such smart therapeutics bring to the medical industry as a whole – in essence, smart drug delivery systems help both medical professionals in administering the drug due to its efficacy and ease of access, and patients with dosage monitoring and comfort. It also reduces the preconceived notion on several diseases and ailments being incurable or untreatable, which helps alleviate a lot of anxiety from patients, as scientific advancement continues to march forward exponentially faster. Although major overarching problems such as antibiotic resistance and the evolution of pathogens can never be eliminated with any scientific method, the use of smart materials in therapeutics helps patients recover faster, more comfortably and more successfully from infections, illnesses and trauma meaning that in the long term, the general health of the world’s population has a great potential to increase in quality, and humanity is ensured to have better, more effective tools at securing our health and survival as a whole. With this form of medical technology at hand, in tandem with correct medical practice, careful prevention, safety and vigilance, diseases seemingly improbable to cure and problems seemingly impossible to solve may yet be possible in the years to come.
References –
(1) Berger, D.; A Brief History of Medical Diagnosis and the Birth of the Clinical Laboratory Part 1-Ancient Times through the 19th Century.
(2) Yang, Y.; Zeng, W.; Huang, P.; Zeng, X.; Mei, L. Smart Materials for Drug Delivery and Cancer Therapy. VIEW. John Wiley and Sons Inc April 1, 2021. https://doi.org/10.1002/VIW.20200042.
(3) Liu, D.; Yang, F.; Xiong, F.; Gu, N. The Smart Drug Delivery System and Its Clinical Potential. Theranostics. Ivyspring International Publisher 2016, pp 1306–1323. https://doi.org/10.7150/thno.14858.
(4) Bodei, L.; Cremonesi, M.; Grana, C. M.; Fazio, N.; Iodice, S.; Baio, S. M.; Bartolomei, M.; Lombardo, D.; Ferrari, M. E.; Sansovini, M.; Chinol, M.; Paganelli, G. Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE: The IEO Phase I-II Study. Eur J Nucl Med Mol Imaging 2011, 38 (12), 2125–2135. https://doi.org/10.1007/s00259-011-1902-1.
(5) Malik, K.; Singh, I.; Nagpal, M.; Arora, S. Atrigel: A Potential Parenteral Controlled Drug Delivery System. www.pelagiaresearchlibrary.com.