Recent Developments and Applications of Nanotechnology to Develop Novel Medical Devices, Infectious Disease Diagnosis, and its Treatment.

Introduction

Emerging infections and novel diseases are badly impacting the world’s health and livelihood. Over three hundred contagious diseases were reported till 2004 caused by different strains like bacteria, fungi, viruses, and protozoa. Specific ecological and environmental factors influenced the viral spread of infectious diseases.¹ Recently, some novel disinfecting agents and techniques have been discovered to control some typical diseases, such as cholera, tuberculosis, and pneumonia.² Reusable medical devices undergo multiple usage and reprocessing steps, causing the accumulation of organic residues, which enhance microbial growth. Removal of these resistive contaminants is a challenging process.³ Several techniques are available to control this spread of microorganisms but still need to develop some fast, cost-effective, and consistent approaches.⁴ To overcome these challenges, nanotechnology may be an alternate fast-growing science approach. Nanotechnology is a science which works with a defined scale of 1 to 100 nanometers, inclusive of various domains like biology, chemistry, physics, and material science.⁵ Nanotechnology includes silver nanoparticles, surface coating, nanocomposites, and Quantum dots, among others. Due to silver nanoparticles’ antimicrobial properties, it acts as an effective disinfectant used for the development of silver-enabled air and liquid filters, textiles, food packaging and biomedical.⁶ Surface coatings have a high potential to better the life of reusable medical devices. Improvements in coatings can help in reprocessing, disinfection, and sterilization by minimizing the corrosion, discoloration, bubble formation, and erosion of the outer surface.^7,8 In current scenario, there are limited materials and consumables which have the potential to resolve the issue of antibacterial resistance.

As per current challenges, it is required to develop a sustainable solution to reduce the bacterial adherence probability over the medical devices and different type of consumables. Development of novel coating material by using silver nanocomposite may be a sustainable solution for these challenges. To prevent infections and diagnosis of bacterial disease, it is required to develop novel nanocomposites as a powerful weapon in healthcare sector. This review article highlights the advancement of nanotechnology and applications in medical, water, air, and food organizations.

Various infectious challenges

There is an extensive list of diseases caused by high concentrations of microbes, for example, biofilm treatment is more resistant to “traditional biofilm” and develops in wet environments.⁹ Endoscope is one recent example of infection due to Enterobacteriaceae.¹⁰ Health care units are currently facing the issue of the resistant nature of some specific microorganisms against multiple antibiotics. Due to that, health care experts are unable to provide proper support to patients.¹¹ Due to limited resources and dense population, contaminants in water in microbial form, along with excess contents of chemicals which, may cause severe disease.¹² In present scenario, airborne particles are encouraging the growth of microorganisms like viruses, fungi, and other bacterial strains which cause multiple diseases, for example, anthrax, SARS (severe acute respiratory system), and asthma.¹³ Hospital environment is always prone to spreadinfection and responsible for spreading severe infections to the environment.^14,15 Textile industries are struggling for stable, durable, sweating free and safe one.^16,17 Silver release from food packages system needs more research to evaluate its impacts for consumers.¹⁸ Initial source of contamination in food industry is the processing plant having biofilm. These biofilms sometime become resistant to the disinfection and cleaning detergents.¹⁹ In hatchery rooms viruses, bacteria, bacterial toxins, fungi, spores, pesticides are the contaminants which are produced due to feed residues, feathers, feces, and epiderm.²⁰ Now a days food industries are struggling due to unavoidable bacterial, fungal, parasites and viral infections ²¹ Hospital acquired infections now a days a major challenge which is causing multiple death.²² There are some cases which reported lapses in reprocessing (cleaning, disinfection/ sterilization) even fulfilled the requirements of applicable guidelines. Effectiveness of disinfectant may be increased based on these specific comparisons.²³ These challenges can be taken care of by following standard precautions, transmission-based precautions, and monitoring.²⁴ Usage of nanosilver and nanocomposites are playing a key role in infection control.²⁵ It may be a mistake by regulatory authorities if nano silver does not declare as a new chemical with its multiple properties.^26,27

Proposed practices for safe usage of medical devices, infection diagnosis, and controls

Simulated Reprocessing, cleaning validation, and sterilization:

To control microbial worldwide spread surgeons and researcher proposed few innovative techniques against infectious strains. Disinfection and sterilization technique reduced the infections significantly for different areas like hospitals, clinical areas, and biological research.²⁸ Disinfection process eliminates a variety of pathogenic microorganism but are limited to bacterial spores. Multiple disinfectants were developed from time to time for specific applications. Disinfectants were used as liquid chemicals or wet pasteurization to inhibit the spread of microorganism over a surface.²⁹ Cleaning and disinfection of environmental surfaces plays a significant role in effective infection prevention program for example pulsed-xenon device having mercury bulb to produce UV (ultraviolet) light of range 200-320 nm range is also effective at patient rooms as it significantly decreases the pathogen concentration.³⁰. Along with these innovations, there are some opportunities which can be adopted for further improvements, for example nanotechnology.^31,32

Nanotechnology overview and its advantage over other infection diagnosis and control

Figure 1: Comparative evaluation of Nanomaterials Click here to View Figure

Types of nanomaterials

In combination with above Fig. 1, there are below several types of exemplary nanomaterials which are being used in numerous applications.

Non-metallic inorganic nanomaterials (TiO₂, SiO₂, ZnO, Al(OH)₃, Fe₂O₃, Fe₃O₄,ZrO₂, CaO, ITO, ATO, CeO₂).

Metal alloys and metals (Au, Ag, Pt, Pd, Cu, Fe, Ni, Co, Al, Mn, Mo).

Nanomaterials enabled with carbon like fullerenes, carbon nanotubes, carbon nanofibers, graphene.

Dendrimers and nano polymers (polymeric nanoparticles, polymer nanotubes, nanowires and nanorods, nanocellulose, nanostructured polymer films).

Quantum dots (cadmium telluride, cadmium selenide, quantum dots free of cadmium).

Out of these nanoparticles, silver nanoparticles have various advantages due to antimicrobial potential. Other nanomaterials require more research and experiments to prove their credibility. Except silver nanomaterial, limited data is available for other nanomaterials. Refer below synthesis methods of silver nanoparticles: 

Figure 2: Synthesis methods of silver nanoparticles Click here to View Figure

It was also found that some novel nanoparticles formed by placing silver sources in contact with surfaces. Same scenario is also applicable for copper silver nanoparticles. As there are multiple nanoscale objects which remain in contact with human also the source of incidental nanoparticles in the environment.³³ Apart from the methods explained in Fig. 2, there may be some other innovative methods to develop silver nanoparticles which require more scientific research.

Antibacterial functioning of silver nanoparticles

As per Fig. below Fig. 3, silver ions are responsible for damaging cell wall of the gram positive and gram-negative bacteria responsible for various infectious diseases. Oxidative stress of silver ions generates disruption in metabolic activities which denature the ribosome in cytoplasm and cause cell death.

Figure 3: Antibacterial functioning of silver nanoparticles Click here to View Figure

Various methods for “silver nanoparticle” synthesis, relative benefits, and limitations [34]:

Table 1: Various methods used for silver nanoparticles’ synthesis

Silver and its salts are also beneficial in drug manufacturing, imaging and drug delivery systems³⁵ restorative dentistry, ophthalmology, skin/ tissue repair, and nano biosensors.³⁶ It required more studies to understand the broad application of silver nanoparticles for various medical devices.

Different methods of nanoparticle’s “Surface coating,” relative benefits and limitations:

For any of the metallic device, it is important to understand the type, structure, and its coating process. For example, in food industry, engineered nanoparticles like photocatalyst metal oxides may be the promising agent to manage these resistive contaminants through surface coatings. It includes the development methods of antimicrobial surface coatings, associated characterization methods, evaluation of physical stability of coating along with antimicrobial efficiency.³⁷ There are few exemplary techniques below which can be used for coating metal oxide. Due to metal-to-metal compatibility, surface coating has more potential to increase shelf life of coated materials. Now a days, industries have advanced techniques to develop surface coating, for example coating of metal oxide.

Table 2: Various techniques for coatings of metal oxide

Metal oxides demonstrated improved coating stability for the food packaging system along with other necessary cleaning and sanitization protocols. Ventilation, walls, floors, machinery, cause infections in hospitals.⁴⁷. To overcome some critical surface infections, coating is best alternative. Shelf life of coating material and surface leaching are main challenges which need to be overcome for a stable coated product.

Different methods for “Nanocomposites” development, relative benefits, and limitations

There are some studies which stated novel development of nanocomposites, for example, 3% Ag/TiO-2 nanocomposites developed with UV. It was the better alternative for antimicrobial activity for Gram-negative and gram-positive bacteria [2]. Now a days, nanocompositemembranes are developed to increase the bacterial removal efficiency.⁴⁸ Also, antimicrobial experiment proved that efficiency of Nanocomposite membrane is greater than 98%.⁴⁹ Another example is Titanium dioxide which is synthesized by photocatalytic, can easily perform at ambient conditions, also it is eco-friendly⁵⁰ Few models have capability for treatment of diabetic wound healing process.^51,52 Plasma at low temperature activates the fiber surface to help strong binding of silver nanoparticles onto polyester fabrics.⁵³ Effective composites form can be potential antibacterial agent for sanitation and disinfection industries.^54,55 Based on iodine antibacterial nature and its effects against drug resistant organisms, iodine nanocomposite was developed by iodine immobilization through metal–organic frameworks can be beneficial for orthopedic implant.⁵⁶ If there are alternative approaches to treat microbial infections, usage of silver-based products should be avoided. Overall, it is always a choice to use silver products based on their antimicrobial efficiency over cellular toxicity. Due to limited scope of few materials, nanocomposites have potential to tackle antibacterial resistance. Now a days in industries, advanced techniques are available for alloys combination or development of nanocomposites.

Different methods for “Quantum dots” development, relative benefits, and limitations

Carbon Quantum Dots as assembled Spermidine are found active against resistant bacteria strain. This synthesis used ammonium citrate through pyrolysis and modified spermidine by simple heat treatment. In vitro wound healing studies were performed in mice to show quick healing, quick formation of collagen and better epithelialization when Spd/ CQDs used as a material for dressing.⁵⁷ Biocompatibility results demonstrated no cytotoxic impact on mouse embryonic fibroblast cell lines but showed cytotoxicity against epithelial cell line of human. Few synthesis mechanisms can be used to develop disinfection material.⁵⁸ Minor effect as hemolytic against red blood cells were seen in some cases.⁵⁹

Different methods for “Other nanotechnology approaches,” relative benefits and limitations

Other nanotechnology approaches are more related to air, water, textile, and food applications.

Nanotechnology approaches in “aerosol technology”

To control the aerosol contents, one of the studies was performed in which silver nanoparticles of approximate size 11 mm in diameter were coated onto a medium filter as antiviral agent. This coating was performed by spark discharge generation system. Required parameters like filtration efficiency, anti-viral ability and pressure drop were evaluated with dust loading. Below Fig. 4 states the mechanism of this process. Results show that the purification capability and drop of pressure increase with dust, but the antiviral capability decreases. This mechanism can be useful to predict the filter life, anti-viral abilities of filter.⁶⁰

Figure 4: Anti-viral action with dust loading Click here to View Figure

Silver ions also play vital role against SARS coronavirus due to its bacteriostatic and active ingredients properties. Based on these properties it is using for disinfection of medical equipment, wound therapy, and water purification. Recent studies also demonstrated effectiveness of iodophor iodine against non-enveloped virus.⁶¹

Nanotechnology approaches in “Textile technology”:

Textile industries have been using nanotechnology for a long time. There are few assumptions about nanotoxicity that nanomaterial release during washing, but recent studies showed it is safe to human health as per regulatory requirements. Main concerns for this developing market are to keep the environment safe from residues developed through climate change.⁶⁴ Functionalized technologies are being used to release the total silver and nanoparticles from textiles in the form of artificial sweat. Results of textiles functionalization lab prepared textiles showed the presence of embedded silver nanoparticles.⁶⁵ Also,  some other lab prepared textiles that showed presence of silver on coated fiber surface. This silver release from composites was found less as compared to surface coated textiles.⁶⁶ Synthetic fibers can be used in cloth textiles for manufacturing comfortable clothes like sports clothes. Antimicrobial effect can be evaluated on woven and non-woven fabric with defined methods like padding or exhaust methods. Addition of antimicrobial agent in spinning mass is an effective and durable method to treat the synthetic fibers.⁶⁷

Nanotechnology approaches in “Food technology”:

There is a variety of consumer products developed by nanotechnology for children for example, sippy cups, cleaning goods, breast milk storing cups, cleaning products as well as humidified fitment. Ionic silver release was noticed as 1:50 product to liquid mass ration with synthetic saliva, sweat, urine, orange juice, onto dermal wipes and into air. In case of fabrics silver leaching was noticed via dissolution. In case of consumer products used by children silver leach is very minimum, also bioavailable silver can be iconic than normal form of silver.⁶⁸ There are specific approaches for antimicrobial packaging as below:

Table 3: Antimicrobials into polymers and food packaging applications

Migration of nanoparticles from food composites to food is also examined by insignificance level of migration inductively and attached ICP-MS (Inductively Coupled Plasma Mass Spectrometry) and based on improved specifications, Ag/PVC nanocomposites films are much promising of long-term food packaging applications.⁷⁸

Nanotechnology approaches in “water purification technology”:

Availability of Safe and clean water now a days is a big concern worldwide. There are some specific steps by which this challenge can also be resolved, for example, development of green materials, polymers, adsorbents, and nanomaterials used for purification of water.⁶² There is defined procedure and protocol to develop new materials for water treatment.⁶³ Refer below flow diagram in Fig. 5 for one of the water purification approaches:

Figure 5: Waste water treatment by use of nanomaterial. Click here to View Figure

For water treatment, if method used in combinations, it would show more effective results for water treatment. Specific absorbent may help with fast cleaning of water. There are other specific protocols which can be used for removing pollutants in water.

Associated risks or limitations of Nanotechnology

In present scenario, world is facing several types of medical challenges which cause the degradation of healthy life. Nanotechnology is playing a vital role in eliminating the infectious challenges through innovative developments. Based on novel innovations of nanotechnology there is much relief in healthcare sector but still there are many factors that function as major limitations in growth of nanotechnology. Few of them are summarized in the table below:

Table 4: Limitations of Nanotechnology

For above risks or limitations, regulatory support is required to develop and sustain advancement in nanotechnology. ISO (International Organization for Standardization), ASTM (American Society for Testing and Materials) and FDA (Food and Drug Administration), can play a vital role in continual improvement in product and processes. More studies are required to understand the toxic aspects of nanomaterials. These studies can be planned with risk-based approaches.

Applications of Nanotechnology

Nanotechnology plays a vital role in diagnosis and disease control due to its antibacterial properties. To sustain a healthy life, free from any type of bacterial infection is possible through innovative approach of nanotechnology. Nanotechnology is useful in different sector due to its advanced applications. Different fields like medicine, food, household, water, hospitals, labs, and pharmaceuticals are taking advantage of these innovative approaches to nanotechnology. Few of them are explained in the table below:

Table 5: Nanotechnology’s applications

 Conclusion/ Future prospectives

Nanotechnology is the interlinked branch of various sciences which have nanoparticles within range of 1 nm to 100 nm. Nanoparticles exist in different forms like silver nanoparticles, gold nanoparticles, surface coating metals, nanocomposites, Quantum dots, nano polymers. Due to antimicrobial properties of silver nanoparticles, it has shown effective disinfection. As a disinfectant, silver nanoparticles are used to develop air filters, animal farming, fabrics, biomedical and food wrapping items. Silver nanoparticles development is possible by three major methods i.e., biological methods (by algae, bacteria, plant extracts, fungus), physical methods (laser, arc-discharge, ball- milling, vapor condensation) and chemical methods (reduction, electrochemical, irradiation, pyrolysis). Out of these methods, biological method is effective and preferrable for synthesis of silver nanoparticles. To overcome various infectious challenges in biomedical field, silver nanoparticles are much promising agent. Risk associated with reusable medical devices can be minimized through surface coating of silver nanoparticles. Such coatings have high potential to improve the life of reusable medical devices. Based on specific features of silver nanoparticles, it is used in biomedical applications (devices, wound healing, hospital acquired infections), industries applications (textile, food packaging, animal husbandry), environmental applications (air disinfectants, water disinfectants, medical premises), drug delivery, catalytic actions, biomagneticseparations, biodetection and labelling. Silver nanoparticles are effective against different type of bacterial infections, and they are effective agents for the cases of antibiotic resistance. As per these properties and applications, usage of silver nanoparticles can save time, efforts, and cost. This new field of silver nanoparticles can function as a strong backbone for industrial challenges and therapeutic issues. Reusable medical devices and medical consumables are always prone to get infectious if not fulfill the criteria of appropriate cleaning, disinfection, and sterilization. Non-fulfillment of monitoring, effectiveness checks and required evaluations are the possible root cause of current infectious stage. COVID-19 was one of the examples for such type of infectious environment. Nanotechnology in aspects of different nanomaterials can be the solution to these challenges. Silver nano particles have immense scope to develop innovative medical devices and related consumables. For development of antimicrobial material/ devices, more research work is required to understand the concept of biocompatibility (sensitivity/ toxicity).

Discussion

Nanotechnology provides a strong platform to evaluate antimicrobial properties of different nanomaterials. As per review, silver nanomaterials can be used as an effective weapon against antibiotic resistance. Life of reusable medical devices can be increased through coating of silver nanomaterials. Nanotechnology can help in different areas like food, medicine, water, and air but there are certain limitations which require more scientific advancement and research. Development of nanomaterial required high input amount and time for initial set up with appropriate safety and consumption. Aper from that if devices are developed as implants, then biocompatibility evaluation is the area which required more experiments are research.

Acknowledgement

I would like to express my profound gratitude to The NorthCap University Gurugram, Haryana for its world class research facility in terms of labs, faculty, and library as valuable assets to complete this review article.

Funding Sources

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Conflict of Interest

The author(s) do not have any conflict of interest.

Data Availability Statement

This statement does not apply to this article.

Ethics Statement

This research did not involve human participants, animal subjects, or any material that requires ethical approval.

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