To understand the current status of medical nanotechnology, I recently made a futures study review of current advances, organizing approximately 50 individual research findings into five categories. These fundamental enabling technologies, developed by leaders in their fields, could have a broad impact beyond their initial application within the next five to ten years.

Drug Delivery

Drug delivery has long been a key ‘killer app’ for nanomedicine. Cytosolic drug delivery is an important contemporary focus using nanoparticles, peptoids, stapled peptides, and other techniques. Another area of investigation is using microneedle arrays for enhanced transdermal drug delivery with coatings and other methods to facilitate continuous condition management.

Organ Repair

Organ repair through regenerative medicine and stem cell therapies could have an extensive near-term impact. Significant progress is being made in regenerative medicine, with full organ printing, augmentation conduits, and vascularization in development for twenty-six different human organs. Stem cell therapies are in research for a number of cell types including neural, cardiac, adipose, skin, and bone marrow cells, as well as investigating methods for enhanced delivery and adhesion.

Fundamental Nanomedical Technologies

There has been notable progress in two fundamental nanomedical technologies. First in integrating organic and inorganic matter through engineered fusion proteins, graphene sheets sandwiched in phospholipid bilayers, genetically-engineered peptides (GEPIs), and interlocked organic-inorganic structures such as catenanes and rotaxanes. Integrated organic-inorganic materials have the properties of both organic and inorganic matter which greatly extends the functionality, manipulability, and control of materials in nanomedical environments. Second is molecular programming through DNA nanotechnology and nanodevices. DNA nanotechnology, using DNA as a structural material in building molecularly precise structures, is progressing from the creation of simple structures to the development of more complex structures and systems that include granular control mechanisms. Nanodevice advances focus on improved control sophistication through torque and temperature management in microfluidics and the development of a light-driven linear motor for molecular transport.

Engineering of Biology

The active engineering of biology is an important area for the future of nanomedicine. The current status is improving tools and techniques for reading (sequencing) and writing (synthesizing) DNA, particularly with automation and the establishment of re-usable intermediate parts. Simultaneously, progress has been made characterizing and mimicking natural bio-nanomaterials processes in understanding biomineralization, cyanobacteria feedstock, and signaling networks.

Working with the Brain

Working with the brain continues to be an exciting frontier. One advance has been made with brain coprocessors using light to activate and silence neurons (optogenetics). In brain-computer interfaces (BCIs), user fatigue has been reduced and the understanding of motor control improved. Another technique, transcranial magnetic stimulation (TMS) is being used in the clinical treatment of depression, and to elucidate the processes of motor learning and perception.

Conclusion

Nanomedicine, bio-nanomaterials, and nanodevices could be instrumental in continuing the medical tradition of eradicating whole classes of problems over time and might possibly be used to target tissue, organ, and limb repair, cancer, neural disorders, and aging. This could allow the focus of medicine to shift from cure to prevention, and ultimately to enhancement. The larger context for nanomedicine is the eventual ability to characterize, understand, and proactively manage all biological processes, human and otherwise.