Session C4 Paper # 115 Disclaimer—This paper partially fulfills a writing requirement for first year (freshman) engineering students at the University of Pittsburgh Swanson School of Engineering. This paper is a student, not a professional, paper. This paper is based on publicly available information and may not provide complete analyses of all relevant data. If this paper is used for any purpose other than these authors’ partial fulfillment of a writing requirement for first year (freshman) engineering students at the University of Pittsburgh Swanson School of Engineering, the user does so at his or her own risk. GOLD NANOPARTICLES: A POSSIBLE CURE FOR PANCREATIC CANCER Julia McKay, [email protected], Mena, 1:00, Madeleine Braun, [email protected],Sanchez, 5:00, Erin Cannon [email protected], Budny, 10:00 Abstract- Pancreatic cancer is particularly problematic across the world due to its high resistance to chemotherapy and radiation and the late stage in which the cancer is often diagnosed. By the time that many people discover they have the disease it is often too late for surgical intervention. Gold nanoparticles (AuNPs) could be a potential solution to this dilemma. AuNPs are a form of targeted drug delivery that transport drugs to the main tumor and metastasis site. AuNPs have properties such as microscopic size, biocompatibility, and high surface reactivity that allow them to effectively inhibit tumor cell reproduction and growth. This technology is projected to improve drug reception efficiency while providing a less invasive treatment as compared to those currently available. While this technology is theorized to have several positive effects on those who face pancreatic cancer, there are also some challenges with the development of these AuNPs. As with any new technology, there are several obstacles that those leading the development are facing. This includes, the elimination of long term cytotoxicity within the cell that may be caused by the use of gold nanoparticles. Possible solutions to these challenges are being investigated with the help of animal and clinical experiments. The goal of these experiments is to create a sustainable treatment option that could improve the quality of life for those with pancreatic cancer. Key Words- AuNPs, gold nanoparticles, nanotechnology, pancreatic cancer, targeted drug delivery, therapeutic devices NANOPARTICLES: POSSIBLY REVOLUTIONIZING CANCER TREATMENT Pancreatic cancer is the fourth leading cause of cancer deaths in America. “It continues to have a survival rate of less than five percent over five years, with a median survival of only six months” [1]. Pancreatic cancer is an aggressive and elusive disease that is typically diagnosed in the later stages when it is too late for surgical intervention to remove the tumor [1]. This disease is often University of Pittsburgh Swanson School of Engineering 1 03.31.2017 viewed as incurable and, for that reason many scientists have chosen to direct their efforts towards finding a new treatment method. Scientists and engineers are exploring different forms of targeted drug delivery as possible remedies. One that has much promise is gold nanoparticles (AuNPs). They have several advantageous properties that allow them to function well within the body without causing harm. Researchers hope that when gold nanoparticle development is complete, their implications will improve the quality of life for thousands of people across the globe. WHAT IS TARGETED DRUG DELIVERY? Targeted drug delivery is a method of transporting medication to a patient in a manner that increases the concentration of the substance in some parts of the body while limiting it in others. This allows for healthy cells to remain unaffected by the medication. The development of targeted drug delivery systems is a sustainable approach in both chemical and biological engineering to transporting drugs throughout the body. In this context sustainability is the consideration of the whole system, in which the process of drug delivery will take place rather than just focusing on the process itself. The main vector for delivering these drugs are forms of biological nanotechnology, including nanoparticles. These nanoparticles are being designed to combat the significant side effects of traditional drug delivery methods. Targeted drug delivery systems have proven, through in vitro and in vivo trials, to function effectively within the human body. The developers of these currently researched drug delivery systems have taken many factors into account that simulate the human body such as fluctuating pH, temperature, and other chemical interactions. The nanodrug delivery systems are very integrated and therefore require many different specialists. For example, biologists, chemists, and engineers all work together to make the best quality system possible. Dr. David A. Giljohann, an adjunct professor of chemical and biological engineering at Northwestern University, participates in research related to controlled drug release systems. In his professional paper on gold nanoparticles for medical applications he explained, “when implementing a targeted release system, the following design criteria for the system must be taken into account: the drug Madeleine Braun Erin Cannon Julia McKay properties, side-effects of the drugs, the route taken for the delivery of the drug, the targeted site, and the disease” [2]. The main method for transporting the drug delivery agent into the body is oral ingestion. Once it is absorbed it can enter the circulatory system and travel to its destination. After the drug has reached its specified target the system has completed its task. The primary goal of targeted drug delivery is to improve the efficacy of drug delivery while reducing the side effects. The advanced drug delivery systems currently being developed could potentially meet both of these goals. patients who do have surgery, because it comes back about 85 percent of the time. At best, 25 to 30 percent of patients are alive five years after surgery” [4]. These statistics are a harsh reality for those who battle pancreatic cancer, regardless of when they were diagnosed. APPLICATION AND IMPACTS RELATING TO PANCREATIC CANCER Cancer cells replicate at a faster rate than normal cells and divide to form a cluster known as a tumor. Once this tumor has formed it is difficult to remove because it has already intertwined with vessels and other organs. Tumors caused by pancreatic cancer are especially risky because they easily metastasize, meaning that the cancer cells can spread to any part of the body through the lymph nodes and begin to grow there. Eventually this leads to the cancer taking over the entire body and the need for drastic treatment measures [2]. Currently, pancreatic cancer is considered by many to be an “incurable” disease. The difficulty in treatment of pancreatic cancer is caused by a variety of factors. The symptoms of this disease occur much later than other forms of cancer and often depend on the initial location of the cancerous cells within the pancreas. Unless a patient has a family history of pancreatic cancer, due to its hereditary nature, it is unlikely that they will be tested for the disease without the presence of symptoms. Testing is not done on the general public because there are limited options for a non-invasive or cost effective test that can easily be done prior to the appearance of symptoms [3]. A lack of testing allows for the tumor to spread across the body and becomes so invasive that attempted removal of the tumor is rarely possible or effective. The only current method to fully eradicate pancreatic cancer cells from the body is complete surgical resection. Due to the positioning of the pancreas in the body, it is a very difficult organ to surgically access [3]. The location of the pancreas can be seen in Figure 1. Also, in order for the tumor metastasis site to be removed, surgeons must remove large portions of the pancreas, sometimes up to 95%. This greatly affects the health of the patient. While it is possible to live with only a small portion of the pancreas, it requires large lifestyle changes such as daily insulin injections and frequent hospital visits. Doctors must continuously monitor hormone levels and residual cell growth to ensure that the cancer does not return. According to Dr. Allyson Ocean, a respected oncologist at the Weil Cornell Medical Center, “the prognosis is poor even in 2 FIGURE 1 [5] Anatomical diagram of the human body (pancreas in red) Although surgical resection is the only potential “cure” for pancreatic cancer, there are many treatment methods currently in existence. Two of the most common therapeutic treatments are chemotherapy and radiation. However, these solutions tend to be relatively unsuccessful. The pancreas has one main blood supply, known as the greater pancreatic artery, through which chemical substances can travel to the pancreas. Thus, the probability of chemical injections into the bloodstream impacting the tumor is very low. During the process of chemotherapy or radiation treatment, a significant number of healthy cells are killed, due to the lack of specialized targeting agents. The molecules cannot efficiently locate the cancer cells and, as a result, end up killing a large number of healthy cells [3]. Considering that the three main treatment options for other cancers are not sustainable for pancreatic cancer, and have major side effects, many have sought an alternative method to treating this disease. The most promising solution comes from targeted drug delivery systems. For those with pancreatic cancer, nanotechnology provides a potential cure that has been previously unavailable. These patients often have to go through the painful and strenuous process and recovery of chemotherapy and radiation. Based on the potential impacts of this technology, scientists have chosen to further explore targeted drug delivery. The application of targeted drug for pancreatic cancer could potentially provide a better quality of life and survival rate than currently offered, thus theoretically providing a more sustainable option. Madeleine Braun Erin Cannon Julia McKay EXPLANATION OF GOLD NANOPARTICLES The research behind nanoparticles stems from the naturally existing organic transportation agents within the body. These include proteins, liposomes, and polysaccharides. By observing functions of the compound, modern forms of nanotechnology have been developed to mirror the capabilities of these organic agents. Gold nanoparticles (AuNPs) are among the most studied and promising of nanotechnology. Successful animal testing and in vitro experiments on human cells have already taken place [2]. Because of the biocompatibility of these nanoparticles many exciting applications are foreseen. The foremost of these applications is in targeted drug delivery. Why Gold? In the days of the ancient Egyptians, it was believed that ingesting gold had medicinal properties. Many applications of gold have since been discovered and are currently being researched. Interest in this specific element, gold, is due to its biocompatibility and ideal properties. These properties include, being non-toxic, easily shaped, and never corroding or tarnishing. Gold is a good conductor of both heat and electricity. This is advantageous when it comes to dealing with the natural electric signals within the body. The surface chemistry of elemental gold is highly reactive with other substances [2]. This allows for more versatility in the design of the nanoparticles and what they can deliver. Unique Characteristics of Gold Nanoparticles Gold nanoparticles have a variety of beneficial characteristics that allow them to perform efficiently within the body. The properties of elemental gold and the structure of the nanoparticle itself enable them to act as multimodal drug carriers [3]. This means that they can be used not only to transport the medication, but also to image the disease internally, sensitize cells and potentially apply electromagnetic radiation to disease sites. These characterics allow for AuNPs to act as transporters of substances, when on their own in the body, prove to have poor cellular penetration, solubility, and pharmacokinetics, properties that relate to how pharmaceuticals move throughout the bloodstream to specific tissues and organs. “AuNPs are one hundred times smaller than human cells and can offer unprecedented interactions” [6]. Their size allows them to enter into the cell through the plasma membrane. The most commonly used nanoparticle is the nanosphere [7]. Nanospheres have a large surface area where ligands can be attached and interactions can occur [1]. This increases the likelihood that the nanoparticle will make it to the disease site and be accepted by the cell. Typically, foreign substances are rejected by the body. Therefore, scientists have been making alterations to the surface of nanoparticles that make them compatible with cancerous tissue to ensure that gold nanoparticles can overcome this obstacle. Metallic nanoparticles are conductors which means that they have electrons scattered throughout the particle which tend to rest on the surface, but are free to move throughout the particle. It is this trait of AuNPs that allows them to not only be drug deliverers, but act as multimodal agents. Imaging of the cancer is crucial in predicting what treatment options are best suited for each patient's case, and dosage amounts to be delivered. Drug Carriers to Tumor Sites Gold nanoparticles as a form of targeted drug delivery perform the intended equivalent task as that of chemotherapy and radiation. The AuNPs transfer the same anti-cancer drugs as those currently used in chemotherapy such as emcitabine, carmustine, paclitaxel and doxorubicin to limit tumor growth, but they do it in a more direct and efficient manner [8]. This minimizes side effects and long term damage to regions of the body. The most important characteristic of the gold nanoparticle is its malleable design. There are multiple options for the shape of the nanoparticle, each with a different purpose. Overall, their structures have universal features. These include a center, where the gold is contained and surrounded by a compact protective layer. This is known as the Stern Layer. This is covered with a second biocompatible layer known as the Gouy layer. The Gouy layer is where the drug is attached using ligands. Ligands are molecules that are attached to a metal ion using coordinate bonding [1]. This bonding can either be covalent or noncovalent. Often it occurs between a functional group and a ligand. This functional group is the drug that the nanoparticle is delivering. The structure of the gold nanoparticle is shown in Figure 2. The functional group keeps the ligand attached to the surface of the nanoparticle. The body now recognizes the nanoparticle and permits delivery of the drug. FIGURE 2 [6] The complex structure of the Gold Nanoparticles with ligands, R-Group, and drug attached to the surface 3 Madeleine Braun Erin Cannon Julia McKay Multiple factors can influence the performance of these ligands. Binding affinity of the targeting ligand is crucial for favorable interactions between the surface and the ligands. Binding affinity is the strength of the attractions between the ligand and the surface of the nanoparticle. If the ligand has a strong affinity, then it will be more likely to bond and aid in the drug delivery process. If there is low affinity of a ligand to its receptor, this limits targeting efficiency. Another component that impacts the construction of this structure is the surface density of the ligands. The more densely packed the ligands are on the surface, the more they can penetrate the cancerous tissue. The nanoparticles will then be more effective in destroying the malignant cells. This activity is dependent upon the nanoparticles being delivered as one unit to the metastasis site. Targeted ligands need a long half-life to provide sufficient time for the drug to reach the target at therapeutic levels. After all of the previous constraints are met pertaining to the structure of the ligand and the characteristics of the gold nanoparticle, the nanoparticle can finally reach its destination. Once there, the gold nanoparticle enters the cell through receptor-mediated endocytosis. This means that a small hole opens up in the plasma membrane and allows the particle to enter. It then closes up behind it so that nothing from inside of the cell can escape. The particle is now inside of the cancerous cell where it can finally perform its task, releasing the drug. The coating on the outer surface of the nanoparticle is able to partition hydrophobic molecules from surrounding aqueous medium [6]. This tells the nanoparticle the correct time to release the drug, which in when it is either inside of the cell or just outside of it, depending on the delivery system. Once released, the drug travels throughout the cell and triggers apoptosis. This means that the cancer cell dies and the nanoparticle has completed its task [9]. Enhanced Permeability and Retention In order for gold nanoparticles to effectively reach the site of the malignant cells, the properties of such cells must be studied in order to better understand nanoparticle-cell interactions. Due to the abnormally large presence of blood vessels within tumor cell clusters, the increased permeability of these blood vessels, made possible by loosely compacted vasculature, and lack of lymphatic drainage, nanoparticles are able to invade and accumulate in the tumor tissue [8]. This is known as the Enhanced Permeability and Retention (EPR) Effect, which was first established by Matsumura and Maeda. Although these qualities, caused by EPR, generally improve delivery of chemotherapeutic agents to cells through nanoparticles, it only results in a maximum ten-fold increase in delivery in comparison to unaffected organs. This small increase is insufficient for achieving optimal therapeutic levels in patients suffering with cancer [8, 9]. This led scientists to 4 utilize these traits of tumor tissue to passively target cancerous tissue in addition to other modifications on the nanoparticles themselves for active targeting to improve the levels of drug successfully delivered to the cancerous cells. The Importance of Surface Receptor Targeting It is impossible for any type of nanoparticle to be able to track and locate a specific area of the body without chemical modification to the surface of the particle. There are two distinct types of drug targeting systems that are used: active and passive. Active targeting involves the conjugation of natural biological agents which track and treat disease such as antibodies and peptides. Passive targeting is achieved by taking advantage of the EPR effect previously discussed. Both methods can be used within a single nanoparticle to improve both the accuracy and precision of the targeting [10]. It is well known that within most cancerous cells the epidermal growth factor receptor (EGFR) is often overexpressed by the EGFR gene. This factor is overexpressed in up to 90 percent of pancreatic cancer cells, and this expression has been a huge focus of a variety of different targeting treatments for pancreatic cancer. These researched treatments include a drug called Erlotinib, a drug currently listed as an available potential treatment by the American Cancer Society for pancreatic cancer, which is currently used in addition to chemotherapy and radiation. The EGFR gene mutation allows for cancer cells to constantly grow and divide into clusters of tumors. By targeting cells with this mutation-using surface-modification, drug delivery could be possible. Studies have been performed using AuNPs conjugated with anti-EGFR proteins, which were effective in tracking cells with the overexpressed EGFR on the cancer cells surface when compared to similar testing on healthy cells. Another method to targeting this specific gene through surface modification is the conjugation of whole antibodies or fragments of one to utilize natural targeting abilities of the body [11]. This method grew in popularity due to recent FDA approval of antibody immunotherapies in other fields of study. In recent research, there has been promising statistics using this antibody approach on cancerous tissue. Alyssa Master, a researcher of biomaterials and drug delivery systems at Case Western Reserve University, referenced, “several studies including those performed by El-Sayed et al. and Melancon et al. have shown the ability to cause almost 100% cell death in vitro through the use of these antibody-targeted gold nanoparticle systems” [10]. Based on these results, this is clearly a favorable surface modification method. However, it is extremely expensive to use and experiment with living antibodies. Peptide conjugation is a common and promising new area of research within drug delivery that can be used to locate the cancer using this gene mutation as well to deliver chemotherapeutics to diseased cells. A peptide is a compound consisting of two or more amino acids linked together in a chain. One EGFR-specific peptide currently being researched is called “GE11”. The results on several in vitro human cell lines showed Madeleine Braun Erin Cannon Julia McKay that the GE11 peptide targeting method increased cellular uptake of the drug, and resulted in 80% cell death in cancer cells with the gene mutation [10]. Cellular uptake, the process of absorbing a substance into a cell, is a key component to a successful drug delivery system [8]. Electromagnetic Properties Resulting in Imaging, Detection, and Thermal Therapy Receptor-Mediated Endocytosis Receptor-mediated endocytosis is the final step of drug delivery for AuNPs, in which the subcellular nanoparticles enter the cancerous cell itself to release the drug. Attaching specialized ligands can allow for the nanoparticle to penetrate cancerous cells themselves and release the drug within the cell resulting in apoptosis, or cell death. The ligands used to modify the surface of the cell must be compatible with cellular surface receptors of the cancerous cells. If the particles successfully bind with the receptors, then the nanoparticle can be internalized into the cancerous cell through a process called receptor-mediated endocytosis which is typically used by healthy cells to intake metabolites, hormones, and other proteins [7]. This process can be seen in Figure 3. Although not the primary function this paper focuses on, an important part of this technology is the imaging and detection of cancer cells both prior to treatment and the residual cells left after treatment. It is the electrons within the gold of these particles that allow for this advantage. Gold utilizes its intense light scattering power to identify cancerous growths prior to the attempted resection of the affected area. This could allow for surgeons to judge whether surgery is possible or if it will be effective. They can also be used during surgery to help the surgeon visualize the site on a cellular level. “Gold nanoparticles with diameters between 12 and 20 nm are known to efficiently scatter visible light in the wavelength region around 530 nm and can thus easily be detected by wavelength selection using optical methods such as dark field or confocal microscopy” [12]. This means that gold particles of a certain size coupled with light of a specific wavelength scatter the light in such a way as to optimally visualize infected tissue. Examples of these imaging processes can be seen in Figure 4. This discovery could indicate ability for earlier detection and more targeted treatment in cancer patients. The process of imaging and detection consists of two distinct sections, absorption and scattering. When metal nanoparticles are exposed to light, the electrons circling the particle band together. This gives the surface of the particle a negative charge. Because of this, the particles oscillate at a precise frequency and this is referred to as surface plasmon resonance (SPR) [7]. Then, based on the SPR, the energy absorbed from the light by the gold in the particles is then scattered hitting the targeted organic material in the form of heat [8]. FIGURE 3[7] Receptor-Mediated Endocytosis of gold nanoparticle into cancerous tissue The intake of nanoparticles largely depends on the size of the particle. The optimal structure of nanoparticle for this specific process is a spherical gold nanoparticle with a diameter of 50 nanometers. These results proved to be consistent regardless of the dosage and ligands used for targeting Prior to entering the cells the drug-ligand-surface bonds are stable, but within the cell due to the chemical conditions of the cytoplasm, the jelly-like material within the cell, these same bonds become unstable causing the release of the drug from the nanoparticle. This allows for the chemotherapeutic to interact with the cancerous cell and eventually lead to the death of the cell [7, 11]. FIGURE 4 [13] Example of imaging methods of in vivo rat testing based on conductivity and heat transfer In addition to the benefits of free electrons for imaging purposes, their conductive properties of both electricity and heat, allow them to trigger hyperthermia in an infected area. Hyperthermia is a condition in which a system is a few degrees above its ideal temperature. If a cell is raised three to six degrees Celsius above its optimal temperature it can die or become 5 Madeleine Braun Erin Cannon Julia McKay extremely damaged. Metallic nanoparticles have the ability to induce hyperthermia in clusters of cancer cells. If this technique is carried out along with the delivery of the chemotherapeutic, then the cell will be more susceptible to death. This process is called photothermal therapy. “For imaging, larger nanoparticles are preferred because of higher scattering efficiency, whereas for photothermal therapy, smaller nanoparticles are preferred as light is mainly adsorbed by the particles and thus efficiently converted to heat for cell and tissue destruction” [14]. Therefore, when used for drug delivery, smaller nanoparticles are optimal. CHALLENGES IN DEVELOPMENT OF GOLD NANOPARTICLES As with any new technology being developed, there are many challenges that the engineers at the forefront of this technology are facing. They must ensure that the technology not only upholds the health standards set out by the U.S Food and Drug Administration (FDA), but also are ethically accepted and trusted by the community. The use of gold nanoparticles as a form of pancreatic cancer treatment has not yet been approved by the FDA. Scientists are still perfecting the technology and ensuring its reliability. Until it is officially accepted, it will not have a set of specific guidelines put in place so that it can be used on patients. One of the main obstacles that engineers are facing with the function of the product is making sure that it does not aggregate within the body. Aggregation is when the nanoparticles cluster together. This can be dangerous as it can lead to blood flow blockages and cause ischemia, insufficient blood supply to a specific region of the body. One way that engineers are trying to prevent aggregation is with the addition of a monolayer or bilayer cap to the gold nanoparticle [6]. Although this technique has potential, it has not proven to fully prevent aggregation. Researchers are still working on perfecting the design and composition of these caps. The development and formation of gold nanoparticles to optimize their efficiency targeting, imaging, and thermal therapy has proven to be difficult. Although AuNPs are capable of performing all three tasks, each of these is dependent on the structure and size of the particle. Nanoparticles greater than six to eight nanometers are not efficiently excreted from the body, yet the most effective particles in terms of cellular uptake would be fifty to sixty nanometers in diameter due to their large surface area for conjugation. Imaging nanoparticles tend to be most optimal when they are larger whereas for thermal therapy ideally they would need to be smaller. This inconsistency in best possible size for each mode of the nanoparticle has limited success of all three modes working together in testing [10]. 6 Research into Cytotoxicity for Sustainable Gold Nanoparticles A major challenge that has been a concern for all metallic nanotechnology being researched is the possibility of cytotoxicity due to long term exposure of cells to the metal. Cytotoxicity is the ability of certain chemicals to harm or destroy living cells. Cells are considered the basic unit of human life, so any interference with their function is carefully studied. The ideal size of nanoparticles based upon in vitro research is often too large for the AuNP to exit cells once they enter and they often cannot be excreted naturally, which would be preferred. This means that that the majority of gold nanoparticles used for the treatment would remain within the body for the duration of the patient’s life after treatment [15]. Continued medical complications due to the cytotoxicity from AuNPs could potentially lead to death or a poor quality of life and would lead the AuNPs to be considered an unsustainable treatment method. As of now there are long-term experiments going on for metallic nanoparticles to ensure that this will not pose this extreme of an effect. This research remains premature, so no simple conclusions have been drawn as to whether gold nanoparticles would be safe enough for a clinical setting. Based on existing uses of gold in unrelated medical applications such as the use of gold-based compounds for the treatment of rheumatoid arthritis, gold usage has been safe and bulk gold is considered biocompatible and “chemically inert” within the body. In the application of gold in use of treatment for cancer, nanoparticles will have to be compatible with a variety of complex solutions such as the cytoplasm of cells and blood. The continued nanoparticle-fluid reactions on a molecular level have been the focus of cytotoxic research. The concern of harmful side effects in a patient following AuNP cancer treatment is similar to those of chemotherapy and radiation. As discussed previously, the effects of chemotherapy and radiation on a patient with pancreatic cancer tend to be very harmful. There is a possibility that all cancer patients face when receiving either of these treatments that they could die from the effects even if it successfully kills the cancer. Therefore, the treatment methods discussed in this paper could be considered not fully sustainable and could be replaced by future alternatives. Scientists and engineers are working to ensure that the reactions between golf nanoparticles and the cell will not lead to any impairment of the cells within the body. Other forms of nanoparticles are also being researched to compare their respective advantages and disadvantages to those of gold nanoparticles Comparison to Polymeric nanoparticles Due to the rise in interest nanotechnology and projected growth of it within the next few years, there has been research on an assortment of different materials and structures of nanoparticles as drug deliverers, not just gold. One of the most common materials used to construct nanoparticles currently being researched is polymers. Polymers are large complex Madeleine Braun Erin Cannon Julia McKay molecules that can be found naturally or synthesized in a laboratory. They are built out of many smaller often repeating units that form very useful materials [16]. This material is beneficial for pancreatic cancer treatment due to their advantageous properties. Similar to gold nanoparticles, polymeric nanoparticles can function effectively within the human body without causing significant harm. Polymeric nanoparticles are of high interest in the field of nanotechnology because they tend to be biodegradable, biocompatible, cost-effective, and very versatile since they can be constructed out of countless chemical formula units. Polymeric nanoparticles can be surface functionalized similarly to how gold nanoparticles are in order to target drug delivery [16]. As of now they have been researched more heavily than metallic nanoparticles, so there has been more success in their testing. Although polymers are shown to have some advantages over AuNPs, they also have disadvantages that need to be investigated. Some polymers, mostly natural hydrophilic polymers, are hard to produce batch-to-batch because the combination of formula units is so unique. Another disadvantage is a result of polymers being naturally formed, because of this it is possible for the body to form antigens that will label the nanoparticle as an invader and destroy the particle prior to it reaching its destination. In addition, polymeric nanoparticles are often faulty if not operating in optimal conditions. For example, if the pH is imbalanced or the temperature is too low or high, the particle could release its drug prematurely or not at all [16]. Another disadvantage when compared specifically to AuNPs is that they only currently act as drug carriers and are not considered to be multimodal. Because of this specification, polymeric nanoparticles can perform fewer functions within the body as compared to gold nanoparticles. While this may not seem to be a good thing, this means that more of the research into polymeric nanoparticles goes into their application to cancer treatment, while gold nanoparticles research branches off into multiple categories as explained previously. ETHICS OF GOLD NANOPARTICLE RESEARCH AND DEVELOPMENT In addition to technological barriers to the formation of gold nanoparticles, engineers working with AuNPs are facing ethical and economic issues. The development of new medical technology is a long and difficult process, consisting of product formulation, lab testing, animal testing, and clinical trials. Following all of these steps, the product still may not be ready for human use. Even if the technology performs perfectly in every stage of its development, and does not need any modifications, the process can still take up to ten years [17]. Once the product is available to the public, it takes time for people to begin 7 to trust it. Until there are human tested statistics, beyond clinical trials, to support the claims of the product, it will not become a standard treatment. Especially for a disease as widespread as cancer, it would most likely take even longer for a new cancer treatment to circulate into use, because it would be met with skepticism. Those who are developing this cancer treatment face a struggle between fast tracking the process of development while possibly not being as thorough as they should be or waiting to release the treatment as thousands of people die from the disease. World Pancreatic Cancer Day, an organization that spreads awareness of pancreatic cancer, stated that “an estimated 985 people worldwide die from pancreatic cancer every day” [18]. This statistic demonstrates the need for prompt and effective advancements in pancreatic cancer treatment. With this being said, there are multiple consequences that would come from releasing a product before it is truly prepared. If the product has a problem, it could end up doing more harm than good. This would create a stigma associated with the treatment method and would limit its future application. How Cost Influences Research After the treatment method is developed and introduced into industry, there is still the over lining issue of making the product affordable for the masses. A huge misconception of this new technology is that, because gold is involved and is seen as an expensive material the production of AuNPs will be incredibly expensive. This has proven to be untrue based on the synthesis of the nanoparticles used recently in the trials we discussed. When produced in large quantities the total cost of gold salt required to produce a “full-course phase I dosage” of nanoparticles was 12 cents [7]. When it comes to the expenses of the nanoparticles, the issue is not with the synthesis of the product itself, but rather with the research and potentially longterm clinical trials behind still required prior to its appearance in industry. Potentially, billions of dollars are put into researching new medical technology. The companies designing the product will expect a return on their investment, therefore when the product is released it will be expensive. As a result, many of the people who need the treatment will not be able to afford it which would lead to it being considered economically unsustainable. This creates an additional dilemma for those researching the technology. THE OUTCOME OF GOLD NANOPARTICLES ON CURRENT PANCREATIC CANCER TREATMENTS Pancreatic cancer affects the lives of thousands of people across the globe. Therefore, alternative treatment methods for pancreatic cancer have become a recurring research topic in the field of medicine as well as in engineering. This technology provides a potential solution over current forms of treatment, such as chemotherapy and radiation. It has the capacity to be Madeleine Braun Erin Cannon Julia McKay both effective in its eradication of cancer cells and in its protection of unaffected areas. The advantageous properties of nanotechnology-based treatments allow for them to supply both a protective and healing function within the body. These properties include biocompatibility, high surface-to-mass ratio, enhanced permeation of cancerous tissue, and improved selectivity over current treatment. Gold nanoparticles could not only become a way of allowing for a less painful treatment process for cancer patients, but also provide hope for a cure in the near future. There is still a long way to go before this technology is approved for human use. It is currently only being tested on animals and on in vitro cell lines. Although there has been significant success in these stages, it is unpredictable whether this will translate in human clinical trials. The human body often reacts differently to drug treatments than animals and therefore, the potential of the product will not be confirmed until the final stages of testing. Overall, gold nanoparticles as a form of targeted drug delivery for pancreatic cancer treatment could possibly revolutionize the way society views cancer. It is currently viewed by many as an incurable disease, but with the establishment of this new technology, it may limit its threat on society. SOURCES [1]Kudgus, Rachel A., Annamaria Szabolcs, Jameel Ahmad Khan, Chad A. Walden, Joel M. Reid, J. David Robertson, Resham Bhattacharya, and Priyabrata Mukherjee. "Inhibiting the Growth of Pancreatic Adenocarcinoma In Vitro and In Vivo through Targeted Treatment with Designer Gold Nanotherapeutics." PLoS ONE 8.3. 2013. Accessed 1/17/2017. http://web.a.ebscohost.com/ehost/detail/detail?vid=13&si d=e e1eb0fb-b347-4ea7-9f06e2fd0aff3506%40sessionmgr4007&hid=4101&bdata=Jn Npd GU9ZWhvc3QtbGl2ZQ%3d%3d#AN=87679816&db=ap h [2] Giljohann, David A., and Dwight S. Seferos. "Gold Nanoparticles for Biology and Medicine." 2010. Accessed 1/15/2017. file:///C:/Users/julia/Downloads/Giljohann_et_al-2010Angewandte_Chemie_(International_ed._in_English).pdf [3] "Drug Delivery Systems: Getting Drugs to Their Targets in a Controlled Manner." National Institutes of Health. U.S. Department of Health and Human Services. 2016. Accessed 1/11/2017. https://www.nibib.nih.gov/science-education/sciencetopics/drug-delivery-systems-getting-drugs-their-targetscontrolled-manner [4] Moyer, Melinda Wenner. “Why is Pancreatic Cancer So Deadly?” Scientific American. 10.05.2011. Accessed 2/12/2017. 8 https://www.scientificamerican.com/article/why-is-pancreaticcancer-so-deadly-steve-jobs/ [5] "Celprogen 3D Prints a Pancreas from PLA and Human Stem Cells." 3DPrint.com. N.p., 02 Dec. 2016. Web. 30 Mar. 2017. https://3dprint.com/157430/3d-printed-pancreas-celprogen/ [6] Fratotti, I. "Gold nanoparticles and gold nanoparticleconjugates for delivery of therapeutic molecules. Progress and challenges." Journal of Materials Chemistry B (RSC Publishing). The Royal Society of Chemistry. 2014. Accessed 1/22/2017. [7] Dreaden, Erik C., Lauren A. Austin, Megan A. Mackey, and Mostafa A. El-Sayed. "Size Matters: Gold Nanoparticles in Targeted Cancer Drug Delivery." Therapeutic Delivery. U.S. National Library of Medicine, Apr. 2012. Web. 02 Mar. 2017. [8] Greish, K. "Enhanced Permeability and Retention (EPR) Effect for Anticancer Nanomedicine Drug Targeting." Methods in Molecular Biology (Clifton, N.J.). U.S. National Library of Medicine, 24 June 2010. Web. 02 Mar. 2017. [9] Arvizo, R., R. Bhattacharya, and P. Mukherjee. "Gold Nanoparticles: Opportunities and Challenges in Nanomedicine." PubMed. U.S. National Library of Medicine, June 2010. Web. 18 Mar. 2017. [10] Master, Alyssa M., and Anirban Sen Gupta. "EGF Receptor-targeted Nanocarriers for Enhanced Cancer Treatment." Nanomedicine (London, England). U.S. National Library of Medicine, Dec. 2012. Web. 02 Mar. 2017. [11] American Cancer Society. "What's New in Pancreatic Cancer Research?" American Cancer Society. ACA, Jan. 2017. Web. 30 Mar. 2017. https://www.cancer.org/cancer/pancreatic-cancer.html [12] Wolfgang, Eck. "PEGylated Gold Nanoparticles Conjugated to Monoclonal F19 Antibodies as Targeted Labeling Agents for Human Pancreatic Carcinoma Tissue." PEGylated Gold Nanoparticles Conjugated to Monoclonal F19 Antibodies as Targeted Labeling Agents for Human Pancreatic Carcinoma Tissue - ACS Nano (ACS Publications). N.p., n.d. Web. 11 Jan. 2017. http://pubs.acs.org/doi/pdf/10.1021/nn800429d [13] Southwestern Medical Center. "Sun Lab." UT Southwestern Medical Center. N.p., n.d. Web. 30 Mar. 2017. http://www.utsouthwestern.edu/labs/sun/research/targetingtumors.html [14] Huang, Jiale. "Biosynthesis of silver and gold nanoparticles." IOPScience. 02.01.2007. Accessed 1/30/2017. http://iopscience.iop.org/article/10.1088/09574484/18/10/105104/meta [15] Jong, Wim H De, and Paul JA Borm. "Drug delivery and nanoparticles: Applications and hazards." International Journal of Nanomedicine. Dove Medical Press. 2008. 1/10/2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527668/ [16] Singh, Rajesh, and James W. Lillard. "Nanoparticle-based Targeted Drug Delivery."Experimental and Molecular Pathology. U.S. National Library of Medicine, June 2009. Web. 02 Mar. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249419/ Madeleine Braun Erin Cannon Julia McKay [17] Tandon, Nina. "Could Tissue Engineering Mean Personalized Medicine?" TEDglobal. Edinburgh. June 2012. TED. Web. 24 Oct. 2016. https://www.ted.com/talks/nina_tandon_could_tissue_eng ineering_mean_personalized_medicine [18] World Pancreatic Cancer Coalition. "World Pancreatic Cancer Day." World Pancreatic Cancer Day. World Pancreatic Cancer Coalition, 2016. Web. 02 Mar. 2017. http://www.worldpancreaticcancerday.org/about/ ADDITIONAL SOURCES Hronek, Jan W. “Nursing Implications of Chemotherapy Agents and Their Associated Side Effects in Patients With Pancreatic Cancer.” Clinical Journal of Oncology Nursing N.p., n.d. Web. 21 Jan. 2017. http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?si d=91273b43-766a-4877-b0a7296166028f87%40sessionmgr101&vid=6&hid=12 Patra, Chitta Ranjan, Resham Bhattacharya, Debabrata Mukhopadhyay, and Priyabrata Mukherjee. "Fabrication of gold nanoparticles for targeted therapy in pancreatic cancer." Advanced Drug Delivery Reviews 62.3 (2010): 346-61. Web. http://ac.els-cdn.com/S0169409X09003457/1-s2.0S0169409X09003457-main.pdf?_tid=0806369c-d4f311e6-966a00000aacb35e&acdnat=1483805276_ba91c3a5b7003fc03 248ea50653b2767 Yu, Xianjun, Yuqing Zhang, Changyi Chen, Qizhi Yao, and Min Li. "Targeted drug delivery in pancreatic cancer." Biochimica et Biophysica Acta (BBA) - Reviews on Cancer 1805.1 (2010): 97-104. Web.http://ac.elscdn.com/S0304419X09000729/1-s2.0S0304419X09000729-main.pdf?_tid=b2a70a2a-d4f511e6-a3df 00000aab0f6c&acdnat=1483806421_47b3f489d5c944444 b3ea030903e53a2 ACKNOWLEDGMENTS We would like to thank our professors for helping us to become better students. We would also like to thank our parents for supporting us and allowing us to pursue our goals. Finally, we would like to acknowledge all of the resources here at The University of Pittsburgh that we have utilized while writing this paper. They include the Writing Center, the Engineering writing instructors, the library staff, and our co-chair. Thank you for guiding us through this process. 9
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