Nanomedicine, Volume I: Basic Capabilities—A Review

by Robert A. Freitas, Jr.

ISBN 1-57059-645-X, Landes Bioscience: Georgetown, Texas USA. 1999.

Lawrence Rosenberg

The term nanotechnology describes a variety of nanoscale technologies. Molecular nanotechnology has been defined as the three-dimensional positional control of molecular structure to create materials and devices to molecular precision—the ability to construct objects with atomic-scale control.

Molecular nanotechnology will usher in an unprecedented era of dramatic progress in the way medical care is provided. More than just an extension of "molecular medicine," nanomedicine will employ molecular machine systems to address medical problems and will use molecular knowledge to maintain and improve human health at the molecular scale. Nanomedicine will have extraordinary and far-reaching implications for the medical profession, for the definition of disease, and for the diagnosis and treatment of medical conditions, including aging.

The hallmark of medicine up to the present time has been the establishment of a delicate synergy between the tools of the physician/surgeon and those of nature. In most cases, however, one is forced to concede that we doctors have had to rely chiefly on the body’s own self-repair capabilities. The best example, perhaps, is the recognition that antibiotics will not perform their intended function in the absence of an intact immune system.

The coming ability to carry out targeted medical procedures at the molecular level will bring unprecedented power to the practice of medicine, and promises to dominate medical technology research in the coming decades as much or more than even the Human Genome Project.

Nanomedicine, Volume I is the first book-length technical discussion of the potential medical applications of molecular nanotechnology and medical nanorobotics. It is meant to help us to frame the research issues that must be addressed, and to develop a knowledge base with which to proceed on the path toward medical nanotechnology.

The author, Robert Freitas Jr., has degrees in physics, psychology, and law, and has written on a diverse set of scientific, engineering, and legal topics, including a NASA feasibility analysis of self-replicating space factories. He later authored the first detailed technical design study of a medical nanorobot ever published in a refereed biomedical journal.

When completed, Nanomedicine will be a three-volume technical work with 31 chapters. Its intended audience is technical and professional people with a serious interest in the future of medical technology. The three volumes build upon each other cumulatively. Volume I, the subject of this review, describes basic capabilities common to all medical nano-devices, and the physical, chemical, thermo-dynamic, mechanical, and biological limits of such devices. Its primary audience is physical scientists, chemists, biochemists, and biomedical engineers engaged in basic research. Volume II, still in progress, deals with aspects of device control and configuration, biocompatibility and safety issues, and basic nanomedical components and simple systems. Its primary audience will be systems and control engineers, research physiologists, clinical laboratory analysts, biotechnologists, and biomedical engineers doing applied research. The third volume will discuss the use of nanomedical technology in clinical medicine. Its primary audience is clinical specialists and clinician-scientists.

Volume I of Nanomedicine, Basic Capabilities, begins with a comprehensive and thoughtful account of the underpinnings of modern medicine. Chapter 1, The Prospect of Nanomedicine, defines the field of nanomedicine and its objectives. Several thought experiments are employed to help the reader develop an intuitive appreciation of time, space, and mechanics in the microworld, where nanorobots will be operating. The goals of our current "molecular medicine" are carefully distinguished from the goals of nanomedicine. The evolution of the concept of nanomedicine and cell repair machines is discussed as the natural culmination of several thousand years of medical discovery and innovation. The chapter finishes with an overview of the entire three volume series.

Since nanomachines cannot yet be built, it is important to establish that such devices are in fact feasible, and that their design, fabrication, and operation violate no physical laws and will obey sound engineering principles. Chapter 2, Pathways to Nanomedicine, begins with a discussion of a number of classical objections to nanotechnology such as quantum mechanics, which after careful consideration, are resolved satisfactorily. Next, precursor technologies to nanotechnology and nanomedicine, such as micromachines/MEMS, telemicrosurgery, and tissue engineering, are briefly considered. This is followed by an introduction to the concept of molecular manufacturing. The chapter concludes with brief descriptions of molecular machine parts, nanocomponents, and nanomaterials.

Surgeons and other clinical specialists should have little trouble in following the author’s discussion to this point. These chapters, though, are followed by a necessarily terse and detailed elaboration of the set of basic capabilities of molecular machine systems that may be required by medical nanorobotic devices. These latter chapters will be best appreciated by those in biomedical engineering or the physical sciences. The capabilities discussed include the abilities to recognize, sort and transport important molecules (Chapter 3); sense the environment (Chapter 4); alter shape or surface texture (Chapter 5); generate onboard energy to power effective robotic functions (Chapter 6); communicate with doctors, patients, and other nanorobots (Chapter 7); navigate throughout the human body, i.e., determining location within vessels, organs, tissues, or cells (Chapter 8); manipulate microscopic objects and move about inside a human body (Chapter 9); and timekeep, perform computations, disable living cells and viruses, and operate at various pressures and temperatures (Chapter 10).

Many of the concepts presented by the author, if not the underlying premise itself, atomic-scale control, are sure to engender controversy. The implications for the future of medicine, would be profound should the technical and theoretical underpinnings of nanomedicine prove to be correct. Given the current pace of development in nanotechnologies generally, the future of medicine really does appear to be nothing short of awesome. Seen in this context, Nanomedicine by Robert Freitas is a must read. It is the authoritative roadmap to the future of medicine.