1. Convergence of Nanotechnology and Cardiovascular Medicine Harsharan Pal Singh 1 *, Ishpreet Kaur 2 1 Department of Pharmacology & Toxicology, Noida Institute of Engineering & Technology, Greater Noida 2 Department of Quality Assurance, Delhi Institute of Pharmaceutical Sciences & Research, Pushp Vihar, New Delhi-110017 Email id: harsharanpal.singh@gmail.comharsharanpal.singh@gmail.com Abstract Conclusion Introduction Novel Nanotechnologies as Potential Therapies The role of nanotechnology in analytical, diagnostic, and therapeutic modalities related to cardiovascular pathologies is expanding. With the continued innovations in imaging, biomaterials, tissue-targeted nanoparticles, biosensors, and personalized medicine, nanotechnology has the potential to offer cardiologists and vascular surgeons new ways to improve patient care, and to diagnose, monitor, and treat cardiovascular events more efficiently. and effect Advances in the emergence of biological probes, materials, and analytical tools limited to the nanoscale size range, collectively referred to as ‘nanotechnology’, are increasingly being applied to the understanding and treatment of the major pathophysiological problems in cardiovascular medicine. Analytical techniques based on high-resolution microscopy and molecular-level fluorescence excitation processes capable of detecting nanoscale interactions have been used to elucidate cardiovascular pathology. Nanotechnology has also significantly impacted diagnostic intervention in cardiology, with the use of nanoparticles as contrast agents, for targeted biomedical imaging of vulnerable plaques, for detection of specific pathologic targets signaling the onset of atherosclerosis, and for tracking inflammatory events. Real-time nanoscale biosensors can be used to measure cardiovascular biomarkers, and nanopore sequencing has the potential to speed up the analysis of gene expression in cardiovascular disease. Potential therapeutic applications include the use of nanomaterials in cardiovascular devices, for delivery of drugs and bioactive molecules, or in novel technologies for reducing cholesterol accumulation and for dissolving clots. Nanomaterials relate to new materials synthesized and manipulated by precisely engineering atoms and molecules to yield new molecular assemblies on the scale of individual cells, organelles, or even smaller components, generally in the range of 5–500 nm. An important area of application is the diagnosis and treatment of cardiovascular disease, the leading cause of deaths in industrial-ized nations. Nanoparticles are being widely accepted as biosensors and imaging tools for detection and monitoring of the progression of the disease, as well as drug delivery systems for therapeutic purposes. Nanotechnology as an Analytical Platform o Imaging/ Detection using Nanotechnology Advances in nanoparticle technology have significantly impacted the area of biomedical imaging for the targeting of pathogenesis and functional imaging. Nanoparticles functionalized with antibody fragments specific to the cross- linked fibrin peptide domains are successfully used to image vulnerable plaques with ultrasound or paramagnetic magnetic resonance contrast agents. (Fig d) Angiogenesis, is similarly imaged through the use of αvβ3-integrin targeted paramagnetic nanoparticles and MRI. The biomolecular specificity of nanoparticles can also be harnessed to detect specific types of cells, such as smooth muscle cells and targeted pathologic cells, i.e. in atherosclerotic lesion formation. Presented at RACS-7 held at Amity University, Noida on 10-11 th March 2015. 57 Recent technological developments in the field of imaging have advanced our understanding of cardiovascular diseases through the use of techniques and instrumentation capable of detecting nanoscale interactions and phenomena. Nanotechnology as a Diagnostic Modality o Atomic Force Microscopy (Fig a) This technique was used to quantitatively study the structure of C-reactive protein (CRP), a risk factor for both atherosclerotic coronary heart disease and peripheral arterial disease. o Near Field Scanning Optical Microscopy (Fig b) Methods such as this could be applied to numerous vascular cell lines and tissues to visualize and understand phenomena with a high resolution that was previously unachievable. o Resonance Energy Transfer (Fig c) Using this technology researchers have been able to intracellularly monitor subunit interactions of protein kinase A, an intracellular effector of cardiovascular disease. o Liposomes (50-to 700 nm) uni- or multilammelar vesicles comprising lipid bilayer membranes surrounding an aqueous interior, have been approved for enhancing the efficacy and safety of drugs such as doxorubicin. o Polymers (40 to 200 nm) offer a wide variety of flexible “designer approaches” to construction of molecular imaging agents and therapeutic delivery devices. o Metallic particles such as iron oxide nanoparticles (15 to 60 nm) generally comprise a class of superparamagnetic agents that can be coated with dextran, phospholipids, or other compounds to inhibit aggregation and enhance stability for use as passive or active targeting agents. o Metal-based agents such as gold shell nanoparticles (120 nm) have been used for both imaging and therapy. o Biosensors Molecular beacons (Fig e) have the ability to target nucleic acids with high specificity and high signal-to-background ratios for disease detection applications. Mutations in genes such as methylenetetrahydro- folate reductase, which is linked to an in-creased risk of cardiovascular disease, have been detected via molecular beacon assays that are able to rapidly screen blood samples. Nanotechnology as a Therapeutic Modality o Sonothrombolysis Sonothrombolysis is an emerging therapeutic application of nanotechnology. When a blood clot reduces or blocks the flow of blood through a vessel, sonothrombolysis bubbles can be introduced to the blood stream. The bubbles infiltrate the clot and can destabilize the clot upon ultrasound activation. This can further clear the vessel for recovered flow. o Nanolipoblockers Nanolipoblockers (NLBs) are nanoscale assemblies that have been designed to bind to scavenger receptors on macrophages, which can inhibit the accumulation of highly oxidized low-density lipoprotein (hoxLDL). 1.Lanza G, Wickline SA. Targeted ultrasonic contrast agents for molecular imaging and therapy. 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