Session Speaker

Nanotechnology in Cardiology: Nanoparticle Based Targeted Delivery of Therapeutics and Non-Invasive Imaging of Unstable Endothelium
Nicholas Kipshidze

The incidence of atherosclerosis, accompanying acute coronary syndromes and specifically, vulnerable plaque remain significant issues, both medically as well as a considerable cost to the healthcare system. With an estimated 180 million individuals affected at various stages of the disease process, clinically symptomatic disease accounts for approximately 34 million patients worldwide.

The need for improved therapies for cardiovascular diseases and the rationale for angioplasty and stent therapy is based on the underlying pathology of the disease process.

Recently, a new focus has emerged on an approach for the site-selective delivery of therapeutic agents to areas of the injured or dysfunctional vascular wall including vascular segments at risk.

A number of important properties of these nanoparticles make them ideal as targeted delivery vehicles, including: 1. Increased adherence to damaged vasculature and endothelium; 2. Ability to non-covalently complex selected compounds; and 3. Potentiation of compound uptake by cells or tissue. The most well studied and the focus of the present report is the use of perfluorobutane / dextrose / albumin nanoparticles. Drugs can be incorporated into the microbubbles in a number of different ways, including binding of the drug to the microbubble shell and attachment of site-specific ligands. As perfluorocarbon-filled microbubbles are sufficiently stable for circulating in the vasculature as blood pool agents, they act as carriers of these agents until the site of interest is reached.

Despite important pharmacologic and interventional strategies to treat atherosclerotic vascular disease, it remains a serious clinical problem today. Intravenous microbubbles have been developed which can be used to detect where endothelial dysfunction exists, and which can be targeted to detect inflammatory and pro-thrombotic mediators on the plaque surface. These same microbubbles can then be used for site specific delivery of agents which inhibit plaque progression. These novel diagnostic and treatment strategies have the potential to significantly alter patient outcomes in atherosclerotic vascular disease.