Nanorobots can be used to cure an extensive number of diseases ranging from common cold to diabetes to more terrible ones like Cancer and cardiac problems. Nanomedicine is the study of medical nanorobots which is a huge prospect to new treatment tools to improve the human biological system. This article presents a brief study in the development of nanorobots and some of their applications in the field of medicine.
Nanotechnology, as a new arising science, was first foreseen in 1959 by a Nobel laureate, Richard Feynman. Nanotechnology has the capacity to develop several new tools and gadgets with numerous applications in the fields of medicine, electronics and energy production. Nanorobotics is all about applying the nanotechnology engineering methods to design and manufacture Nanorobots, which are machines varying in size from 0.1-10 micrometers and made up of nanoscale or molecular components .
3. Nanorobotics in Medicine; Nanomedicine
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Nanotechnology when applied in the field of medicine gives birth to Nanomedicine. Progress in nanotechnology will allow the scientists to build nanorobots, which are complicated, programmable devices and could be administered from outside. Nanorobots will accomplish different tasks inside the human body at molecular level. Nanomedicine promises to produce a precious set of research tools and clinically beneficial machines in the near future, which will help the medical specialists to overpower the drawbacks of present medicine to produce enhanced diagnostic tools and treat disorders which are insensitive to present traditional procedures, resulting in an improved healthcare for the patients. A few of many possible applications of nanomedicine could be timely disease diagnosis, directly aimed drug delivery to the infected area, biomedical transcription, surgeries and an active check on diabetes.
4. Architecture of a Nanomedical Robot
Nanorobots are theoretical machines and still going through the building phase. Present architecture of a nanorobot is identical to that of previously existing in the biological system. A nanorobot should be constructed by keeping in mind the human body from a molecular point of view . A standard medical nanorobot will presumably be a micron-scale robot made up from nanoscale components. These components could physically vary from 1-100 nm and could be assembled to produce a fully functional device having a diameter of 0.5-3 microns . A nanorobot operating in a tissue could be between 50-100 microns, while that in the bloodstream should be 500-3000nm to avoid any blockage in the capillaries . Carbon, being a strong and chemically neutral and biocompatible element, will comprise most of a medical nanorobot. Possible forms of Carbon could be diamond or diamondoid/fullerene nanocomposites. Other parts could be made up of Hydrogen, Sulphur, Oxygen, Fluorine and Silicon . To avoid phagocytosis by body's natural immune system, it is suggested to use diamond for the outer surface of the nanorobot with smooth and perfect finishing. Preliminary analysis show that diamond builds up lower leukocyte activity and fibrinogen absorption as it is chemically neutral and biocompatible . Additionally, medical nanorobots should be non-replicating because replication may accumulate machine complication, decrease its reliability and disturb its medical operations.
4.1 Introducing the Nanorobots inside the Body
A probable method of entering the nanorobots inside the body may be by suspending them in a water/saline fluid and directly injecting few cubic centimetres of that solution into the circulatory system .
4.2 Moving the Nanorobot around the Body
The first probable way to transfer the nanorobot to the designated area could be with the help of normal blood flow. Another method could be to compel the nanorobot to the desired position. Various methods can be used for compulsion of nanorobot such as propellers, cilia/flagella, electromagnetic pump, jet pump and membrane propulsion. These machines could be amalgamated in the nanorobot during its manufacturing .
4.3 Navigating & Tracking the Nanorobot
These can be accomplished by using external sensors. Their ultimate aim will be bifacial; firstly to locate the designated area, and secondly to calculate the whereabouts of the nanorobot with respect to that area. Ultrasonic, NMR/MRI, radioactive dye, X-ray and radio/microwave/heat could be used for such external sensors .
4.4 Recognition of the Target Site
Internal sensors, which are an essential part of a nanorobot, can carry out this task. Chemo tactic sensors attached with particularly common antigens on the designated cells, spectroscopic sensors, TV camera and UHF sonar could be used as internal sensors .
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4.5 Power Supply of the Nanorobot
The nanorobot could acquire its power supply from internal as well as external sources. Internal sources could be metabolism of local glucose and Oxygen within the blood flow and body heat. Externally supplied sources may include microwave, ultrasonic and induced magnetic. Another possible way could be to pre-equip the nanorobot with the enough energy it would need for carrying out entire operation. This could be achieved by using regular chemical batteries and high voltage capacitors [16, 19].
4.6 Means of Recovery from the Body
Few nanodevices would be able to exit the body through the normal human excretory system. Alternatively they could be brought out by the medical staff by performing procedures like aphaeresis or using a system such as active scavenger .
5. Biomedical Applications of Nanorobotics
The planned applications of medical nanorobots may progress biomedical mechanisms with least intrusive surgeries and an enhanced treatment effectiveness and results through timely detection of disorders. Hypertensive and diabetic patients, who need persistent observation of body function, would also get assistance from these devices .
5.1 Drug Delivery Systems
Capacity to aim at specific cells or receptors inside the body is an enduring purpose of drug delivery systems. Currently, there are two major requirements which are compelling the improvement in new drug delivery methods; one is to more efficiently deliver drugs to the infected area, enhance patient's response and decrease healthcare expenses, and secondly to discover new means to transfer latest pharmaceuticals which are undeliverable by using current methods. Drug transmitting nanoparticles can enhance the solubility and transfer of badly soluble drugs in blood. They can also regulate the drug amount that is to be delivered at the designated spot and prevent its speedy dissipation. This maximizes the effectiveness of the drug whereas minimizing the undesired reactions .
Drug encapsulation in protective materials, such as liposome, polymers or lactide co-glycolide (PLGA), protects it from immature enzymatic and chemical reductions during its journey inside the body and results in better efficiency [12, 4]. Dendrimers, hydrogels, molecularly imprinted polymers & microelectromechanical systems (MEMS) are among other likely drug transmitters . A precise and exact delivery of multiple and high potency drugs at the designated site will produce higher drug concentration at the point of need while decreasing its systematic concentration. This will aid in curing diseases like, Parkinson's, Huntington's, Alzheimer's and those of the eyes .
5.2 Nanorobots in Diagnosis, Treatment & Control of Diabetes
The blood glucose level can be continuously monitored with the help of medical nanorobots. The protein hSGLT3, which is basically related to the glucose molecule, helps in appropriately looking after the gastrointestinal cholinergic nerve and movements of skeletal muscle. This protein can serve as a sensor to recognize glucose, therefore, calculating the glucose level in the diabetic patient .
Nanorobot based on CMOS (complementary metal oxide semi-conductor) is used in the prototype model. To observe the glucose level, the nanorobot uses built-in chemo sensor which include the inflection of hSGLT3 protein glucosensor movements. Since the nanorobot is biocompatible, the natural immune system of body does not invade it, and it reveals the blood glucose level without any obstruction . The nanorobot is ~2 micrometer in size, so it moves in the blood without any hindrance, thus calculating the glucose level easily and keeping it between 90- 130 mg/dl. If a change is observed from the defined range, the patient is informed about it through an RF signal to his mobile phone. If the glucose level increases or decreases to a dangerous level, the nanorobot sends off an alarm through the patient's mobile phone advising him to carry out necessary precautions [21, 8].
The nanorobots will be able to calculate the blood glucose level at several different areas throughout the body at differently chosen time intervals. At the same time, other onboard sensors can measure some helpful information for diagnosis like blood pressure and changes in local metabolism etc. . The gathered data will aid the doctors to monitor and refine the patient's medication and diet and, thus, will produce a superior glucose control in that patient.
5.3 Nanorobots in Cancer Detection and Treatment
At present, treatments for cancer like chemotherapy and radiation therapy have many critical undesired reactions such as crashing of healthy cells more than those affected by cancer and damaging the immune system resulting in more troubles for the patients as well as the doctors. Betterment in nanorobotics will help in on-time detection and rectification of cancer.
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The cancer nanorobot will comprise of chemo tactic sensors which will recognize the harmful and healthy cells by examining their surface allergen . This will result in timely discovery of cancer. Once the tumour is spotted, the nanorobot can be instructed to stick to it and invite other already specified nanorobots towards it and start a thorough chemotherapy action with accurate drug delivery .
5.4 Nanorobots for Cardiology
Nanotechnology can be applied in the field of cardiology to carry out non-interfering investigation of the cardiovascular disorders and directly aimed treatment of atherosclerotic plaque.
Most likely, the nanorobot will be able to locate atherosclerotic lesion in the stenosed vessels and cure them by mechanical, chemical or pharmacological means [11, 7]. Nanorobots operating in blood could perish the arteriosclerotic deposits, opening up the blocked blood vessels. Additionally, they may also help to fix the vessel wall and lining infected by the plaque formation within the vessel. This will result in avoiding heart attacks . Vasculocytes are theoretical nanorobots aimed for vascular repair of arteriosclerotic lesions .
5.5 Nanorobots for Fight against Life Threatening Infections
Studies reveal that nanorobots can efficiently enhance health care and medical resistance. Present remedy for septicaemia demands ample volumes of medication provided for lengthy time durations. Usually, this results in partial extermination or slow evolution of the pathogen .
An unreal and theoretical phagocyte nanorobot called "microbivore", whose principal objective resembles that of a normal phagocyte could securely produce a speedy and thorough extermination of pathogens being transported in blood. These nanorobots will act on the basis of "digest and discharge". These nanorobots will be able to recognize and dissolve the undesired pathogens such as bacteria, viruses and fungi. Microbivores could clear away the sternest septicaemia infections within the time frame of one hour as compared to the several weeks and months taken by the natural phagocytes aided by the antibiotics [21, 14].
5.6 Surgical Nanorobots
Medical gadgets based on nano and micro technologies will not only enable surgeons to carry out operations with more accuracy and precaution, but also to observe physiological and biomechanical specifications more flawlessly . Tele-operated surgeries will also be possible with the help of nanorobots where surgeons would be able to do operations remotely .
Surgical nanorobots are being produced to accommodate surgeons with exceptional command over equipments which demand accuracy. This will be extremely helpful in least obtrusive surgeries such as laparoscopic surgeries for cancer cure. The actions of surgeon will convert big remote control gestures into micro-actions on the arms of the robot to exceptionally enhance mechanical accuracy and precaution .
5.7 Nanorobots as Substitute for Blood Cells
A Respirocyte is an imaginary nanorobot which operates like an unreal red blood cell with the capacity to bear Oxygen and Carbon dioxide which, in the case of damaged circulation, can supply tissue oxygenation. A Respirocyte behaves like a pressure tank which on need can be pushed out carrying Oxygen and Carbon dioxide and empowered to move in bloodstream without any restriction. It behaves like a natural red blood cell but actually it is able to provide with 236 times more Oxygen per unit volume than that of a natural red blood cell [21, 13].
Anaemia, perinatal and neonatal afflictions, and several of lung illnesses can be taken care of with the aid of these nano-technological gadgets. In unfavourable conditions, it can provide artificial breathing to avoid asphyxia. Aerobic and anaerobic contaminations like clostridial myonecrosis, chronic refractory osteomyelitis, and necrotizing soft tissue infections including cutaneous ulcers, can be cured with hyperbaric oxygenation by Respirocyte. It can also help in healing burns by decreasing the fluid demand, enhancing micro-circulation and trimming away the necessity of transplant .
A Clottocyte is an unnatural mechanical platelet which is capable of carrying out hemostasis at a greater speed as compared to natural platelets, even if the injuries are considerably bigger. Clotting operation is also accomplished by clottocytes just like the natural biological platelets, but at an exceptionally low blood concentration rate of 0.01%, or in other words nearly 20 nanorobots per cubic millimetre of serum. This makes clottocytes 10,000 times better clotting agents when compared to an identical number of natural platelets .
The Vasculoid is a distinct, multi-sectional nanomedical robotic system which has the capacity to produce a copy of every thermal and biochemical conveyor characteristic of the blood. This involves circulation of respiratory gases, glucose, hormones, and waste products. The Vasculoid system matches the blood vessels physically and can be used as a total substitute of natural blood .
5.8 Nanorobots for Chromosome Replacement Therapy
Chromallocyte is an imaginary nanorobot for fixing the damaged cells, having ability to get through the vascular surface and inside the capillary area of the designated tissue. Ability to replace and rehabilitate whole chromosomes in particular cells would be one of its characteristic. In this way it would be able to alter and treat the genetically damaged cells, including those of cancer, and factors that cause aging on permanent basis [17, 21].
Another nanorobot, known as Pharmacyte, would be designed to carry and transfer pharmaceutical agents on the desired time to the particular addressed area inside the body. Starting the process of apoptosis in cancer and precisely administering the cell signalling process are among the other functionalities of Pharmacyte .
6. Further Applications of Nanorobots in Medicine
Nanotechnology can also have a significant influence in the fields of tissue repair and modification. For instance, nanoparticles that are environment-friendly and discharge suitable growth and angiogenic agents can be helpful to enhance the bioengineering of heart or lung tissue as well as the formation of vascular transplants to bring about an operational tissue . Nanotechnology is able to provide an enhanced detection and analysis and in vivo cure of many intracranial complaints such as cerebral aneurysm. Neurodegenerative illnesses such as Parkinson's and Alzheimer's can also be taken care of with the aid of nanotechnology [2, 10].
Nanorobots may also be capable of finding and destroying stones present in kidney and liver [9, 19]. Helping inflammatory cells to quickly restore the wounded tissues could be yet another likely function of nanorobots . Transfer of anti-HIV drugs could be carried out by using the nanorobots fitted with nanosensors . A cream composed of nanorobots could take care of skin infections, including the removal of correct mass of dead skin and extra oils, as well as supplying the lacking oils. They could also provide the skin with the correct quantity of natural moisturizing compounds. 'Deep pore cleaning' could also be performed by literally approaching the bottom of pores and clarifying them . The nanorobots will also be capable of performing wound debridement. Having the advantage of their size, they can not only be of great help in abolishing dirt and foreign particles from the deep bruises, but also in dismissing parasites from within the human body .
Oral health care can be significantly improved with the introduction of nanotechnology in dentistry. Dentinal renaturalization, hypersensitivity therapy and one stop orthodontic alignment could be a few of many characteristics of a dental nanorobot. There could be a mouthwash containing intelligent nanomachines which would be able to distinguish between pathogenic bacteria and harmless flora, killing the former whereas letting the latter to prosper. These intelligent nanomachines would also be capable of recognizing and clearing away the food particles, plaque or tartar found on teeth. Again having the advantage of their size and ability to swim, they could easily approach the areas where toothbrush cannot access [1, 15]. Gene therapy via chromosome replacement, anti-aging, retinal and cochlear implants and creation and substitution of entire body organs could be of the several other possible functionalities of medical nanorobots [12, 21].
7. Conclusion & Critical Analysis
Nanomedicine since its inception has become one of the fastest growing fields in medicine and also the most debatable one. If application of nanorobots in medicine is as successful as scientists and researchers claim to be, its effect on medicine would be massive and may be able to reshape the future of current medicine. Though still hypothetical, nanomedicine is expected to revolutionize medicine in the next 20-30 years as some experts suggest. This however will require an excellent infrastructure and would require a lot of expenditure. It will have wide range of applications which will include diagnosis, prevention & treatment of life threatening diseases. Nanomedicine will be able to overcome the shortcomings of current conventional medicine and it will not only be able to eliminate diseased cells from the body, but will also aim to fix these cells to preserve and rebuild organ systems. It does, however, have its shortcomings which include safety concerns and toxicology issues. It is important that fundamental research be carried out to address these issues if successful and efficient application of this technology is going to be achieved. For now nanomedicine holds the greatest promise for curing diseases, reducing patient suffering and increasing the human health span of millions in need around the world.