Medicine Goes Small

Nanotechnology is taking health care to the molecular level and changing it in profound ways. But is it all good?

Meet the Domino, a little chip that can diagnose your health.
Meet the Domino, a little chip that can diagnose your health. Photo courtesy of University of Alberta

Let’s start by agreeing that nanotechnology is magical science. Most of us know that it’s about scientists operating at a molecular level. Many of us understand that it usually involves the tiniest of “machines” assembling themselves through chemical interactions. But when researchers start talking about creating molecule-sized robots that can repair cells inside our bodies, they’ve moved so far beyond my comprehension that I’m reduced to blubbering, “Sounds good…keep ‘em coming.”

One thing even I can understand, though, is how profoundly nanotech can transform medicine and health care–whether it’s cell-sniffing nanobots that can seek and destroy cancer cells with no collateral damage or replace abnormal genes with normal ones or help broken bones heal faster.

Other nano-driven medical advances, while not as dramatic as detonating chemo bombs inside tumors may actually be more far-reaching in that they transform something as basic as how disease is diagnosed. Take two inventions announced last week.

The first, called Domino, is a small plastic chip that can perform 20 different genetic tests from a single drop of blood. It was created by a team at the University of Alberta in Edmonton and it works like this:

The blood flows into 20 separate tiny compartments, each filled with a gel. Then the chip gets put into a small portable lab about the size of a toaster where a molecular test is run on each compartment. From that one drop of blood, the doctor can determine if the patient has breast cancer and if so, whether she is resistant to cancer drugs. Or it can determine if she has malaria, even what type of malaria.

The second innovation, developed at UCLA, combines nanotechnology, a cell phone and Google Maps to create a device that reads Rapid Diagnostic Tests–strips that change color if there’s infection–with much more precision than a human can out in the field. The strips are inserted into the device, a reader that clips on to a smart phone. Then the phone’s camera, working with a mobile app, converts the strip into a digital image.

From that, the app determines if the results of the test–for HIV or malaria or TB, for example–are positive or negative. And here’s where Google Maps comes in. If positive, the device wirelessly transmits the results to a map that tracks the spread of diseases around the world.

What these nanotests mean for most of us, ultimately, is an end to those long, and often stressful waits for results to come back from the lab. Increasingly, doctors will be able to do DNA and other diagnostic testing right in their offices, with results available within the hour. Plus, $100 lab tests could end up costing only a dollar or two.

Not that these mini-labs are brand new. Harvard professor George Whitesides, for one, has been working on “diagnostic stamps” for several years now. But these “labs on a chip” have become such a popular field of research that there’s now a website called simply “Lab-on-a-Chip”, which reports on the latest developments. Most, however, are still in the trial stage.

“Lab tests are fine,” says David Alton, one of Domino’s creators. “But we need to show that it works. We need to show the results from a thousand tests. Then people start saying `OK, this is real.”

Then there’s the dark side

Of course, as with any cutting edge science, questions arise about how the wizardry of nanotechnology could go wicked. As useful as they can be, nanoscale forms of materials like silver, carbon, zinc and aluminum can be ingested, inhaled and perhaps, absorbed through the skin. No one’s sure how harmful that may be. About two weeks ago, the FDA issued a draft of guidelines suggesting that companies using nanoparticles in food or cosmetics may have to do extra tests to show the products are safe.

And just last week a paper by Kathleen Eggleson, a scientist at Notre Dame, raised the novel kind of ethical dilemma nanotechnology can stir up. She notes that in an effort to fight infections in hospitals, medical supply companies have taken to coating nearly everything–door knobs, bed rails, sheets, curtains–with nano-sized particles of silver, a material known for blocking the spread of microbes.

But, as Eggleson points out, the vast majority of bacteria and other microorganisms are actually neutral, or even beneficial. Some bacteria, for instance, are needed to maintain necessary levels of nitrogen in the air; others help us digest food.

So covering every surface with tiny flecks of silver, she argues, could end up doing more harm than good.

Yes, even in a world we can’t see, life is complicated.

Where the small things are

Here are other recent nanotech developments. These are outside the world of medicine.

Video bonus: The National Cancer Institute makes its case for how nanotechnology could be the cancer-fighting weapon we’ve been waiting for.

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