RESUMO
A retinal prosthesis, also known as a bionic eye, is a device that can be implanted to partially restore vision in patients with retinal diseases that have resulted in the loss of photoreceptors (e.g., age-related macular degeneration and retinitis pigmentosa). Recently, there have been major breakthroughs in retinal prosthesis technology, with the creation of numerous types of implants, including epiretinal, subretinal, and suprachoroidal sensors. These devices can stimulate the remaining cells in the retina with electric signals to create a visual sensation. A literature review of the pre-clinical and clinical studies published between 2017 and 2023 is conducted. This narrative review delves into the retinal anatomy, physiology, pathology, and principles underlying electronic retinal prostheses. Engineering aspects are explored, including electrode-retina alignment, electrode size and material, charge density, resolution limits, spatial selectivity, and bidirectional closed-loop systems. This article also discusses clinical aspects, focusing on safety, adverse events, visual function, outcomes, and the importance of rehabilitation programs. Moreover, there is ongoing debate over whether implantable retinal devices still offer a promising approach for the treatment of retinal diseases, considering the recent emergence of cell-based and gene-based therapies as well as optogenetics. This review compares retinal prostheses with these alternative therapies, providing a balanced perspective on their advantages and limitations. The recent advancements in retinal prosthesis technology are also outlined, emphasizing progress in engineering and the outlook of retinal prostheses. While acknowledging the challenges and complexities of the technology, this article highlights the significant potential of retinal prostheses for vision restoration in individuals with retinal diseases and calls for continued research and development to refine and enhance their performance, ultimately improving patient outcomes and quality of life.
Assuntos
Engenharia Biomédica , Retina , Doenças Retinianas , Próteses Visuais , Humanos , Qualidade de Vida , Retina/patologia , Retina/fisiologia , Doenças Retinianas/patologia , Doenças Retinianas/terapia , Próteses Visuais/efeitos adversos , Próteses Visuais/normas , Próteses Visuais/tendências , Engenharia Biomédica/instrumentação , Engenharia Biomédica/tendências , Eletrodos Implantados/normas , Seleção de Pacientes , Resultado do TratamentoRESUMO
Life Sciences are built on observations. Right now, a more systemic approach allowing to integrate the different organizational levels in Biology is emerging. Such an approach uses a set of technologies and strategies allowing to build models that appear to be more and more predictive (omics, bioinformatics, integrative biology, computational biology ). Those models accelerate the rational development of new therapies avoiding an engineering based only on trials and errors. This approach both holistic and predictive radically modifies the discovery and development modalities used today in health industries. Moreover, because of the apparition of new jobs at the interface of disciplines, of private and public sectors and of life sciences and engineering sciences, this implies to rethink the training programs in both their contents and their pedagogical tools.
Assuntos
Descoberta de Drogas/tendências , Biologia Sintética/tendências , Biologia de Sistemas/tendências , Engenharia Biomédica/métodos , Engenharia Biomédica/tendências , Biologia Celular/tendências , Biologia Computacional/métodos , Desenho de Fármacos , Descoberta de Drogas/métodos , Humanos , Modelos Biológicos , Biologia Sintética/métodos , Biologia de Sistemas/métodosRESUMO
The ability of cancer cells to become resistant to chemotherapeutic agents is a major challenge for the treatment of malignant tumors. Several strategies have emerged to attempt to inhibit chemoresistance, but the fact remains that resistance is a problem for every effective anticancer drug. The first part of this review will focus on the mechanisms of chemoresistance. It is important to understand the environmental cues, transport limitations and the cellular signaling pathways associated with chemoresistance before we can hope to effectively combat it. The second part of this review focuses on the work that needs to be done moving forward. Specifically, this section focuses on the necessity of translational research and interdisciplinary directives. It is critical that the expertise of oncologists, biologists, and engineers be brought together to attempt to tackle the problem. This discussion is from an engineering perspective, as the dialogue between engineers and other cancer researchers is the most challenging due to non-overlapping background knowledge. Chemoresistance is a complex and devastating process, meaning that we urgently need sophisticated methods to study the process of how cells become resistant.
Assuntos
Antineoplásicos/uso terapêutico , Engenharia Biomédica/tendências , Avaliação Pré-Clínica de Medicamentos/tendências , Resistência a Múltiplos Medicamentos , Neoplasias/tratamento farmacológico , Neoplasias/fisiopatologia , Animais , Linhagem Celular Tumoral , HumanosRESUMO
In the recent years, there has been a growing interest in the development of nanoparticles based targeting agents for the tumor diagnostics and therapeutics. This is because of their potential to detect the tumor and treat the diseased tissue at the cellular and molecular level. In this respect nanoscale magnetic materials have shown a very promising therapeutic concept and offer a new perspective for the diagnostic and target drug delivery approach. The magnetic nanocarriers have the ability to accumulate at any desired pharmacological site just by the guidance of external magnetic field. But, the interactions of these magnetic nanocarriers with the biological environment are rare and depend largely upon their surface chemistry and size. To increase the interactions and achieve the desired pharmaceutically acceptable delivery system, the surface of magnetic nanocarriers is modified in various ways by coating with organic polymers and inorganic metals or oxides. On the basis of surface characteristics, a number of effective magnetically driven therapies have been proposed by many researchers and protected through patents time to time.
Assuntos
Engenharia Biomédica/tendências , Sistemas de Liberação de Medicamentos/métodos , Magnetismo/métodos , Nanopartículas/uso terapêutico , Animais , Compostos Férricos/química , Compostos Férricos/uso terapêutico , Humanos , Hipertermia Induzida/métodos , Separação Imunomagnética/métodos , Nanopartículas/química , Nanotecnologia , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Patentes como Assunto , Propriedades de SuperfícieAssuntos
Ciência de Laboratório Médico/tendências , Neurologia/tendências , Otolaringologia/tendências , Ciência/tendências , Especialização/tendências , Engenharia Biomédica/tendências , Comportamento Cooperativo , Previsões , Alemanha , Saúde Holística , Humanos , Equipe de Assistência ao Paciente/tendências , Próteses e Implantes/tendênciasRESUMO
Magnetic nanoparticles with appropriate surface coatings are increasingly being used clinically for various biomedical applications, such as magnetic resonance imaging, hyperthermia, drug delivery, tissue repair, cell and tissue targeting and transfection. This is because of the nontoxicity and biocompatibility demand that mainly iron oxide-based materials are predominantly used, despite some attempts to develop 'more magnetic nanomaterials' based on cobalt, nickel, gadolinium and other compounds. For all these applications, the material used for surface coating of the magnetic particles must not only be nontoxic and biocompatible but also allow a targetable delivery with particle localization in a specific area. Magnetic nanoparticles can bind to drugs and an external magnetic field can be applied to trap them in the target site. By attaching the targeting molecules, such as proteins or antibodies, at particles surfaces, the latter may be directed to any cell, tissue or tumor in the body. In this review, different polymers/molecules that can be used for nanoparticle coating to stabilize the suspensions of magnetic nanoparticles under in vitro and in vivo situations are discussed. Some selected proteins/targeting ligands that could be used for derivatizing magnetic nanoparticles are also explored. We have reviewed the various biomedical applications with some of the most recent uses of magnetic nanoparticles for early detection of cancer, diabetes and atherosclerosis.
Assuntos
Compostos Férricos/uso terapêutico , Imageamento por Ressonância Magnética/tendências , Magnetismo/uso terapêutico , Nanomedicina/tendências , Nanopartículas , Engenharia Biomédica/tendências , Meios de Contraste , Sistemas de Liberação de Medicamentos/métodos , Compostos Férricos/química , Previsões , Aumento da Imagem/métodos , Técnicas de Sonda Molecular/tendências , Nanopartículas/química , Nanopartículas/uso terapêutico , Nanopartículas/ultraestrutura , Propriedades de Superfície , Transfecção/tendênciasAssuntos
Engenharia Biomédica/ética , Melhoramento Biomédico/ética , Estimulação Encefálica Profunda/ética , Terapia por Estimulação Elétrica/ética , Implantação de Prótese/ética , Engenharia Biomédica/tendências , Estimulação Encefálica Profunda/tendências , Terapia por Estimulação Elétrica/tendências , Previsões , Humanos , Defesa do Paciente/ética , Defesa do Paciente/tendências , Filosofia Médica , Desenho de Prótese/ética , Desenho de Prótese/tendências , Implantação de Prótese/tendências , Avaliação da Tecnologia Biomédica/ética , Avaliação da Tecnologia Biomédica/tendênciasRESUMO
The Fourth Biomedical Imaging Research Opportunities Workshop (BIROW IV) was held on February 24-25, 2006, in North Bethesda, MD. The workshop focused on opportunities for research and development in four areas of imaging: imaging of rodent models; imaging in drug development; imaging of chronic metabolic disease: diabetes; and image guided intervention in the fourth dimension-time. These topics were examined by four keynote speakers in plenary sessions and then discussed in breakout sessions devoted to identifying research opportunities and challenges in the individual topics. This paper synthesizes these discussions into a strategy for future research directions in biomedical imaging.
Assuntos
Engenharia Biomédica/tendências , Diagnóstico por Imagem/tendências , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos/tendências , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/tendências , Animais , HumanosAssuntos
Controle Comportamental/métodos , Encéfalo/fisiologia , Estimulação Encefálica Profunda , Terapia por Estimulação Elétrica/tendências , Eletrodos Implantados , Sistemas Homem-Máquina , Neurociências/tendências , Experimentação Animal , Animais , Membros Artificiais , Controle Comportamental/ética , Biorretroalimentação Psicológica , Engenharia Biomédica/métodos , Engenharia Biomédica/tendências , Melhoramento Biomédico/ética , Cibernética/tendências , Estimulação Encefálica Profunda/ética , Estimulação Encefálica Profunda/métodos , Imagem Ecoplanar/tendências , Terapia por Estimulação Elétrica/ética , Eletroencefalografia/ética , Eletrochoque , Ciências Forenses , Experimentação Humana , Humanos , Literatura Moderna , Transtornos Mentais/terapia , Doenças do Sistema Nervoso/terapia , Neurociências/ética , Paralisia/reabilitação , Robótica/tendências , Estimulação Magnética Transcraniana/tendênciasAssuntos
Engenharia Biomédica/instrumentação , Engenharia Biomédica/métodos , Biotecnologia/instrumentação , Biotecnologia/métodos , Terapias Complementares/instrumentação , Terapias Complementares/métodos , Engenharia Biomédica/tendências , Biotecnologia/tendências , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Terapia Combinada/tendências , Terapias Complementares/tendências , Avaliação da Tecnologia Biomédica , Resultado do TratamentoAssuntos
Engenharia Biomédica/instrumentação , Engenharia Biomédica/métodos , Biotecnologia/instrumentação , Biotecnologia/métodos , Terapias Complementares/instrumentação , Terapias Complementares/métodos , Engenharia Biomédica/tendências , Biotecnologia/tendências , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Terapia Combinada/tendências , Terapias Complementares/tendências , Japão , Integração de Sistemas , Avaliação da Tecnologia BiomédicaAssuntos
Pesquisa Biomédica/normas , Pesquisa Biomédica/tendências , Cooperação Internacional , Pesquisadores/normas , Academias e Institutos , Animais , Fibrilação Atrial/genética , Engenharia Biomédica/tendências , Pesquisa Biomédica/educação , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Indústria Farmacêutica/economia , Indústria Farmacêutica/tendências , Emigração e Imigração , Genética Médica/tendências , História Antiga , Humanos , Cooperação Internacional/história , Investimentos em Saúde , Modelos Animais , Seleção de Pessoal , Primatas/genética , Pesquisadores/educação , Recursos HumanosRESUMO
The history of interventional electrophysiology is long and fascinating. In the beginning, there is not simply the anatomy and physiology of the heart, but also analysis of the pulse, which indicates the activity of the heart. The analysis of the (peripheral) pulse as a mechanical expression of heart activity goes back several millennia. In China, in 280 B.C., Wang Chu Ho wrote ten books about the pulse. The Greeks called the pulse "sphygmos", and the sphygmology thus deals with a theory of this natural occurrence. In Roman times, Galen interpreted the various types of pulse according to the widespread presumption of the time, that each organ in every disease has its own form of pulse. The basic tool for arrhythmia diagnosis became the electrocardiography introduced by Willem Einthoven who obtained the first human electrogram 1902 in Leiden, The Netherlands. The growing clinical importance of electrical cardiac stimulation has been recognized and renewed as Zoll (1911-1999) in 1952 reported a successful resuscitation in cardiac standstill by external stimulation. Meanwhile all over the world, millions of patients with cardiac arrhythmias have been treated with pacemakers in the last 45 years. The concept of a fully automatic implantable cardioverter-defibrillator system (ICD) for recognition and treatment of ventricular tachyarrhythmias was first suggested in 1970. The first implantation of the device in a human being was performed in February 1980. Further developments concern atrial and atrioventricular defibrillators, radiofrequency ablation, laser therapy and advanced antiarrhythmic surgery, new antiarrhythmic drugs and sophisticated devices for preventive pacing. The advances in the field of diagnostic and therapeutic application of pharmacologic and electrical tools as well as alternative methods will continue as rapidly as before in order to give us further significant aid in taking care of the patient.