Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
University of Torvergata, Rome, Italy.
Curr Pharm Des. 2018;24(15):1717-1726. doi: 10.2174/1381612824666180110151318.
Genetic alterations cause Hereditary Diseases (HDs) with a wide range of incidences. Some, like cystic fibrosis, occur frequently (1/1,000 newborns), whilst others, such as Pompe disease and other metabolic disorders are very rare (1/100,000 newborns). They are well under the threshold of 1/3,000, denoted by the European Community as Rare Diseases (RDs). Genetic alterations are also associated with multifactorial disorders like diabetes, and underline both somatic and germline mutations in cancer. Nowadays, thanks to the interventions of the European Union and the American National Health Institute as well as others, Hds are under an international lense, which has stimulated discussions and research targeting gene identification, prenatal diagnosis and care optimization leading to the development of new treatment options. Nanomedicine is paving the way toward some highly appealing clinical and research avenues in HDs. Nanotechnologies lend themselves to many aspects in human healthcare, such as in vitro diagnostics (nanobiosensors and nanoplatforms), drug delivery (nanovectors), drug monitoring (nanosensors) and artificial organs to study the genome variant meaning (nanostructures).
With a significant reduction in costs and simplified healthcare delivery, nanodiagnostics can potentially provide the tools to diagnose diseases at an early stage with precision. In vitro nanodiagnostics are already diagnosing RDs, with many nanodevices having been successfully introduced over the last few decades. Nanovectors represent an emerging approach in drug delivery and treatment for several diseases such as cancers, infectious diseases, cardiovascular disorders and neurological pathologies. Artificial tissues have valuable implications in replacing compromised organs, thus offering unique opportunities to explore pathogenic mechanisms as well as new drug targets in a personalized context.
This article outlines and discusses the recent progress in nanotechnology and its potential applications in HDs. It is a pivotal field for research and innovation in healthcare, with emphasis on diagnostics, disease monitoring, biomarker assaying and drug delivery. We underlined the nanomethod's capacity to identify genetic alterations and the follow up of important aspects of the disease course, including therapies. We extensively described the new field of nanodelivery for experimental drugs, focusing on new genetic therapies and their implications in hereditary disorders. We also detailed innovative tools as artificial tissues based on nanomatrices and their use to identify or study genetic alterations.
遗传改变导致遗传性疾病(HDs),其发病率范围很广。有些疾病如囊性纤维化,发病率较高(每 1000 名新生儿中有 1 例),而其他疾病如庞贝病和其他代谢疾病则非常罕见(每 100,000 名新生儿中有 1 例)。这些疾病的发病率都低于欧洲共同体定义的罕见疾病(RDs)的 1/3000。遗传改变也与糖尿病等多因素疾病有关,并强调了癌症中的体细胞和种系突变。如今,由于欧盟、美国国立卫生研究院和其他机构的干预,HDs 受到国际关注,这激发了针对基因鉴定、产前诊断和护理优化的讨论和研究,从而开发出新的治疗选择。纳米医学为 HDs 的一些极具吸引力的临床和研究途径铺平了道路。纳米技术适用于人类医疗保健的许多方面,例如体外诊断(纳米生物传感器和纳米平台)、药物输送(纳米载体)、药物监测(纳米传感器)和人工器官来研究基因组变异意义(纳米结构)。
随着成本的显著降低和医疗保健的简化,纳米诊断有可能提供精确诊断疾病的早期阶段的工具。体外纳米诊断已经在诊断 RDs,过去几十年已经成功引入了许多纳米设备。纳米载体代表了一种新兴的药物输送和治疗方法,可用于治疗癌症、传染病、心血管疾病和神经病理学等多种疾病。人工组织在替代受损器官方面具有重要意义,因此为在个性化背景下探索致病机制和新的药物靶点提供了独特的机会。
本文概述并讨论了纳米技术的最新进展及其在 HDs 中的潜在应用。它是医疗保健领域研究和创新的关键领域,重点是诊断、疾病监测、生物标志物分析和药物输送。我们强调了纳米方法识别遗传改变的能力,以及疾病过程中包括治疗在内的重要方面的后续监测。我们广泛描述了实验药物的纳米输送新领域,重点介绍了新的基因治疗及其在遗传性疾病中的应用。我们还详细介绍了基于纳米基质的人工组织等创新工具的使用,以识别或研究遗传改变。