There's a revolution in medical care that will make an inexorable impact on our lives. Whether one is being treated in a doctor's office, a medical laboratory, a hospital, or an emergency room, the coalescing medical advances are nothing short of amazing, including in-vivo (inside the body) and in-vitro (outside the body) diagnostic and therapeutic devices, and implantable and disease-targeting drugs.
These breakthroughs are largely based on emerging microtechnology and nanotechnology electronics. New tools with microrobotic grippers and tweezers will offer surgeons an unparalleled ability to operate on just about any part of the human body, no matter how small. Targeted drug delivery and analysis devices also are making great gains.
Micro-array lab-on-a-chip products for point-of-care diagnostics are already at the clinical trial stage. They will be available once the U.S. Food and Drug Administration (FDA) approves them. A micro-array lab-on-a-chip is an array matrix that lets doctors instantaneously analyze fluids, cells, and even DNA structure right in the office. This high-throughput analysis will be a boon to medical and pharmaceutical industries. The lab-on-a-chip promises high-speed fine-tuned identification of the protein sequences that make a difference in specific diseases. Many of these devices can be worn on the wrist or tucked under a belt.
Expect to see diagnostic chips for such vital organs as the brain, heart, eyes, lungs, liver, and kidneys, possibly within five years. We can look forward to new therapeutic methods to treat various medical conditions. Just one example is a novel means to stimulate retinal cells affected by macular degeneration and retinitis pigmentosa, two common eye diseases.
Implantable brain probes for the detailed study of neural activity are already here. Under rapid development too are so-called "brain-on-a-chip" devices, which allow physicians to view the simultaneous interactions occurring between brain neurons. The devices enable treatment of various mental and other brain disorders.
Revolution Coming In Drug Analysis And Delivery: Few things in the medical sciences are more exciting than the drug analysis and delivery systems expected over the next few years. Implantable devices consisting of sealed arrays of reservoirs will be available for in-vivo and in-vitro drug analysis and delivery. These devices are filled with chemicals that can be released on demand and can check the efficacy of drugs released over long periods of time (Fig. 1). Subcutaneous implanted mi-crochips have already proven their value in these applications.
It may take a few more years, but nano-size porous membranes with 7- to 9-nm pores will offer size-based exclusion and controlled diffusion of drug biomolecules. The idea is to allow the diffusion into the body of small therapeutic drug molecules while excluding larger molecules, providing significant advantages in cell immuno-isolation and controlled drug-delivery applications.
Depending on the medical application, these devices can be administered by many different routes: by subcutaneous implants, surgical implants, oral pills, intravenous injection, and possibly pulmonary inhalation. These biomolecular drugs have the potential to significantly improve drug delivery for the treatment of chronic hepatitis C, anemia, neutropenia, multiple sclerosis, psychosis, diabetes, and cancer. One of the more exciting developments is an intravenous injectable drug-delivery platform to target and treat metastatic solid-breast tumors as well as lung and colon cancer tumors.
Already, patch-type insulin pumps can diffuse insulin into the body. The patch is worn on a patient's arm and has a metering device to show how much insulin has been delivered over a period of time. Implantable pumps and MEMS micro-needles for the precise and effective delivery of insulin are on the horizon (Fig. 2). Before long, micro-insulin pumps, complete with the insulin, a pump, a microprocessor, and microneedle arrays for drug injection, no bigger than 1 or 2 cm2, will be available for implants.
In a few more years, nanorobots injected into the body will become a reality. They could work in the patient's blood system, so their overall sizes would be just 1 or 2 mm. Even more exciting will be microrobotic grippers and tweezers. When placed in catheters, they'll give surgeons pinpoint access to the areas of the body they need to work on, something not yet possible for certain types of maladies or small patients like premature babies.
So many microelectronic devices are being used for monitoring, control, and treatment in implants and artificial prostheses for joints, hips, legs, and spines, some recipients are being likened to "bionic" creatures. Major advances in this area will certainly continue.
Because spinal problems beset a large number of people, a lot of activity is ongoing to develop implantable and therapeutic sensory systems. These will make back pain more tolerable and act as instrumentation systems, letting doctors study the long-term efficacy and effects of implantable devices.
Completely implantable hearing aids that will enable totally deaf individuals to hear are within a year or two from the market. They stimulate the ear's nerves and let them regenerate themselves back into action (Fig. 3).
What will this mean for mankind? It's nothing less than the complete and precise control of presently known diseases and maladies, as well as the prediction and treatment of not-yet-detected illnesses lurking in the human body.
It will certainly mean fewer adverse side effects from drugs because many of these chemicals will be designed to slowly seep into the body's tiny crevices, in a controlled manner, at precise locations. No drug is free of some side effect, but the tiny mechanisms and vehicles being designed now for them to ride in on will make these drugs much more "disease-specific." Some futurists are calling such drugs "magic bullets."
A New World: Many see the emergence of advanced biomedical devices as creating a new world of "bio-IT," in which the biological sciences of diseases, drugs, and tissue interactions converge with the world of information technology. The catalyst will be microelectronics technology like MEMS and nanoelectronics, with advances in telemetry and software piggybacking on these technologies.
There are already questions about whether biomedical technology developments are a blessing or a bane, as they bring potentially undesirable ramifications. The same advances in sensing, communications, and control technology can also be used by the government to keep tabs on individuals implanted with these devices, a clear invasion of privacy. Already, civil liberty advocates are protesting such potential misuses. Where do we draw the line? Only time will tell.