Converging Technologies for Improving Human Performance Episode 1 Part 10 docx

Converging Technologies for Improving Human Performance (pre-publication on-line version) 167

favorite alternative routes for drug delivery, with nanovesicles and microcrystals as popular drug

carriers (Langer 1999). Cancer treatment has yet to fully benefit from the targeted delivery to tumors

of drugs in microdevices with local nanoscale interactions. Likewise, cancer monitoring and surgery

would benefit enormously from miniaturized sensor or other diagnostics systems that could be used in

the pre-, peri-, and postoperative environment.

The Prospects for Life Extension

Any quantitative discussion on the prospects for life extension through nanobiotechnology

intervention in disease must be purely hypothetical at this stage. However, speculating across the

human-organ-cell-molecule model may give some idea of the possible times to application of some of

the approaches under development. Table C.2 summarizes what is a very personal view of the likely

outcome of convergence in NBIC.

Table C.2

Some Potential Gains in Life Extension from NBIC convergence

Level of Intervention Key Advance Timescale Life Extension

Noninvasive diagnostics 5-10 years Lifesaving for some conditions

Cognitive assist devices 15-20 years Higher quality of life for several years

Human

Targeted cancer therapies 5-10 years Reduction in cancer deaths by up to 30%

Organ Artificial heart 0-5 years 2-3 years awaiting transplant

Neural stimulation or cell

function replacement

5-20 years 10-20 years extra if successful for

neurodegenerative patients

Improved cell-materials

interactions

0-15 years Lowering of death rates on invasive

surgery by 10% and extending life of

surgical implants to patient’s lifetime

Genetic therapies 30 years Gains in the fight against cancer and

hereditary diseases

Cell

Stem cells 5-10 years Tissue / brain repair

Life extension of 10-20 years

Localized drug delivery 0-10 years Extending life through efficient drug

targeting

Molecule

Genetic interventions 0-30 years Life extension by targeting cell changes

and aging in the fight against disease

Likely to be a very complex

environment to successfully manipulate

Visions for the Future

Loss of mobility and therefore independence is critical in the onset of decay and isolation for many

older people, and one area in the developed world where people are very dependent for mobility is in

the use of a car. Confidence and cognizance decline for many people as they age; in the car of the

future there is the possibility to see the true convergence of NBIC in extending independence and

warding off part of the decline in the older person. Higher-speed, higher-density computers and

effective sensors driven by nanotechnology may combine with on-board artificial intelligence in the

car, helping the driver plan routes and avoid hazards and difficult traffic situations.

Nanobiotechnology may also be present in on-board minimally invasive biosensors to monitor the

driver’s health, both in terms of physical stress and physiological condition, to be fed back to the car’s

168 C. Improving Human Health and Physical Capabilities

computer. In a further interpretation, since the possibility of implanted devices to stimulate or

improve cognizance are emerging, the driver may be also benefit from neuronal stimulation designed

to keep him or her alert and performing optimally during the trip.

The convergence of NBIC in the field of life extension will lead to implanted devices such as sensors

and drug delivery systems being developed to replace or monitor body function. Implanted devices,

whether macro or micro in scale, present a problem today in terms of biocompatibility. Implantation

of a heart valve in a patient means that a drug regime for anti-coagulation is mandatory — usually

through administration of warfarin. Since inflammatory response and immunogenic response take

place in vivo, many of the devices being discussed and designed today to improve human performance

incorporating nanotechnology will not be implantable because of biocompatibility issues. A further

complication will be how to keep a nanodevice biologically or electronically active (or both) during

sustained periods of operation in vivo. Sustained exposure to physiological fluid, with its high salt and

water content, destroys most electronic devices. Likewise, devices that emit biological molecules or

are coated with biological molecules to ensure initial biocompatibility must have their biological

components renewed or be destined to become nonfunctional some time after implantation. Little

attention is being given to these problems, which may prove major stumbling blocks in the next 10 to

30 years to the successful application of nanotechnology in a range of medical conditions.

A “holistic human project” could bring together the best research clinicians, biomedical engineers, and

biomedical scientists to discuss the main life-shortening diseases and conditions and current progress

or problems in their treatment or eradication. Together with the nanotechnologists, areas where

conventional medicine has not been successful could be identified as strategic targets for

nanobiotechnology. Specific project calls could follow in these areas, with the condition that the

applicants’ teams must show sufficient interdisciplinary interaction to provide a comprehensive

understanding of the nature of the problem. The opportunities are immense, but the resources

available are not unlimited, and only strategic planning for project groups and project themes will

realize the maximum benefit for biomedicine and society.

References

Dario, P., M.C. Carozza, A. Benvenuto, A. Menciassi. 2000. Micro-systems in biomedical applications. J.

Micromech. Microeng. 10:235-244.

Douglas, J.T., and D.T. Curiel. 1998. Gene therapy for inherited, inflammatory and infectious diseases of the

lung. Medscape Pulmonary Medicine 2, 3.

EIA (Energy Information Administration, U.S. Dept. of Energy). 1998. Impacts of the Kyoto Protocol on U.S.

energy markets and economic activity. Report No. SR/OIAF/98-03.

Greenberg, R.J. 2000. Visual prostheses: A review. Neuromodulation, 3(3):161-165.

Harris, W.H. 1995. The problem is osteolysis. Clinical Orthopaedics and Related Research 311: 46-53.

Hartgerink, J.D., E. Beniah, and S.I. Stupp. 2001. Self-assembly and mineralization of peptide-amphiphile

nanofibers. Science 294: 1684-1688 (November).

Hu, W-S., and V.K. Pathak. 2000. Design of retroviral vectors and helper cells for gene therapy.

Pharmacological Reviews 52: 493-511.

Khan, Z.P., R.T. Spychal, and J.S. Pooni. 1997. The high-risk surgical patient. Surgical Technology

International 9: 153-166 (Universal Medical Press).

Langer, R. 1999. Selected advances in drug delivery and tissue engineering. J. of Controlled Release, 62: 7-11.

Moore, A. 2001. Brave small world. EMBO Reports, 2(2): 86-89. (European Molecular Biology Organisation,

Oxford University Press).

Pickup, J. 1999. Technological advances in diabetes care. Wellcome News Supplement Q3(S).