NANOTECHNOLOGy

Accomplishing big things by thinking small

By Denny Angelle

drs. harvey smith and bradley Weiner

Imagine standing on the moon, peering down at the bright blue planet in the middle of a black sky. You put a magnifying glass to your eye, and suddenly you can see the faces of everyone on earth. You can pick out your friends and see what they’re wearing and what they’re doing.

Swing your gaze over to Houston, focus on The Methodist Hospital, and you may well see some doctors and researchers who hope to accomplish big things by thinking small.

They work in the world of nanoscale, measuring things smaller than the speck in a fly’s eye, so tiny that molecules swirl around like bright planets in a black sky. They get to this world by using microscopes nearly as powerful as your imaginary magnifying glass on the moon.

Dr. Bradley Weiner, section chief of orthopedic spine surgery at The Methodist Hospital, calls this nanomedicine — treating disease or repairing damaged tissues of the human body on the molecular level. Weiner, chief of spine surgery at Methodist, is also codirector of the Spine Advanced Technology laboratory, the first of its kind in the United States.

He and codirectors Dr. Harvey Smith and scientist Christopher loo are conducting a number of basic research initiatives (occurring in a laboratory setting) that may one day revolutionize orthopedic medicine. “We are shrinking everything down to a whole new level,” Weiner says.

How small?

To give you an idea of how small, nano means billionth, which makes a nanometer one billionth of a meter. An average American male might be six feet tall, or about two meters. So he would be two billion nanometers tall. On the same scale, the page on which these words appear would be about 100,000 nanometers thick.

let’s get small: your average bacteria might be around 200 nanometers long, and a protein inside your body might be about 10 nanometers long. A single atom might be 0.1 nanometer wide, while its nearest neighbor does its own atomic thing about 0.15 nanometers away. “When we get down into this level, it’s another world,” explains Smith, who is an orthopedic surgeon. “When we can get down to the nanoscale, we’re at the level of the basic building blocks of the body, of disease and understanding why things happen the way they do.”

Then doctors like Weiner and Smith, with the help of scientists like loo, can implement technologies — nanotechnologies — to treat diseases and repair damaged tissue.

“The use of nanomedicine to detect disease early, deliver medication and treat disease, or to repair and heal bone, cartilage, muscle and nerves, will make our work safer and more effective,” Weiner adds.

One project they are working on is a method to more effectively deliver medication. “Currently, we give large doses intravenously and the result is systemic, which means it goes throughout the body and can have side effects on the liver or kidneys,” Weiner says. “One of the promises of nanomedicine is that we can deliver much smaller doses to the exact place where they are needed.”

The idea of using a so-called nanocapsule to deliver medication is not exactly new, and in fact, researchers are investigating similar delivery techniques to treat cancer. “But we are just beginning to understand and realize the possibilities of how this might benefit the world of orthopedics,” Weiner explains.

A medication with nano-sized modification could go directly to an affected area, bypassing other tissue and organs. Doctors could deliver an injection and use sophisticated nano-mapping to send it accurately into musculoskeletal tissue — like the spine — and deliver the medication right where it is needed.

“Working on the nanoscale gives us new avenues of intervention, such as a way of delivering anti-inflammatory or pain medications,” Weiner says.

Weiner primarily performed clinical research (involving human volunteers) until a few years ago, when he became involved

with the work of scientist-researcher Mauro Ferrari, ph.D., at the University of Texas Health Science Center at Houston. Ferrari’s group was investigating nanomedical solutions to problems in molecular medicine, and their work fascinated Weiner.

“This group was seeking potential applications for cancer, and I was invited to be the clinical lead for similar research in orthopedics,” Weiner says.

Connecting technology and medicine

The work of the Spine Advanced Technology laboratory began in earnest this past January at Methodist, with clinicians and scientists working in collaboration with the University of Texas under the auspices of The Methodist Hospital research Institute.

Smith describes himself as a “clinician scientist” who connects the medicine and the technology resulting from research in the Spine lab. He does this by determining a way for theories and observations, which are tested on the nanoscale, to lead to a therapy or treatment that could be used on patients. “This is really a huge field, even though the work is at the smallest level,” he says.

“For the first time, we are able to get down on the same level where changes and chemical reactions take place,” Smith says. “Many diseases are protein-based, which means that proteins manipulate the body’s DnA to make changes that result in disease.”

The study of proteins or proteomics came after the largescale study of the human genome that took place in the 1980s and 1990s. Studying the changes in proteins caused by organisms or injury is difficult because proteins vary from cell to cell. They change over time and, more important, can be very different from one person to the next.

“Another one of our aims is to study these proteins at a focused level,” Smith explains. “We can see how they react when a chemical or a compound is introduced so that we can target disease just as it’s taking hold in the body.” proteomics could eventually give physicians a way to deliver individualized treatment, specific medications, or techniques developed to work on a specific person for maximum efficiency. “not only could you treat a problem early, you also would be confident it’s the precise type of treatment a patient needs,” Smith adds.

nanomedicine research at the Spine lab also can yield better and stronger bone implants and prosthetics, and reveal new compounds that can speed bone growth and healing. The lab also will develop a database of patients who may be biologically inclined to not have a good outcome during or after surgery.

“Once we determine why this happens, we can develop screening processes for these patients and give them treatment early, which may help them avoid surgery altogether,” Weiner says.

Weiner and his colleagues believe nanomedicine will one day lead not only to better treatments and more effective surgery, but also to materials that can be implanted and last the remaining life span of a patient. A few of the research projects will soon grow out of the nanoscale phase into a stage where they can be tested on a clinical level. Smith predicts other investigations may take up to a decade before they can be tested on humans.

“We have the tools to move in a number of directions,” Weiner says. “It’s exciting, because this is the future of medicine.” n

“For the first time, we are able to get down on the same level where changes and chemical reactions take place.”