Nanomedicine: a big impact in cardiovascular care?
To answer the big questions in cardiovascular disease, some researchers are thinking small. Steve Robinson was at the British Cardiovascular Society Annual Conference 2018 in Manchester to learn more about the growing field of nanomedicine.
7 June 2018, by Steve Robinson
Nanomedicine – applying nanomaterials to prevent and treat disease – is a hotbed of research in cardiovascular disease: from targeted delivery of drugs to new imaging techniques.
Attendees at the British Cardiovascular Society Annual Conference 2018 in Manchester got a glimpse of the potential that this up-and-coming field of study could have on future medical practice.
Researchers at the Institute of Biomedical Sciences, Academia Sinica, Taiwan are exploring how nanomaterials could be used to repair damage caused by a cardiac event by boosting the regeneration of tissue.
Professor Patrick Hsieh from the institute explained how his team is developing better ways to deliver specifically targeted therapies to the site of injuries.
Transplanting cells into the heart to promote the regeneration of healthy tissue is hampered by the fact that often very few cells are retained and survive. In response, Professor Hsieh’s team seeks to bioengineer the microenvironment for cardiovascular repair and regeneration.
One approach is via a ‘nanopatterned’ cardiac patch. This uses magnetic fields to arrange 'nanofibers' into a pattern that mimics how cardiac cells grow. The patch is then pre-seeded with cells that grow aligned with these fibres, with the aim of promoting better integration of the implanted cells with the existing muscle tissue.
Another innovation is the creation of injectable self-assembling peptide nanofibers. These create a ‘scaffold’ within the microenvironment and, combined with a vascular growth factor, can help promote re-vascularisation and therefore cardiac repair after an infarction.
Meanwhile, BHF Professor of Cardiology David Newby from the University of Edinburgh explored how he and others are investigating using magnetic nanoparticles to improve imaging and risk stratification in cardiac patients.
Identifying high-risk aneurysms
These nanoparticles – called ultrasmall superparamagnetic iron oxide (USPIOs) – are taken up by macrophages, a type of white blood cell, which pass into tissue. When imaged, these can provide greater detail on MRI scans than the traditionally used gadolinium – these are known as MRI contrast agents.
Professor Newby discussed the MA3RS Trial, which is exploring whether MRI with USPIO can provide a better way of identifying which patients with abdominal aortic aneurysm (AAA) are at higher risk of an imminent and potentially life-threatening burst. It comes after previous research showed this technique could reveal ‘hotspots’ in the walls of some aneurysms.
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Professor Jonathan Gillard, Professor of Neuroradiology at the University of Cambridge, described how the ATHEROMA study measured the effect of a statin on macrophage activity and carotid plaque inflammation, using USPIO-enhanced MRI of the carotid artery.
His team’s research found 80mg atorvastatin effectively ‘switches off’ macrophage activity in plaques. The study suggests using MRI with USPIO could help screen and assess which patients with atherosclerotic lesions are benefitting from this anti-inflammatory treatment.
Staying with nanoparticles, Dr Iwona Cicha from University Hospital Erlangen in Germany highlighted that only a very small proportion of all clinically approved nanomedicines are for cardiovascular disease – illustrating the need for more development and clinical translation in this disease area.
Her team is investigating whether superparamagnetic iron oxide nanoparticles (SPIONs), loaded with an appropriate drug, can be localised to a specific diseased tissue using an external magnetic field – known as magnetic targeting.
The potential benefit is that drugs can be concentrated at the disease site and decreased elsewhere in the body, improving the therapeutic effect.
These are just some of the many studies that have taken place in recent years or are ongoing. It’s a field with great potential as scientists look to turn our understanding of the world of the very small into translational medicine to benefit patients.
The BHF is funding other nanomedicine research studies to improve how we diagnose and treat cardiovascular disease.