Nanomedicinal Approaches Towards Cardiovascular Disease E-Book
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- Herausgeber: Bentham Science Publishers
- Kategorie: Fachliteratur
- Sprache: Englisch
Nanomedicinal Approaches Towards Cardiovascular Diseasesummarizes information about nanotechnology that is used in the diagnosis and regenerativetreatment of heart diseases. Chapters in this reference introduce the reader tothe basics of cardiac nanomedicine and cardiac regeneration beforemoving to advanced topics such as nanomedicine in cardiovascular diagnosis,imaging and therapeutics. Key Features- 13 chapters that cover nanotechnological aspects of cardiovascular diseases,contributed by expert scholars- Simple, reader-friendly text suitable for readers of all academic levels- Covers introductory topics of nanomedicine regenerative medicine incardiovascular disease, cardiovascular diagnosis and therapeutics- Covers advanced topics such as cardiovascular nanotheranositics,cardiac reprogramming, biomimetics, drug delivery systems and smart nanomaterials- Includes a chapter on ethical implications in cardiovascularnanomedicine- Includes bibliographic references for each chapter Nanomedicinal Approaches Towards Cardiovascular Disease is asimple. informative reference on cardiovascular nanomedicine for scholars,healthcare professionals and nanotechnology enthusiasts, alike, which provides holisticknowledge on the subject in a single volume.
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Seitenzahl: 316
Veröffentlichungsjahr: 2021
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FOREWORD 1
It is my immense pleasure to write the foreword to this book. The book deals with various aspects of nanotechnology based application for the treatment of cardiovascular disease.
Across the globe cardiac diseases remain the major cause of mortality and morbidity despite current pharmacological advancements, however, a complete cure for the disease has not been accomplished. In cardiac therapy nanotechnology-based therapeutic application has illustrated remarkable progress. Immense usefulness of nanotechnological application towards therapy, it is highly anticipated that nanomedicine may fill the huge gap by initializing the new avenues to meet the existing therapeutic demands of cardiovascular diseases. And it may provide a subtle solution with better prognoses along with a reduced side effect profile.
This abreast book is quite informative as it deals with the understanding of the cardiovascular disease and current progression of nanotechnological mode for the holistic approach of the therapeutic improvement. This book gives the surfeit information about various nanocarriers, biomaterials for cardiac tissue regeneration which is highly beneficial for the students, academicians and clinicians. The simple language with pictorial illustration of the book will surely help for the upgraded understanding of the subject.
I am convinced that my colleagues Dr. Fahima Dilnawaz and Dr. Zeenat Iqbal have done a great, focused and detailed job in compiling and editing this cutting edge and comprehensive book on nanomedicine and cardiovascular disorders written by subject experts. I wish this extraordinary book to entice extensive readership, and I hope the readers will thoroughly enjoy the assortment of recent scientific facts as much as I did!
FOREWORD 2
It is a pleasure to write the foreword to this book. It presents a comprehensive review of various aspects of nanotechnology in the treatment, drug delivery and amelioration of cardiovascular disease.
Up till now, cardiac diseases remain the major cause of mortality and morbidity across the globe and despite the recent therapeutics’ options and pharmacological advancements, a complete cure for cardiac diseases has not yet been achieved. However, in recent years, a tremendous explosion has been seen in the advancement of nanotechnology, where nanomedicine has brought a remarkable improvement in cardiac therapy. And it is expected that nanomedicine will fill the remaining gap by opening new frontiers for inventing newer therapies and addressing the unmet needs of cardiovascular diseases.
This up-to-date book incorporates both the underlying science of cardiovascular diseases and the advancements in the field of nanotechnology in such a balanced fashion that led to the holistic development in the next generation of disease treatment. From nanocarriers to biomaterials for cardiac tissue regeneration, this book gives a plethora of information that will be definitely beneficial for the students and clinicians. Also, simple language and pictorial presentations of the various concepts will help in the better dissemination of knowledge and hence a better understanding of the book.
I am convinced that Dr. Fahima Dilnawaz and Dr. Zeenat Iqbal have done a great, focused and detailed job in compiling and editing this cutting edge and comprehensive book on nanomedicine and cardiovascular disorders, written by subject matter experts from academia. I wish this extraordinary book attracts a broad readership and I hope the readers will enjoy this collection of scientific facts as much as I did.
PREFACE
The last decade has witnessed a tremendous change in the way disease therapy has been impacted by nanotechnology. It has indeed birthed and nurtured a newer branch of advanced therapy and diagnostics vis a vis “nanomedicine” . The uniqueness and propensity of adapting itself to diagnosis and treatment of plethora of diseases makes “nanomedicine” a key area of pharmaceutical research. Although at its nascent stage “the nanomedicine approaches as an intervention for cardiac diseases”, is fast attracting the attention of researchers and practitioners alike. Cardiac diseases are often associated with myriad complications during the lifetime of a patient and continue to remain the cause of frequent deaths worldwide. The disease segment is still on a lookout of well-equipped treatment tools and is poised to explore nanomedicine armamentarium wherein, cardiovascular complications could be diagnosed at the molecular level and its treatment is delivered at the cellular level. This, precisely would make a fit case for early detection and diagnosis followed by quicker remedy for the cardiac ailments. This would indeed be a welcome step as most cardiac diseases often reduce the window of survival time for the patients.
The book entitled “Nanomedicinal approaches for cardiovascular disease” by Dr. Fahima Dilnawaz and Dr. Zeenat Iqbal illustrates the application of nanomedicine and nanotechnology in the diagnosis and treatment of cardiovascular diseases. This book indeed is a humble attempt to present the various approaches of nanomedicine in cardiovascular ailments to the broad readership, including academicians, researchers, scholars and clinicians. The authors have made concerted efforts towards inviting various reputed contributors who have been working in the domain of nanomedicine for quite some time.
This book is divided into separate sections such as: Section 1: Introduction to cardiovascular diseases and need of nanomedicine and regenerative nanomedicine: Nanomedicine aspects in cardiovascular diseases, Role of Nanomedicine in the diagnosis of cardiovascular diseases, Nanotechnology based molecular imaging in cardiovascular disease, Nanocarriers for therapeutics delivery of cardiovascular diseases, Nanocarriers for theranostics delivery of cardiovascular diseases, Nanocarriers for biologicals delivery to cardiovascular delivery and Ethics and regulations for cardiovascular diseases. Section 2: Biomaterials for cardiac regeneration, Biomimetic materials design for cardiac tissue regeneration, Nanotechnology based direct cardiac reprogramming for cardiac regeneration, Smart nanomaterials for cardiac regeneration therapy, Stem cell engineering ability to promote cardiac regenerative activity.
Each section gives a plethora of novel information on a particular field. Summarily, the book is a collection of quality information on various applications of nanomedicine that can be applied for the successful treatment of cardiovascular diseases. The lucid textual and pictorial presentation of the various sections and chapters is primarily in simple language that will support easy dissemination of knowledge.
The authors are hopeful that the collaborative efforts invested in the writing of this book on a very dedicated area of nanomedicine in cardiac diseases would attract good readership.
List of Contributors
Introduction to Cardiovascular Diseases and The Need for Nanomedicine and Regenerative Nanomedicine
Fahima Dilnawaz1,*Abstract
Worldwide, cardiovascular diseases claim a number of lives; however, some of them are preventable with an early and proper management. Still, the treatment of cardiovascular diseases is limited as it deals with prescribed medicines administered orally and under critical condition with invasive surgery. Due to this, there exists an enormous gap in the area of medicine for the development of therapies for better patient outcomes. In this regard, recently, nanotechnological aspects of the development of medicines are sought, which may provide a solution for more effective treatment of disease, having better therapeutic outcomes with reduced side effect profile. Further, the regenerative nanomedicine therapeutic approach opens up a paradigm that deals with the repair of damaged heart tissue and future potential use of such systems.
INTRODUCTION
Cardiovascular diseases (CVDs) are one of the major causes of mortality and morbidity globally and include primarily hypertension and coronary artery diseases and their associated diseases like atherosclerosis, myocardial infarction, cardiac arrythmia, angina pectoris and chronic heart failure. CVDs are being accounted for the death of ~17.8 million people in 2017 and ~ 30% of all deaths occurring globally [1]. Of these deaths, around 7.3 million people died due to coronary artery disease and 6.2 million cases of deaths were due to stroke. Heart problems, which are often associated with reduced physical and mental health, lead to a decreased quality of life [2, 3]. Treatment for various CVDs includes
non-invasive therapy such as prescription medications and lifestyle modifications or invasive or surgical procedures such as bypass surgery, angioplasty etc.
During the past recent years, several advancements have been made in the field of diagnosis and treatment of various diseases with rapid expansion in nanoscience, which includes detailed molecular level understanding of diseases and use of sophisticated technologies in the nano range, in the field of medicine. Nanomedicine has emerged as a novel tool for the diagnosis and therapy of various Cardiovascular diseases [4]. National Institute of Health defines Nanomedicine as “the application of nanotechnological aspects for the diagnosis, treatment, monitoring and control of biological system.” Nanotechnology is a collective term that refers to scaling down the particles to nanometer range (less than 1000 nm) [5]. The nanomaterials possess a relatively larger surface area compared to the same mass of materials, which makes the materials chemically reactive. Recent advances in nanoscience lead to the construction of new materials and devices that are used in molecular diagnostics and manufacturing of nanopharmaceuticals. These nanofeatured structures address the underlying cause of the cardiovascular disease that can improve the detection of early stage diseases so as to decrease premature mortality and enhance patient compliance for treatment [6, 7]. Nanomedicine serves to deliver a valuable set of research tools and clinical devices in the near future. Therapeutic delivery to the cardiovascular system may play an important role in the successful treatment of a variety of disease states, including atherosclerosis, ischemic-reperfusion injury and other types of microvascular diseases, including hypertension. Nanoformulated drugs are designed to protect against systemic degradation, thereby reducing toxicity, immunogenicity, and increasing half-life, bioavailability and precise biodistribution [4, 8]. Further to attain therapeutic selectivity to the heart, functionalization with targeting moieties allows specific accumulation in the diseased heart [6, 7]. In CVDs, thrombotic events occur in ischemic stroke, myocardial infarction, pulmonary embolism, and venous thrombosis, where thrombolytic therapy are used to break up the blood clots. Recombinant tissue plasminogen activator (tPA) is actively used as therapeutic molecule for the treatment of acute ischemic stroke [9]. Multifunctional nanoliposomes are used for highly specific binding to activated platelets whilst minimising undesirable side effects [10, 11]. Many nanoformulations are undergoing clinical trials; some are in the pipeline. CVN should be focused on disease-driven approach rather than formulation-driven approach to strengthen the significant potential and to overcome physiological barriers and improve therapeutic outcomes in patients. However, nanoformulation approach is still in infancy; great efforts are being made by the researchers for improved outcomes in the patients.
Regenerative nanomedicine emerged as another aspect of therapy where it demonstrates a considerable capacity for repairing damaged heart tissue [12]. As injuries to the heart are often permanent due to the limited proliferation and self-healing capability of cardiomyocytes [13]. In this regard, the development of patient specific cardiac cells is recognized as a useful strategy to overcome this problem. Engraftment of the therapeutic cells illustrates little turnout, due to cell rejection activity of the immune system. To overcome this, compatible biomaterials are used, which display exctracellular matrix activity (ECM). Stem cell based therapy has broad applications in cardiac regenerative medicine. To replenish the functional cells to the heart induced pluripotent stem cells (iPSC) and iPSC-derived cardiomyocytes (iCM) presents a better opportunity. The regenerative aspect of the cardiac cells can be further addressed with developed functional biomimetic engineered cardiac tissues through precise control over cell-cell and cell-ECM interactions can mimic the biological properties of the native environment in some way. The ongoing activities for cardiac regeneration are emerging fast and demonstrating promising outcome in preclinical studies [14].
Plasmonic nanoparticles for cardiovascular disease are quite specific and useful at different wavelengths of irradiation. These nanoparticles are responsive to various optical response and exhibit important changes which are strongly influenced by surface plasmon resonance (SPR) which are extremely useful in biomedical applications [15, 16]. The clinical application of nanomedicines in CVDs is currently under various clinical trials. Functional restoration of the vessel wall is very challenging; in this regard, nanoburning technique is implemented which can demolish and reverse the plaque, especially in combination with stem cell technology. In a 5 year clinical cohort study: nanomedicine in the real-world clinical practice, wherein, NANOM first-in-man trial was evaluated with an intention-to-treat population (nano vs ferro vs stenting) to demolish and reverse the plaque, especially in combination with stem cell for promising functional restoration of the vessel wall by the process of nanoburning. Outcome of this trial demonstrated high safety with a better rate of mortality, target lesion revascularization, major adverse cardiovascular events at the long-term follow-up when compared with everolimus drug eluting coronary stent XIENCE V® [17]. A clinical trial using gold nanoparticles with silica-iron oxide shells versus stenting was evaluated for the treatment of atherosclerosis. For which bioengineered structure NANOM-PCI was used, which effectively showed the ability for high-energy plasmonic photothermic burning under the near-infrared laser irradiation on the lesion and reduces the volume of the plaque with most optimal long term approach compared to stenting [18]. In the following section of chapters: section -1, we discuss various aspects of nanomedicinal approach towards CVDs along with ethical issues pertaining to it. In section-2: we discuss the regenerative cardiovascular nanomedicine.
CONSENT FOR PUBLICATION
Not Applicable.
CONFLICT OF INTEREST
The author confirms that this chapter contents have no conflict of interest.
ACKNOWLEDGEMENT
FD gratefully acknowledges the Dept. of Science and Technology, Govt. Of India, for the financial grant [SR/WOS-A/LS-448/2017 (G)] in the form of women scientist fellowship (WOS-A).
REFERENCES
[1]Roth GA. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392(10159): 1736-88.[http://dx.doi.org/10.1016/S0140-6736(18)32203-7] [PMID: 30496103][2]Hobbs FD, Kenkre JE, Roalfe AK, Davis RC, Hare R, Davies MK. Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population. Eur Heart J 2002; 23(23): 1867-76.[http://dx.doi.org/10.1053/euhj.2002.3255] [PMID: 12445536][3]Juenger J, Schellberg D, Kraemer S, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002; 87(3): 235-41.[http://dx.doi.org/10.1136/heart.87.3.235] [PMID: 11847161][4]Martín Giménez VM, Kassuha DE, Manucha W. Nanomedicine applied to cardiovascular diseases: latest developments. Ther Adv Cardiovasc Dis 2017; 11(4): 133-42.[http://dx.doi.org/10.1177/1753944717692293] [PMID: 28198204][5]Sahoo SK, Parveen S, Panda JJ. The present and future of nanotechnology in human health care. Nanomedicine (Lond) 2007; 3(1): 20-31.[http://dx.doi.org/10.1016/j.nano.2006.11.008] [PMID: 17379166][6]Lanza GM, Winter PM, Caruthers SD, et al. Nanomedicine opportunities for cardiovascular disease with perfluorocarbon nanoparticles. Nanomedicine (Lond) 2006; 1(3): 321-9.[http://dx.doi.org/10.2217/17435889.1.3.321] [PMID: 17716162][7]Marsh JN, Senpan A, Hu G, et al. Fibrin-targeted perfluorocarbon nanoparticles for targeted thrombolysis. Nanomedicine (Lond) 2007; 2(4): 533-43.[http://dx.doi.org/10.2217/17435889.2.4.533] [PMID: 17716136][8]Dormont F, Varna M, Couvreur P. Nanoplumbers: biomaterials to fight cardiovascular diseases. Mater Today 2018; 21(1): 122-43.[http://dx.doi.org/10.1016/j.mattod.2017.07.008][9]Colasuonno M, Palange AL, Aid R, et al. Erythrocyte-inspired discoidal polymeric nanoconstructs carrying tissue plasminogen activator for the enhanced lysis of blood clots. ACS Nano 2018; 12(12): 12224-37.[http://dx.doi.org/10.1021/acsnano.8b06021] [PMID: 30427660][10]Hsu HL, Chen JP. Preparation of thermosensitive magnetic liposome encapsulated recombinant tissue plasminogen activator for targeted thrombolysis. J Magn Magn Mater 2016; 427: 188-94.[http://dx.doi.org/10.1016/j.jmmm.2016.10.122][11]Huang Y, Yu L, Ren J, et al. An activated-platelet-sensitive nanocarrier enables targeted delivery of tissue plasminogen activator for effective thrombolytic therapy. J Control Release 2019; 300(28): 1-12.[http://dx.doi.org/10.1016/j.jconrel.2019.02.033] [PMID: 30807804][12]Cassani M, Fernandes S, Vrbsky J, Ergir E, Cavalieri F, Forte G. Combining nanomaterials and developmental pathways to design new treatments for cardiac regeneration: the pulsing heart of advanced therapies. Front Bioeng Biotechnol 2020; 6: 323-1-26.[13]Santoso MR, Ikeda G. Exosomes from induced pluripotent stem cell–derived cardiomyocytes promote autophagy for myocardial repair. J Am Heart Asso 2020; 9(6): e014345-1-14.[14]Dunn DA, Hodge AJ, Lipke EA. Biomimetic materials design for cardiac tissue regeneration. Wiley Interdiscip Rev Nanomed Nanobiotechnol 2014; 6(1): 15-39.[http://dx.doi.org/10.1002/wnan.1241] [PMID: 24123919][15]Liu J, He H, Xiao D, et al. Recent advances of plasmonic nanoparticles and their applications. Materials (Basel) 2018; 11(10): 1833.[http://dx.doi.org/10.3390/ma11101833] [PMID: 30261657][16]Kim M, Lee J-H, Nam J-M. Plasmonic photothermal nanoparticles for biomedical applications. Adv Sci (Weinh) 2019; 6(17)1900471[http://dx.doi.org/10.1002/advs.201900471] [PMID: 31508273][17]https://clinicaltrials.gov/ct2/show/NCT01270139[18]https://clinicaltrials.gov/ct2/show/NCT01436123Nanomedicinal Aspects in Cardiovascular Diseases
Uzma Farooq1,Mohd. Amir Mirza1,Sradhanjali Mohapatra1,Zeenat Iqbal1,*Abstract
There is hardly any approved drug product for a cardiovascular ailment that utilizes nanotechnology. Although there are a few products in this category, they do not claim to be nano-therapeutics. An exhaustive evaluation of clinical trial databases indicates that in the near future, we may see some drug products in the market in this category. There are several similar investigational products by different groups across the globe. A comprehensive collection of published literature augurs the inclination of scientists in this field. The use of nanotechnology in cardiovascular is beneficial owing to Critical Quality Attributes that can be imparted based on the size, spatial arrangement of drug molecules, release profile, etc. In some cases, drug release characteristics have to be in sync with circadian rhythm, which can be easily obtained using this technology. The section of the book tries to highlight some of the aspects related to the exploration of nanotechnology in the case of cardiovascular treatment.
INTRODUCTION
According to the WHO’s records, cardiovascular diseases are found to be the top most leading cause of death. Approximately 17.9 million people die every year worldwide due to the severity of cardiovascular disease and incurs (i.e. 31%) of all deaths. Out of these deaths, 85% are due to heart attack and stroke [1]. Annually by the year 2030, nearly 12 million deaths are expected to be caused by coronary atherosclerosis, which includes acute coronary syndromes like ST segment (i.e interval between ventricular depolarization and ventricular repolarization) or non ST segment elevation myocardial infarction. Cardiac ischemia might not reverse promptly; leading to the initiation of irreversible cell death, contractile dysfunction and scars tissue development [2].
Despite the era of advanced technology in our scientific and clinical area, the death rate of heart diseases still remains high. Nanomedicine is the transitional science of nanotechnologies in healthcare, which involves the mechanism that leads to the development of new pathways at the molecular stage for the development of novel therapeutics and diagnosis of cardiovascular disease (CVDs) [3]. Nanomedicine has various applications in therapeutics; nanotechnologies such as nanoemulsions, nanoparticles or nanodevices are used to penetrate the biological barriers. The nano-devices can contain encapsulated active molecules for the locoregional delivery of the targeted area. These are also used to cross the biological barrier for the systemic effect [4]. The advance of treatment modalities include pharmaceuticals, reconstitution by surgery and implantation of devices. Although these conventional treatment technologies provide a better quality of life but still needs improvement in therapeutics, or else it requires other alternative therapeutic approaches. Recent technologies of nanostructured systems, nanomedicines, nanoscience and nanotechnology have provided unique properties that can potentially overcome the limitations of conventional cardiovascular pharmaceutical medicines through the development of novel pharmaceutical nanomedicines and biomedical devices. Bioengineering perspective towards the diagnosis of atherosclerosis and other cardiac disorder provides exclusive opportunities for the diagnostic and management of these disorders. Further, studies on molecular engineering have provided new pathways that can potentially serve for diagnostic and therapeutic targeted delivery (Fig.1).
Fig. (1)) Nanoparticles or nanostructured biomaterials can be used for delivery of cells and molecules and for targeted therapy of artherosclerosis or Ischaemic myocardial injury.Radiotracers images obtained by various nuclear imaging techniques, such as single-photon emission computed tomography (SPECT) and positron emission, respectively (PET), are used to determine the cardiac disorder via exogenous administration whereas, for the anatomical imaging of arteries, advanced nanomedicine techniques are used including magnetic resonance imaging (MRI), ultrasonography (US) and computed tomography (CT) [5]. Drugs are commonly delivered either via oral route or needle based routes, such as intramuscular, intravenous or subcutaneous, which are painful for the patients. In the current technology platform, nanoparticles can be administered via intranasal route to treat cardiac disorder. As we know, inhalational delivery is a common route for a respiratory disorder. In one study, peptide –loaded nanoparticles are administered via inhalation for cardiac targeted therapy [6]. This study, reported that inhalation therapy is suitable for carrying peptide based nanoformulation to the cardiac disorder as it deals with biomineralized inspired technique without any toxic effect and lacks interference in the functional activity of the cardiac myocytes. For imaging aspect, nanoparticles are formulated with the contrast agent that are either attached on the particles surface, or encapsulated with fluorescent dyes in the matrix or a combination of both.
Advances of nanomedicine for diagnosis of CVDs
Vascular physiology under normal condition was found to be tight (< 2 nm) junction of endothelial membrane, which is responsible for preventing the penetration of nanoformulations. However, endothelial dysfunction creates gap in-between the cells, which enables the microparticles or nanoparticles to penetrate from the blood vessels at topical sites, in turn, unabling to get cleared owing to its lymphatic impairment. Development of contrast generating nanomaterials for the use of radioactive imaging, fluorescent, para/super-paramagnetic, LSP (light scattering particles) and electron dense method were sought by combining multiple contrast agents at nanoscale for the detection and analysis of cardiovascular disorders at an early stage. MRI for cardiovascular imaging requires powerful magnetic fields or radiofrequency waves for the diagnosis via internal structures scanning. The size dependent imaging properties of fluorescent nanoparticles enable the detection level from ultraviolet to mid-infrared range and its enhancement of emission wavelength are correlated with the particle size [7]. These multistage nanoparticles provide images of the target areas where macrophages are accumulated. Nanocontrast agents like 18F-CLIO (18F-cross linking with iron oxide) are used for the detection with PET and MRI. Three iron oxide nanoformulations such as AMI-121 (FerumoxsilTM); OMP50 and AMI-25 (Feridex) are approved for imaging by FDA [7].
Nanoparticles for MRI
Various types of contrast agent, such as inorganic metal oxide having limited transverse relaxation time are used for signal enhancement in MRI imaging. Super-paramagnetic iron oxide and gadolinium have the ability to reduce the relaxation time of tissues longitudinally and to enhance the strength of signals for positive contrast [8]. Therefore, nanocrystal of magnetic moment and hydrophilic core exposure is responsible for determining the intensity of signal.
Nanoparticles for Positron Emitting Tomography (PET)
PET imaging is suggestively used to determine the variation in the anatomical, physiological, functional changes in transmitted signals in the cardiovascular system. PET provides high sensitive images due to the radiation emitted from radiopharmaceutical that is being injected to patients intravenously. These radiotracers suffer short half-lives and are also toxic to tissues. In order to overcome these issues, multi-imaging nanoparticles were designed by incorporating Quantum dots (QD), super-paramagnetic iron oxide nanoparticles or gold nanoparticles. Surface of the nanoparticles is coated with radioligand chelate i.e. capable of introducing PET imaging [9].
Fig. (2)) Immobilization and characterization of PLGA nanoparticles on polyethylene terephthalate cardiovascular grafts for local drug therapy of associated graft complication: reused with kind permission of authors of another study [22].For coronary atherosclerosis, biodegradable nanoparticles are designed for therapeutic delivery of biomolecules to the targeted area, which can control the plaques by reducing inflammation via activation of pro-resolving pathways or removing crystals of lipids and cholesterol. To reduce the inflammation, biodegradable polymeric material will be able to release the encapsulated biomolecules or proteins in a controlled manner. A membrane receptor (CD163) can be used for imaging of CD163 expression macrophages in order to detect atherosclerosis plague [10]. Tarin et al. designed a targeted probe based on gold-coated iron oxide nanoparticles conjugated with anti-CD163. Results demonstrated that these developed nanoparticles are highly sensitive and capable of detecting CD163 expression which in turn can provide useful information regarding the disorder [11]. In another study, superparamagnetic nanosilica@ PLGA nanoparticle loaded quercetin are formulated for the treatment of heart failure, myocardial infarction, coronary cardiac disease, atherosclerosis and inflammatory heart disease and other related CVDs. Widest health problems across the globe includes unhealthy diet, sedentary lifestyle, various other diseases like obesity that leads to many CVDs can be preventable and few can be treated with the help of the nanoformulations (Fig. 3).
Fig. (3)) Fabrication and characterization of superparamagnetic nano-silica of quercetin-encapsulated PLGA nanoformulation: Effect on rat cardio after 1month of treatment observed by hematoxylin and eosin (H&E) staining which shows significantly widening of left ventricle. Effect on rat cardio after 1month treatment observed by PSR staining [24].Moreover, CVDs remained the leading cause of death, in which the mortality rate has been steadily increased and even crossed the statistics of cancer. Currently, the treatment of CVDs is revolved around the oral medications, lifestyle alteration and invasive surgery. Hence, this area demands intervention of newer technology. Nanomedicine, which is among the fastest emerging area of medical research is expected to provide a greater potential and effective treatment approach with fewer side effects. Various experiments have been conducted which are focused on cardiovascular applications, but very few of them have entered the clinical trials Table 1
Nanotechnology can be exploited for the early detection and treatment of several diseases. Based on the classification of antihypertensive drugs, angiotensin converting enzyme inhibitors such as enalapril, captopril, ramipril are mostly administered to prevent the conversion of angiotensin I into angiotensin II [16]. These administered drugs incur various adverse effect such as limited bioavailability, permeability, which in turn demands high frequency of dosing. In this regard, nanotechnology based formulations have provided an alternative strategy for resolving related problems as well as challenges. Drugs like digitalis or digoxin are generally administered in acute myocardial infarction and arrhythmia to increase the transmitted signal for normalizing the heart function. HMG-CoA reductase inhibitor inhibits the action of enzyme, which is responsible to transfer HMG-CoA into mevalonic acid for the synthesis of cholesterol [17]. The main objective of using nanotechnology in pharmacy is to treat the patient effectively and efficiently with increased patient compliance. Formulated nanodrugs are intended to prevent adverse side effects by introducing ligand-targeting, receptor-mediated targeting or stimuli-responsive targeting approaches, that might provide an additional strategy for implementation of localized release of the loaded drug for better use in diagnostics, molecular imaging and tissue engineering etc [18]. The following table provides brief information of recent advances of nanomedicine formulations developed by using various evaluation parameters for early diagnosis and treatment of cardiovascular disorders (Table 2), and brief idea about the development of technologies up-till now as well as patents related to advancement of nanomedicine (Table 3).
