Nanoteranostics
Diagnosis and treatment "in one bottle": how science is fighting cancer today
Mortality from cancer in Russia is in second place after mortality from cardiovascular diseases, and, according to some estimates, may come out on top. The search for new ways to treat cancer has led to the emergence of a new direction of science – theranostics. What is it? What are the novelty and advantages of this direction? This was told to the correspondent of the project "Social Navigator" MIA "Russia Today" by the head of the Laboratory of the Engineering Physics Institute of Biomedicine of the National Research Nuclear University "MEPhI" (NRU MEPhI), head of the laboratory of the Institute of Bioorganic Chemistry named after M.M. Shemyakin and Yu.A. Ovchinnikov of the Russian Academy of Sciences, Corresponding member of the Russian Academy of Sciences Sergey Deev.
– Sergey Mikhailovich, theranostics attracts many researchers today. What is it and why is the development of this science very important for us?
– The term "theranostics" appeared in 2002. It comes from two words – "therapy" and "diagnosis". This means that "in one bottle" we must produce both therapeutic and diagnostic effects. At first, few people noticed this new field of science, but now it is actively developing. Over the past year, there have been several thousand scientific publications in this field.
Theranostics is developing rapidly, it is in demand in various fields of medicine, but I would like to focus on oncology. There are successes in the treatment of oncological diseases today, there are a number of standard chemotherapeutic drugs that work well. Nevertheless, the severity of the problem dictates the need to find new approaches and solutions. Theranostics provides such solutions.
– Tell us more about it, please.
– Since standard chemotherapeutic methods act non-specifically, for effective treatment, it is important for doctors to know the molecular portrait of the tumor and to target it. Despite the great success of chemotherapy, when it is used, the patient's liver, kidneys and other healthy organs suffer. Therefore, about 25 years ago, the rapid development of targeted (directed) therapy began.
A couple of weeks ago, we witnessed the awarding of the Nobel Prize in Chemistry for the phage display of peptides and antibodies. Sir Gregory Winter received this award for creating a technology for producing antibodies that can provide targeted effects in cancer therapy.
After the development of the phage display, other display technologies appeared and are actively used: cellular (or yeast) display, ribosomal and others. They make it possible to obtain polypeptides that selectively bind to a specific target. For example, Andreas Plyuktun, with whom we began to actively cooperate in the late 90s, developed the technology of "darpins". These polypeptides are perhaps even more promising for these purposes.
With the use of these technologies, theranostics has gained the possibility of targeted delivery of both active agents – chemotherapeutic, biological toxins, radionuclides, and imaging compounds.
– How did the prefix "nano-" join the "theranostics"?
– Recently, the direction "Cancer Nanotechnology" has been formed in the West and even a scientific journal with this name has appeared. Here we are talking about the use of not only individual compounds, but also nanoparticles.
The fact is that nanoparticles provide qualitatively new opportunities for the purposes of theranostics. Having a developed surface, they make it possible to attach both targeted molecules and a whole set of agents to them and thus create multifunctional structures. In addition, they themselves can act as contrasting agents, and their unique physicochemical properties allow the use of external influences (laser or radiation radiation, ultrasound) to increase the selectivity of action.
Thus, theranostics gives physicians the opportunity to learn the molecular portrait of the tumor and to carry out targeted delivery of agents to the tumor for both high-precision diagnostics and effective therapy.
Combining diagnostic and therapeutic agents in one structure will allow not only to carry out targeted effects, but also to monitor treatment. It should be taken into account here that tumors often change their morphology, their molecular portrait under the influence of therapeutic agents and, thus, "leave" treatment. In these cases, the effect of the drug becomes not only useless, but also harmful.
– Does nanoteranostics still exist only at the level of clinical research or is it already being introduced into treatment?
– There are a huge number of scientific papers in this field. As far as I know, several dozen drugs related to nanotechnology are already undergoing the second and third stages of clinical trials.
Today, multifunctional agents come to the fore, because for the success of therapy, a complex effect on the tumor of several agents that differ in the mechanism of action – for example, radioactivity, biological toxin, antibiotic.
Their combination with a subtle effect on the patient's immune system is likely to be particularly promising. It was for "the discovery in the field of inhibition of the immune system for a more effective attack of cancer cells" that another Nobel Prize in Physiology or Medicine was awarded this year.
It is no coincidence that I mentioned the Nobel Prizes: initially, the research of this year's laureates was pure science, but today targeted drugs based on genetic engineering of antibodies and targeted peptides are sold for tens of billions of dollars a year! This field of science has become an important area of tumor therapy.
The field of nanooncotechnology will be actively developing in the coming years, therefore, meeting the requirements of the time, we have created an onkonanotechnology group in the Immunology Department of the Institute of Bioorganic Chemistry of the Russian Academy of Sciences. As far as I know, this will be one of the first scientific departments of this kind in Of the Russian Federation.
We plan to work closely with the NRU MEPhI and the divisions of the Academy of Sciences. I think this will allow us to provide a synergistic effect from the joint work of physicists of the MEPhI Research Institute, bioorganic chemists and molecular biologists from the Academy of Sciences and to find new solutions useful for patients.
– How soon will new diagnostic and treatment methods be available to Russian patients?
– Previously, 10-15 years passed from the origin of the idea to the last stages of clinical trials. Now this process is accelerating, but for this it is necessary to combine the efforts of scientists and doctors. We, scientists, know how to do it, and doctors should tell us what to do and check how effective our findings are.
If there is a political will that unites groups of physicists, technologists, molecular biologists and doctors into strong interdisciplinary teams, this will lead to accelerated development and introduction of new research into medical practice.
The interview is presented within the framework of the III International Symposium "Engineering and Physical Technologies of Biomedicine", organized by the National Research Nuclear University "MEPhI" (NRU MEPhI).
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