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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5533_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Acknowledgements
- •Chapter 3
- •Chapter 4
- •Chapter 5
- •Chapter 6
- •Chapter 7
- •Editor biographies
- •Vivek Kumar Chaturvedi
- •Anurag Kumar Singh
- •Jay Singh
- •Dawesh Prakash Yadav
- •Short description about chapters
- •Chapter 1
- •Chapter 2
- •Chapter 8
- •Chapter 9
- •Chapter 10
- •Chapter 11
- •Chapter 12
- •List of contributors
- •Introduction
- •1.1 Introduction
- •1.2 Nanotechnology in medical science
- •1.2.1 Nanomaterials in drug delivery
- •1.2.2 Use of nanomaterials in designing diagnostic nanosensors
- •1.2.3 Nanomaterials as theranostics
- •1.3 Artificial intelligence in medical science
- •1.3.1 Machine learning in diagnostics
- •1.3.2 Natural language processing in healthcare
- •1.3.3 Predictive analytics in patient care
- •1.4.1 Nanoscience in controlled drug release in the GI tract
- •1.4.3 Nanotechnology in gastrointestinal endoscopy
- •1.4.4 Nano-biotechnology in gastrointestinal cancer
- •1.5 Role of nanoparticles for the treatment of gastric cancer
- •1.6 Artificial intelligence in hepatitis and chronic liver disease
- •1.7 Artificial intelligence applications for clinical decisions support
- •1.9 Nanomedicines for liver fibrosis
- •1.10 Artificial intelligence-based colonoscopy
- •1.12 Summary and conclusions
- •Acknowledgments
- •References
- •2.1 Introduction
- •2.2 Causes
- •2.3 Mechanism
- •2.4 Diagnosis
- •2.5 Prognosis
- •2.6 Present methods of detection
- •2.7 Biosensors
- •2.7.1 Components of biosensors
- •2.7.2 Types of biosensors
- •2.7.3 Enzyme based biosensors
- •2.7.5 Immunosensors
- •2.7.6 Microbial biosensors
- •2.7.7 DNA-based biosensors
- •2.7.8 Phage sensors
- •2.7.9 Optical biosensors
- •2.7.10 Cantilever-based biosensors
- •2.7.11 Bio-MEMS
- •2.8 Physical biosensors
- •2.8.1 Thermometric biosensors
- •2.8.2 Acoustic biosensors
- •2.8.3 Magnetic biosensors
- •2.8.4 Wearable skins as biosensors
- •2.9 Electrochemical biosensors
- •2.9.1 Potentiometric
- •2.9.2 Coulometry methods
- •2.9.3 Conductometry methods
- •2.9.4 Potentiometric titration
- •2.10 Materials for biosensors
- •2.10.1 Nanomaterials for biosensors
- •2.10.2 Gastrointestinal diseases (GIDs) biosensor
- •2.11 Summary and future perspectives
- •3.1 Introduction
- •3.2 Challenges in drug delivery to the GI tract
- •3.2.1 Residence time
- •3.2.4 Metabolism in the GI tract
- •3.3 Role of nanoscience in drug delivery
- •3.3.2 Targeted drug delivery
- •3.3.3 Increased bioavailability
- •3.3.4 Reduced toxicity and side effects
- •3.3.5 Imaging and diagnostic capabilities
- •3.3.6 Drug designing
- •3.3.7 Delivery system
- •3.4 Methods of nanomedicine formulation
- •3.5 Drug release strategies
- •3.5.1 Active targeting strategies
- •3.5.2 Stimuli-based delivery strategy
- •3.5.3 pH-dependent drug release
- •3.5.4 ROS-dependent drug release
- •3.5.5 Time-dependent dosage forms
- •3.5.6 Gastro retentive strategies
- •3.5.7 Photothermal and photodynamic approach
- •3.6 Types of nanoparticles in drug delivery
- •3.6.1 Liposomes
- •3.8 Application of AI in GI disease
- •3.9 Future perspectives and challenges
- •3.6.2 Polymeric nanoparticles
- •3.6.3 Metallic nanoparticles
- •3.6.4 Quantum dots
- •3.7 Approved nanomedicines
- •3.9.1 Diagnostics
- •3.9.2 Individualized treatment
- •3.9.3 Proactive patient monitoring
- •3.9.4 Decision support systems
- •3.9.5 Biomarker discovery and therapeutic development
- •3.9.6 Patient outcomes and quality of life
- •3.9.7 Regulation and ethical issues
- •3.10 Conclusion
- •References
- •4.1 Introduction
- •4.2 Challenges and barriers in drug delivery
- •4.3 Drugs used in IBD
- •4.4 Novel drug delivery system for inflammatory bowel disease
- •4.4.1 Vesicular delivery system
- •4.4.2 Nanoparticle drug delivery system
- •4.5 pH-dependent nano-delivery systems
- •4.6 Inorganic nanoparticles
- •4.7 Prodrugs based
- •4.8 Hybrid drug delivery systems
- •4.9 Enteric coated formulations
- •4.10 RNA interference-based novel drug delivery
- •4.11 Toxicity profiling of IBD
- •4.11.1 Corticosteroids
- •4.11.2 Immuno modulators
- •4.11.3 Biologic therapies
- •4.11.4 JAK inhibitors
- •4.11.5 Immune dysregulation in IBD
- •4.11.6 Gastrointestinal effects
- •4.11.7 Antibiotics
- •4.11.8 Cyclosporine
- •4.11.10 Surgery-related complications
- •4.11.11 Increased risk of colorectal cancer
- •4.12 Current prospective of IBD
- •4.12.1 Personalized medicine and immunological therapies
- •4.12.2 Disease monitoring and surgical advances
- •4.12.3 Development of IL-6 signaling inhibitors
- •4.12.4 Genome-wide association studies (GWAS)
- •4.12.5 Rare variant analysis
- •4.12.6 Functional genomics and gene expression studies
- •4.12.7 Therapeutic targets
- •4.12.8 Gene-environment interactions
- •4.13 Future prospective of IBD
- •4.13.2 Microparticles-based delivery systems
- •4.13.3 Biological therapies
- •4.13.4 Combination therapies
- •4.14 Conclusion
- •References
- •5.1 Introduction
- •5.2 Nanotechnology
- •5.3 Nanoparticles
- •5.4 Classification of nanoparticles
- •5.4.1 Polymer-based nanoparticles
- •5.4.2 Solid nanoparticles
- •5.4.3 Carbon-based nanoparticles
- •5.4.4 Lipid-based nanoparticles
- •5.4.5 Nanoemulsions
- •5.4.6 Nanoparticles in biomedical applications
- •5.4.7 Characteristics of nanoparticles
- •5.4.8 Characterization of nanoparticles
- •5.5 Intestinal endoscopy
- •5.6 Medical nanotechnology
- •5.6.1 Diagnosis
- •5.6.2 Nanotechnology in the early diagnosis
- •5.6.3 Theragnostic
- •5.6.4 Tissue engineering
- •5.6.5 Targeted imaging and therapeutic in colorectal cancer
- •5.6.6 Gene therapy delivery
- •5.6.7 Colitis therapy
- •5.6.8 Oral delivery of vaccines
- •5.6.9 Mitigation
- •5.6.10 Role in targeted drug delivery
- •5.7 Role of nanotechnology in intestinal tract
- •5.8 Nanotechnological aids
- •5.8.1 Nanopowder
- •5.8.2 Plastic stents
- •5.8.3 Capsule endoscopy
- •5.9 Quality control of nanotechnology
- •5.10 Artificial intelligence in gastrointestinal endoscopy
- •5.11 Future perspectives
- •5.12 Limitations of nanotechnology
- •5.13 Conclusion
- •6.1 Introduction
- •6.2 Global burden of gastric cancer
- •6.3 Gastric cancer risk factors
- •6.3.1 Infection with Helicobacter pylori
- •6.3.2 Age and sex
- •6.3.3 Cigarette smoking
- •6.3.4 Obesity and metabolic dysfunction
- •6.3.5 Dietary factors
- •6.3.6 Alcohol use
- •6.3.7 Medications
- •6.3.8 Host genetics
- •6.4 Other risk factors
- •6.4.1 Epstein–Barr virus infection
- •6.4.2 Autoimmune disorders
- •6.4.3 Ménétrier’s disease
- •6.5 Nanotechnology in cancer diagnostic and therapeutics
- •6.6 Nanotechnology and gastric cancer diagnostic
- •6.6.1 Fluorescence imaging and gastric cancer detection
- •6.6.2 Photoacoustic imaging and gastric cancer detection
- •6.6.3 Computed tomography and gastric cancer detection
- •6.6.4 Magnetic resonance imaging and gastric cancer detection
- •6.6.5 Multimodal imaging and gastric cancer detection
- •6.7 Nanotechnology and gastric cancer management
- •6.7.1 Nanomaterial and chemotherapy
- •6.7.2 Nanomedicine and radiotherapy
- •6.7.3 Phototherapy and gastric cancer detection
- •6.7.4 Combination therapies and theranostics for gastric cancer detection
- •6.8 Challenges and prospectives
- •Acknowledgments
- •References
- •7.1 Introduction
- •7.2 Nanoparticles as drug delivery systems
- •7.2.1 Advantages of nanoparticles for drug delivery
- •7.2.2 Types of nanoparticles used in gastric cancer treatment
- •7.2.3 Targeted drug delivery to gastric cancer cells
- •7.3 Nanoparticles for imaging and diagnosis
- •7.3.1 Nanoparticles in gastric cancer imaging
- •7.3.2 Contrast agents and theranostic nanoparticles
- •7.3.3 Molecular imaging and targeting approaches
- •7.4 Therapeutic applications of nanoparticles in gastric cancer
- •7.4.1 Chemotherapy with nanoparticle formulations
- •7.4.2 Photothermal and photodynamic therapy
- •7.4.3 Immunotherapy and nanoparticles
- •7.4.4 RNA interference (RNAi) and gene therapy
- •7.5 Nanoparticles for combination therapy
- •7.5.1 Synergistic effects of nanoparticle-based combination therapies
- •7.5.2 Sequential and simultaneous delivery of therapeutics
- •7.6 Challenges and limitations of nanoparticle-based therapy
- •7.6.1 Biocompatibility and toxicity concerns
- •7.6.2 Nanoparticle clearance and stability
- •7.6.3 Regulatory aspects and clinical translation
- •7.7.1 Preclinical studies and animal models
- •7.7.2 Clinical trials and human studies
- •7.7.3 Promising results and future directions
- •7.8 Nanoparticles in personalized medicine for gastric cancer
- •7.8.1 Biomarker-driven nanoparticle therapies
- •7.8.2 Individualized treatment approaches
- •7.9 Nanoparticle-based theranostics for gastric cancer
- •7.9.1 Diagnostic and therapeutic integration
- •7.9.2 Multifunctional nanoparticle platforms
- •7.10 Future perspectives and concluding remarks
- •Acknowledgments
- •References
- •8.1 Introduction
- •8.2 Artificial intelligence role in hepatitis disease
- •8.3 Artificial intelligence role in non-alcoholic fatty liver disease
- •8.4 Artificial intelligence role in hepatocellular carcinoma
- •8.5 Conclusion
- •References
- •9.1 Introduction
- •9.2 Overview of clinical decision support
- •9.2.2 Medical imaging and diagnostic services
- •9.2.3 Virtual patient care
- •9.2.4 Patient safety
- •9.2.5 Diagnostic support
- •9.2.6 Medical research and drug discovery
- •9.2.7 Rehabilitation
- •9.2.8 Administrative applications
- •9.3 Types of AI algorithms in CDS
- •9.3.1 Machine learning algorithms
- •9.3.2 Bayesian Gaussian regression
- •9.4 Supervised learning
- •9.4.1 Diagnosis and treatment prediction
- •9.5 Unsupervised learning
- •9.6 Deep learning and neural networks
- •9.7 Natural language processing (NLP) techniques
- •9.7.1 Convolutional neural networks (CNNs) for medical image analysis
- •9.7.2 Recurrent neural networks (RNNs) for signal processing
- •9.8 Current AI-based clinical data support system
- •9.9 Challenges and considerations
- •9.9.1 Current AI-based CDS systems
- •9.10 Regulatory and ethical issues (HIPAA, GDPR, etc)
- •9.11 Challenges for clinical translation
- •References
- •9.12 Obstacles, restrictions, and missing knowledge
- •9.13 Future trends
- •9.14 Future trends and developments
- •9.14.1 Advancements in AI algorithms
- •9.15 Expansion to point-of-care devices
- •9.16 AI-driven drug discovery
- •9.17 AI in public health and epidemiology
- •9.18 Conclusion
- •10.1 Introduction
- •10.2 Developing history of AI
- •10.3 AI’s role in the early detection of GC
- •10.3.1 Screening of GC by AI
- •10.3.2 Accuracy of sampling from early endoscopic diagnosis
- •10.3.3 Digital pathological diagnosis
- •10.4 Role of AI from endoscopic diagnosis to treatment
- •10.5 Artificial intelligence in surgery
- •10.6 Molecules and genes
- •10.7 AI models’ function in prognosis prediction
- •10.7.1 Metastasis and staging prediction
- •10.7.2 AI aided treatment decisions
- •10.7.3 Clinical massive data analysis and prognostic prediction
- •10.8 Survival analysis
- •10.9 Conclusion and future prospects
- •References
- •11.1 Introduction
- •11.2 Stages of liver fibrosis
- •11.3 Etiology of liver fibrosis
- •11.3.1 Chronic viral hepatitis
- •11.3.2 Alcohol-related liver disease (ALD)
- •11.4 Pathogenesis
- •11.5 Symptoms
- •11.6 Diagnosis
- •11.7 Invasive approach
- •11.7.1 Liver biopsy
- •11.7.2 Limitations of liver biopsy
- •11.8 Non-invasive approach
- •11.8.1 Ultrasonographic based
- •11.9 Non-surgical tests
- •11.9.1 Serum biomarkers
- •11.10 Treatment
- •11.11 Limitations of antifibrotic therapy
- •11.12 Role of nanomedicines in the treatment of hepatic fibrosis
- •11.13 Type of nanoparticles currently in use for LF
- •11.13.1 Phytochemical compound for LF
- •11.13.3 siRNA derived NPs
- •11.14 HSC targeted nanoparticle delivery
- •11.15 Advantage of nanomedicine for LF
- •11.15.2 Enhanced drug delivery
- •11.15.4 Reduced adverse effects
- •11.15.5 Improved pharmacokinetic properties
- •11.16 Challenges of nm for LF
- •11.17 Future of nm in the treatment of LF
- •References
- •12.1 Introduction
- •12.2 Medical requirement for colonoscopy
- •12.3 Limitation of colonoscopy
- •12.4 Advancement of colonoscopy
- •12.5 High-definition and ultra-high-definition imaging technology
- •12.6 Computed tomography
- •12.7 Artificial intelligence and machine learning
- •12.8 Advancement in patient experience
- •12.9 Capsule endoscopy
- •12.10 Simulated detection systems
- •12.11 Improved training and workshop programs
- •12.12 Future of colonoscopy
- •12.13 Multi-spectral imaging
- •12.14 Machine learning algorithms integration
- •12.15 Robotic-assisted colonoscopy
- •12.16 Virtual colonoscopy
- •12.17 Tailoring colonoscopy screening
- •12.18 Patient-compatible techniques
- •12.19 Remote monitoring and consultations
- •12.20 Alternative bowel preparation methods
- •12.21 Preventive measures enhancement
- •12.22 Conclusion
- •References

Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
Figure 5.3. Classification of various NPs: solid NPs, carbon-based NPs, polymer-based NPs, lipid-based NPs
and nanoemulsions.
polysaccharide-chitosan have both received FDA authorization for therapeutic use
since they are biodegradable and biocompatible [31].
5.4.2 Solid nanoparticles
Iron oxides, gold, silver, and various other metal-based NPs are examples of solid NPs.
Iron oxide NPs are created by joining a biocompatible polymer to an organic magnetite
or magnetite core. Extremely paramagnetic characteristics of iron oxide NPs have
received a lot of interest recently. Iron oxide NPs are used as biosensors in magnetic
liquid hyperthermia, targeted medication delivery and gene transmission, and MRI. The
unique optical features of iron oxide NPs, which allow them to function as biosensors in
live cells, have also been employed in a variety of imaging and diagnostic procedures [32].
The NPs of gold have been proposed for use in ionizing radiation treatment, and cancer
detection. This is due to a number of variables including their size, shape, and external
features. Theranostic systems, which integrate diagnostics, imaging, and drugs for better
therapy, can be made using gold NPs. They have been demonstrated to be less harmful
than other inorganic NPs, however, their toxicity profile is still not fully understood [33].
A distinct class of solid NPs that has garnered interest are silver NPs. Due to their
spectral properties and capacity to catch and distribute light, silver NPs are a prime
instance of how NPs may be used as biosensors. Electronics, fabrics, wound dressings,
antimicrobial coatings, and medical equipment all often employ silver NPs [34].
5.4.3 Carbon-based nanoparticles
Carbon-based NPs are being used in a range of biological applications, such as
drug delivery, gene therapy, and imaging. CNTs, which exist in single-walled and
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
multi-walled types, make up a large class of these NPs. CNTs are good prospects for
a variety of biomedical applications, including medication and delivery of genes,
biological sensors, and biological tissue engineering because of their distinctive
physiochemical properties [35]. They also feature a special surface chemistry that
improves the capacity for drug loading and display excellent stability. CNTs’ safety
is still under question because it has been shown that extended contact with them
might injure healthy tissues [36].
5.4.4 Lipid-based nanoparticles
The liposome is the most well-known kind of vesicular lipid-based NP. Liposomes
are composed of a bilayer of lipid and sterol that encloses an aqueous core, as was
first noted in 1965. There are now several liposome formulations in use that have
received FDA approval, and many more are undergoing medical or preliminary
research. One of the most popular medication delivery methods is the use of
liposomes. Liposomes have been used for drug, nutraceutical, and biological
administration because of their excellent encapsulation efficiency and lengthy
circulation endurance [37]. Due to the endothelium layer being damaged, the
lymphatic system being ineffectual, and a higher permeability and retention effect,
liposomes are able to passively aggregate in certain disease areas, such as tumours. A
short half-life and rapid circulatory clearance after being opsonized and removed by
the reticuloendothelial system are limitations of conventional liposomes from the
past [38]. However, sterically stabilized liposomes with better stability and a longer
half-life were produced by using saturated high-phase transition lipids and conjugating polymers like polyethylene glycol with liposomes. These liposomes persist
in the systemic circulation for a longer period of time than normal formulations,
allowing for altered biodistribution and greater build-up in solid tumours. One
advantage of liposomes and other lipid-based NPs is that they have the lowest
toxicity for in vivo applications [39].
5.4.5 Nanoemulsions
Vaccines and anticancer medications have frequently been delivered using nanoemulsions (NEs). Colloidal dispersions known as NEs are suitable for the usage as
medication carriers for compounds with low water solubility. The most common
components of NEs are either water nanodroplets scattered in oil or oil nanodroplets
spread in water. Usually, surfactants are added to improve their stability. However, a
significant drawback of these carriers is that, if their size reaches 500 nm, they become
thermodynamically unstable. NEs of a size between 20 and 200 nm, however, are
more thermodynamically stable [40]. Parenteral, transdermal, and ocular delivery
routes are among the recommended applications for NEs, primarily because of their
capacity to shield encapsulated medicines from enzymatic hydrolysis and degradation.
NEs may also be modified by conjugating them to different ligands in order to focus
on biomolecules that are preferentially abundant in specific diseases, such as cancer.
This is similar to how many of the NPs previously described were changed. For
instance, ligand-conjugated NEs, which may target receptors with expression that is
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
increased in some malignancies, have been shown to have better absorption into
tumour cells, assisting in the reduction of tumour formation [41].
5.4.6 Nanoparticles in biomedical applications
Several NPs, particularly liposomes, metallic NPs, and elastomeric NPs, are being
studied in therapeutic and preliminary research to improve the location-specific
delivery of medications and genes. Many therapeutically useful drugs have a low
water solubility, therefore their entrapment in NPs can boost their stability by
lowering precipitation and the need for hazardous cosolvents. The efficacy of the
therapy is increased because NPs may alter the rates of drug metabolism and
clearance [42]. For instance, the FDA approved the Doxil brand to treat metastatic
breast cancer and Kaposi’s sarcoma. These NPs are far more effective if compared to
a conventional drug. Though specific molecules can be added to NPs to boost delivery
to specific cells, traditional or first-generation NPs are unable to target-specificcells.
As previously mentioned, illness sites may be actively targeted by utilizing NPs by
conjugating them to specific ligands that may identify and attach to proteins in the
membrane known to be overproduced in a variety of disorders, such as cancer.
Additionally, NPs are used as gene delivery systems, and they have shown success in
replacing certain diseased target genes linked to hereditary disorders including
malignancy, certain viruses, and others [43]. Sadly, the immunological sensitivities
that cationic NPscause may limit their use. Additionally, NPs have been used in
cellular imaging to detect cellular changes both in vivo and in vitro.NPscanbejoined
with other moieties, such as antibodies and their target, to increase the efficiency of
their selection. Despite their potential efficacy as drugs or gene carriers, there are fewer
NPs in clinical use than one might predict given the numerous preclinical trials. This is
mostly because of potential toxicity brought on by poorly understood mechanisms,
which is true in particular for NPs administered repeatedly [44].
5.4.7 Characteristics of nanoparticles
Through molecular level manipulation of a substance’s chemical and physical
characteristics, nanotechnology creates a variety of nanomaterials with unique
features. Because they have higher surface area per volume of smaller particle
than larger particles, NPs are more reactive and may be coated with a variety of
chemicals. These outperform macroparticles in strength and weight. The electrical,
magnetic, and optical characteristics of the inorganic nanomaterials are distinctive
[45]. Iron oxide magnetic NPs produce a more powerful more concentrated
magnetic field when compared to larger particles since all of their electrons spin
in the exact same way. This greater magnetic field may enhance the level of contrast
in imaging with magnetic resonance. There are two conceivable energy states for the
electrons in metal NPs: the grounded state and an excited state. The variation
between these two distinct energy levels determines the fluorescence and colour of
any metal NPs [46]. CdSe QDs, sometimes referred to as Qdots, emit significantly
more light than organic material fluorescent dye molecules. A blood sample may be
quickly and affordably screened for a variety of peptides, infectious agents, and
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
other useful substances using a QD of a certain colour. Unlike microparticles, NPs
may cross the blood–brain barrier. Due to their lengthy half-life and ability to avoid
immune system detection, they can be used to deliver medications. NPs are useful in
the treatment of cancer because tumour cells tolerate them. They may deliver
therapeutic and diagnostic agents to specific organelles and cells as well as interact
specifically with biological molecules on and inside of cells. Due to the unique
properties of NPs and the inherent nanoscale activities of cellular biological
components, nanotechnology can be applied in the medical field [47].
5.4.8 Characterization of nanoparticles
At a very small scale, nanotechnology has become extremely prominent in the
majority of scientific fields. Atoms and molecules behave differently at this scale and
provide a variety of fascinating and enticing uses. NPs, nanospheres, nanocapsules,
nanoemulsions, nanoliposomes, and nanoniosomes are examples of pharmaceutical
nanocarriers. To achieve particular goals, managing particle size, surface characteristics, and drug release are the main design considerations for nanocarriers.
Controlling the desired in-the-laboratory and in vivo animal behaviour of tiny
carrier molecules is essential because of this [48 ]. Nanocarriers may be recognized by
their size, shape, and surface charge using highly advanced microscopic techniques
including microscopy with scanning electrons, electron microscopy with transmission, and atomic force microscopy. While the size of particles and size
distribution are detected using the dynamic scattering of light and photon-correlation spectroscopy, surface shape and size may be examined using electron microscopy [49]. Zeta potential, an indirect measurement of surface charge, may be used
to determine colloidal stability, and differential scanning calorimetry can be used to
characterize particles and study drug interactions. Additionally, cell uptake research
might reveal the binding and internalization of targeted carriers to the particular
cells. Confocal imaging may be used to analyse the biodistribution of specific
nanocarriers and validate their intracellular uptake and subcellular localization [50].
5.5 Intestinal endoscopy
In order to quickly identify malignancies and locate and treat early precursor
lesions, endoscopy is a helpful inspection technique utilized in intestinal cancer
screening programmes. The intestinal morphology of the tissues surrounding the
digestive system may be seen in real time using endoscopic white light imaging, and
tissue samples can be collected from highly dubious lesions to aid in the diagnosis.
However, endoscopy also has substantial challenges in detecting GIC early on. The
prognosis of early microscopic lesions was bad, and lesions that were unseen due to
image quality limitations were microscopic [51]. Endoscopy is a useful examination
tool used in colorectal tumour detection programmes in order to rapidly detect
malignancies and discover and cure early precursor lesions. Endoscopic white light
imaging allows for the real-time visualization of the intestinal morphology of the
tissues around the digestive system, and tissue samples from highly suspect lesions
can be obtained to help with the diagnosis. Endoscopy, however, also has significant
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
difficulties in spotting GIC at an early stage. Early microscopic lesions had a poor
prognosis, and microscopic lesions that could not be noticed owing to imaging
quality restrictions existed [52]. Early GIC exams are impacted by endoscopy since
these semi-invasive procedures frequently leave patients feeling uncomfortable and
anxious. Therefore, the primary research focus going forward will be on increasing
the comfort and accuracy of endoscopy, which is a crucial diagnostic method for
early screening of GI disorders [53].
5.6 Medical nanotechnology
5.6.1 Diagnosis
As completely novel nanomaterials are developed to detect and treat cancer, the
discipline of nanomedicine has recently experienced unprecedented progress. Novel
biological sensors that utilize nanotechnology have the potential to improve
therapeutic investigations’ sensitivity in the early diagnosis and monitoring of
GIC as well as in the earlier and more accurate identification of specific affected
tissues or organs. For example, immuno-microfluidic chips using QDs of semiconductors provide precise identification of cancer markers linked with humans,
which may help GIC therapies be more successful. Biocompatible nanodevices
include integrated gadgets for cancer detection before it occurs [54].
Nevertheless, despite the discovery of further microscopic cancer lesions in an
individual’s body, combating treatment resistance and improving the solubility of
drugs and utilization efficiency continue to be major challenges in the medical
treatment of GIC. The main advantage of employing nanotechnology to develop a
drug delivery system is its enormous specific surface area and changeable modification capabilities, which are effective techniques to boost medicine utilization [55].
By modifying the surfaces of NPs to more precisely target tumour tissues, it is
feasible to increase the concentrations of pharmaceuticals that are beneficial in
treating cancer while reducing the side effects of drugs used for chemotherapy and
improving the effectiveness of anticancer drug therapy. NPs’ enormous functional
surface areas make it possible for them to bind, absorb, and carry small-molecule
drugs, RNA and DNA, as well as proteins, and probes [56]. They are also highly
sought-after in many medical fields because of their adjustable size, shape, and
surface properties, which provide them with good stability, large carrier capacities,
their capacity to absorb water-based and hydrophobic agents, and compatibility
with different drug delivery paths. Additionally, we may develop detecting and
curative NPs that are ideally suited for more targeted and individualized illness
treatment by merging diagnostic and therapeutic functionalities into just one
biodegradable and biocompatible NP. These NPs have generated a lot of interest
since they can increase the effectiveness for GI malignancies [57]. Due to their
significant particular surface domains, surface, and interfacial effects, NPs are
naturally advantageous as drug carriers. When coupled with bioactive compounds,
they can be used for both cancer therapy and imaging. Today’s drug delivery
alternatives include metallic substances, polymer-based NPs, lipid-based formulations, as well as theranostic NPs. In order to further reduce the negative impacts of
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
intestinal reflex movements on the early diagnosis and treatment of GIC, this data
comprehensively explains the uses of the application of nanotechnology in the rapid
identification and treatment of GIC as well as the clinical obstacles for GIC therapy.
It also covers how to promote the earliest feasible clinical use of lab-developed
nanoplatforms [58].
5.6.2 Nanotechnology in the early diagnosis
Medical evidence dating back decades shows that individuals with GIC who have
lesions that are precancerous and the initial stages of carcinoma had better forecasts,
less mortality, and longer life expectancies than patients with advancing disease. The
current main clinical applications of early-diagnosis methods for GIC include an
endoscopic examination, growth indicators, MRI, computed tomography, PET, and
NIRF detection [59]. Given the development of science and technology as well as the
expanding understanding of the aforementioned diagnostic mechanisms, researchers
have found that there is room for advancement and refinement of these diagnostic
techniques. For instance, the application of endoscope capsules can diminish the
discomfort that patients experience during invasive examinations and reduce the risk
of inflammation. Contrast chemicals can be administered before to MRI imaging to
improve its diagnostic sensitivity. Recent research efforts to combine nanotechnology with the existing imaging technologies have boosted their sensitivity [60].
5.6.3 Theragnostic
To produce separate ‘theragnostic’ chemical compounds for cancer imaging and
medical therapy today, the phase of preclinical development is necessary. A single
carrier is used for both therapeutic and diagnostic chemicals in theragnostics. These
nanomaterials are intended to make imaging applications more convenient for both
clinical and evaluation uses. To put this idea into practice, it is crucial to create
important molecules that can react to chemical or physiological stimulus in the
treatment zone. A range of triggers, such as pro-inflammatory signs like pH level
changes in temperature, an oxygen shortage, or specific binding to an inflamed
ligand, may have an impact on the system [61]. Messenger chemicals may be
included within or bound to the carrier to help with imaging applications. Molecules
may unite instantly through noncovalent or linked contacts during the creation of
the nanocarrier, or subsequently through surface modification activities.
Noncovalent or covalent interactions are selected depending on the goal and level
of specificity of the region that has to be addressed. Under various pH or oxidative
regimes, covalent linkages based on carbonyl, amine, or methicone coupling
chemistries carry out a range of activities. If chemical adaptability is needed,
covalent bonds can be replaced by hydrophobicity, electrostatic attraction, or
hydrogen-bonding affinity [62]. There are various potential links between the test
substances or curative molecule and the nanocarrier since polymers can be chosen to
have a range of functional groups and/or polar sites. Coulomb or hydrophobic
bonds (hydrophobic chemical loading) or interactions between ionic compounds
(nucleic acids) have been successfully made possible by the use of amide, ester,
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
disulfide, hydrazone, or thioether connections. Yang et al showed how a practical
approach to treating pancreatic cancers may be used [63]. To prevent the uPA
receptor from interacting with its own organic ligand, uPA, this study used the
urokinase plasminogen in order stimulating activator amino-terminal disintegration
peptide as a substitute ligand with a strong propensity for binding to uPAR. ATF
peptides have been shown to suppress angiogenesis and cancer development in a
variety of animal carcinoma models. Yang et al discovered that cancer cells easily
absorbed the ATF-coated NPs, elevating their respective roles in the development of
tumour-specific therapeutic medication delivery and carcinoma imaging [64].
5.6.4 Tissue engineering
In tissue engineering, growth factors and scaffolds made of the right materials are
combined with cell proliferation. For best effectiveness, biomaterials for biomedical
engineering need to have linked pores and a large surface area. By allowing for cell
movement, fluid diffusion inside the biological material (such as the diffusion and
discharge of nutrients), and electronic and chemical liaison among the cells
producing the biomaterial, the holes support proper cell culture development [65].
In the digestive system, gastric ulcers may be treated using tissue engineering
procedures. Hassani et al claim that polystyrene NPs adhered to the enlarged
mucosal regions. This study demonstrated that tiny NPs, which adhered to injured
tissue more frequently than healthy tissue, were most closely linked to this relationship. This finding emphasises the notion of using NPs as a technological extension
for treating hepatic ulcers [66].
5.6.5 Targeted imaging and therapeutic in colorectal cancer
NPs offer benefits in cancer, particularly imaging, due to their tiny size. When
combined with magnetic resonance imaging, QDs, or NPs with quantum confinement qualities like size-tunable light emission, can generate great pictures of cancer
locations. These NPs can be activated by any light that is proportionally blue-shifted
to the emission spectrum since they are much brighter than organic dyes. When
compared to conventional pigments, which are employed as a contrast medium,
luminescent QDs may generate pictures with a greater contrast at a lesser cost [67].
The disadvantage is that making QDs typically involves using dangerous substances.
For the treatment of cancer, nanotechnology-based treatments have already
received approval. NPs like abraxane or liposomes like Doxil are examples of
products that have received approval. Small nanocarriers tend to collect at tumour
sites because there is ineffective lymphatic drainage there. In photodynamic treatment, particles are supplied to a particular area of the body and illuminated by an
external light source [68]. The particle absorbs the light, and if it is made of metal,
the light’s energy may heat both the metal and the tissue around it. Additionally, by
using light to create highly reactive oxygen molecules, it is possible to destroy
neighbouring organic molecules by combining them chemically with the oxygen
molecules. Photodynamic treatment provides a number of benefits. Chemotherapy
does not spread a ‘toxic trail’ of chemically reactive compounds throughout the
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
body since it only affects the area that has been lit via particle delivery. A
noninvasive approach of treating illnesses, growths, and tumours is photodynamic
therapy [69]. Recently, Kirui et al reported on the creation of advantageous oxidebased gold–iron NPs for the inspection, photothermal stimulation, and focusing of
cancer cells utilizing laser light at 800 nm. After the gold NPs had been functionalized using carboxy-terminated phospholipids and linked to the A33 antigen seen in
colorectal cancer cells, a single-chain antibody, scFv, was conjugated to them. The
A33 antigen is overexpressed on the surface of SW1222 colorectal cancer cells, which
led to the NPs becoming particularly immobilized on the cancer cells’ surfaces. The
NPs were then selectively absorbed by the cancer cells. After 808 nm light was
absorbed, malignant tissue was specifically removed, demonstrating the suitability of
this technique for cancer diagnosis and therapy [70].
5.6.6 Gene therapy delivery
Due to the ineffectiveness of gene transfection, gene therapy still has significant
drawbacks. Vectors produced from viral or nonviral transporters are the two
primary kinds employed in gene therapy. Despite having a high transduction yield,
the viral gene delivery approach has a variety of undesirable side effects, including
immunogenicity and probable carcinogenic consequences. The capacity of cationic
polymers, such as chitosan, to bond with DNA or short-interfering RNA to form
complexes that might serve as nonviral substitute carriers for gene therapy
applications is another advantage [71]. The limited capacity of bare DNA inside
cells and siRNA units to enter cell membranes is a significant barrier to DNA and
siRNA treatment. As solutions to this issue, several distribution tactics have been
studied. Recently made attempts to create synthetic reagent-based tissue-targeted
gene transport mechanisms have shown intriguing outcomes. More and more
‘targeted NPs’ are being developed, which have a surface reconfigured with a
synthetic protein, and an attractive substance, or an antibody implanted to the
matrix of polymers in order to focus on a specific site before distributing the active
agent [72]. This is done to increase the efficacy of siRNA-loaded polymer NPs.
Whether biodegradable or not, NPs have demonstrated an intriguing ability to
adhere to and disseminate DNA and siRNA among therapeutic carriers. In fact, it
has been demonstrated that NPs may protect DNA and siRNA from degradation
while also greatly increasing their pharmacological efficacy in vivo and in vitro. IBD,
or inflammatory bowel illness, might make a biocompatible system particularly
crucial. The biodegradable polyamide envelope ’ s capacity to safeguard and disseminate the siRNA into the cytoplasm may enable a successful in vivo transfection [73].
5.6.7 Colitis therapy
Effective, specialized drugs are now available for treating IBD, also known as
ulcerative colitis and Crohn’s disease, a severe, chronic inflammatory sickness.
However, these treatments are often limited by major systemic adverse effects. IBD
was treated only with immunosuppressants or anti-inflammatory drugs (5-amino
salicylic acid, steroids) up to the past ten years [74]. Although these drugs are effective,
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
their usage has been restricted due to immune system problems that can be extremely
hazardous. Despite the therapeutic efficacy of more modern biological therapies, such
as monoclonal antibodies that combat tumour necrosis factor (TNF-α), some patients
continue to develop antibodies to the medication, raising the risk of infusion reactions
and decreasing the response of the individual to the therapy [75].
5.6.8 Oral delivery of vaccines
The delivery of vaccinations to the mucosa via nanocarriers is one of the greatest
and most important potential uses for NMs in the future. NPs may be utilized as
delivery vehicles, adjuvants, or both. When giving immunizations to the mucosa,
nano- or microsized compounds may target certain locations and processes to hasten
absorption. The majority of NPs smaller than the wavelengths of 200 nm are
absorbed by M cells or the epithelium of the gut at the tips of villi. Large particles
that can be consumed by GI macrophages include nano-sized liposomes [76]. The
surfaces between NPs and tiny particles now contain a variety of ligands. peptides,
such as glandular IgA, aimed at M cells in the rodent Peyer’s patch, or immunoglobulins such as mAb 5B11, which engages M cells on polymeric latex particles, can
also function as ligands. They can also manifest as other molecules, including the
bacterial molecule Invasin-C192, which is involved in the invasion of cells and
adhesion. Additionally, ligands can be sugars linked to hydrophobic groups, such as
O-palmitoyl the mannan or the B subunit, which is a component of the toxin that
causes cholera [77].
5.6.9 Mitigation
An autoimmune illness of the digestive system, this condition affects the whole GI
tract, with ulcerative colitis causing specificinflammatory processes in the colon.
Serious social, economic, and health issues result from present medications failing and
their negative effects. The ideal target for gene therapy delivery vehicles to treat IBD is
the gut epithelium. Due to the hydrophilic, negatively charged, and biodegradable
properties of nucleic acids (NAs), gene therapy incorporating the use of NA therapies
confronts significant difficulties [78]. Scientists are motivated to create gene therapy
vehicles that can be readily targeted to the appropriate tissues for IBD by recent
success in developing biomaterials for gene therapy and their appearance in clinical
trials for diverse illnesses. Nanotechnology advancements have made it possible to
construct a variety of NPs for NA administration to treat IBD, which still has issues
with targetability, poor therapeutic effectiveness, and GI tract stability [79].
5.6.10 Role in targeted drug delivery
The use of large-sized materials in drug administration also poses a variety of
challenges, such as in vivo strength, poor bioavailability, and issues with targetspecific distribution, in addition to the adverse reactions of the specific medicines
(figure 5.4). Therefore, implementing cutting-edge drug delivery techniques to target
drugs to a specific area of the body may offer a possibility to address these urgent
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Nanobiotechnology and Artificial Intelligence in Gastrointestinal Diseases
Figure 5.4. Role of NPs in targeted drug delivery.
issues. The field of nanotechnology creates nanoscale-sized materials made of lipids,
metals, or natural or synthetic/semi-synthetic polymers [80]. When employed in
targeted drug delivery, NPs can increase the bioavailability, biodistribution, and
accumulation of treatments, concentrating them mostly in the targeted sick region
and serving as stabilizers. The aforementioned variable colloidal systems can deliver
drugs to the right places, increasing therapeutic efficacy while reducing side effects
and toxicity, protecting the drug from biological degradation, and allowing
immediate and physical medicinal properties to control at the exact site of disease.
The early use of nanocarriers for medication administration was founded on an
indirect targeting mechanism in order to increase efficiency over traditional freedrug formulations [81]. A unique approach, on the other hand, uses magnetic fields
or conjugation procedures to increase medication delivery to target locations while
employing active targeting by incorporating specific ligands. Therefore, innovation
in drug delivery systems and formulations might result from the use of nanotechnology. Effective and site-specific medication delivery makes it simpler to get a
therapeutic outcome that can fight immunologic ailments, tumoural diseases, or
neurological disorders. This special issue integrates many elements of nanotechnology research in quest of novel therapeutic targets and approaches. The physiological
acceptance of layered liposomes and hybrids nanotechnology with surfactant agents,
as well as mathematical models to ascertain the body routes of magnetic NPs or to
elucidate the molecular make-up of metal-decorated fullerenes, are some examples
of these [82].
5.7 Role of nanotechnology in intestinal tract
The digestive system is one among the ways whereby environmental NPs enter the
human body. After being consumed, they immediately penetrate into the mucus
barrier and engage the enterocytes. They are removed from the intestinal mucosa by
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