Stories about: anesthesia

Precision drug delivery systems could ‘trigger’ an age of nanomedicine

Nanoscale drug delivery systems could target and destroy diseases in our body with increased precision and reduced side effects.

What if we could deliver biocompatible nanoparticles into the body and then activate them to release drugs exactly where they are needed, without causing side effects elsewhere?

Scientists like Daniel Kohane, MD, PhD, of Boston Children’s Hospital, are developing nanoscale drug delivery systems to do just that, using a variety of materials and triggers that are sensitive to a range of specific stimuli.

“Triggerable drug delivery systems could improve the treatment of many diseases by reducing side effects and increasing the effectiveness of therapeutics,” says Kohane, who directs the Laboratory for Biomaterials and Drug Delivery at Boston Children’s. He is the senior author on a recent article about the topic in Nature Reviews Materials.

One potential use of nanoscale drug delivery systems is of special interest to Kohane and his lab members

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Safety trial of algal anesthetic kicks off

Green algae
Algae similar to these could be the source of a powerful local anesthetic. (Micropix/Wikimedia Commons)
Two years ago, we told the story of the quest of Charles Berde, MD, PhD, of Boston Children’s Division of Pain Medicine, to turn an algal toxin called neosaxitoxin into a long-lasting local anesthetic.

At that time, Berde—together with Alberto Rodríguez-Navarro, MD, from Padre Hurtado Hospital in Santiago, Chile, and a Chilean company called Proteus SA—already knew that neosaxitoxin, a site 1 sodium channel blocker which in nature is produced by algal blooms, could help patients who had undergone laproscopic surgery recover more quickly and experience less pain compared with the current state -of-the-art local anesthetic called bupivacaine.

The group has now taken a big leap forward. In May, they launched a Phase 1 clinical trial at Boston Children’s in healthy male patients, aimed at showing that neosaxitoxin produced by Proteus from bioreactor-grown algae is safe using clinically relevant doses.

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Mounting a lasting blockade against pain

Saxitoxin produced by dinoflagellates (above), algae and shellfish could help stop neuropathic pain before it starts. (fickleandfreckled/Flickr)

A cut, a bruise, a scrape…these can all cause pain that, while unpleasant, usually passes quickly. But for an estimated 3.75 million children and adults in the United States with neuropathic pain, the pain is debilitating and never goes away.

Caused by diabetes, shingles, nerve trauma, cancer and other conditions, neuropathic pain is basically a sign that someone’s nervous system has lost track of what should and shouldn’t cause pain.

There are ways to treat or control neuropathic pain, like lifestyle changes and a range of medications, but they don’t target it at its source. Boston Children’s Hospital’s Daniel Kohane, MD, PhD, wants to do just that: to go for the root of neuropathic pain, maybe even stop it before it starts. And he’s doing it with microscopic beads full of a neurotoxin found in shellfish. 

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Second sight for anesthesiologists

Anesthesiologists have to get by and around a lot of things in order to put a breathing tube into a surgery patient. Kai Matthes thinks that using a pair of endoscopes could make the job easier. (National Cancer Institute)

Intubating the patient is a critical step in any surgery where general anesthesia is being used. But as any anesthesiologist will tell you, intubating a child is very different from an adult, largely because there is less space available in which to maneuver the breathing (aka endotracheal) tube.

There’s also less space in which to see. To place a breathing tube properly and keep the airway open, an anesthesiologist needs to see the patient’s vocal chords and the opening of his or her windpipe. Typically, the doctor uses a laryngoscope to see into the throat, but sometimes tumors, congenital anomalies, inflammation, or other obstructions block the view.

The next tool of choice would be a fiber optic endoscope – essentially a long, thin, tubular video camera – to peer within the throat. Sometimes, however, even the fiber optic scope can’t get a full view, and on occasion the scope and tube can get in each other’s way, making the anesthesiologist’s job harder and the procedure riskier.

But here’s a thought: If one scope can’t do the trick, what about two?

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With algae blooms hope for a long-acting local anesthetic

For decades, Chile’s shoreline has had problems with periodic algal blooms – referred to as Red Tide, but actually containing a mix of microorganisms including bluegreen algae. Their toxins accumulate in shellfish, landing seafood consumers in the hospital, partially paralyzed, sometimes needing ventilators to breathe.

The nerve block caused by the toxins is reversible, so most people fully recover, but it’s led to repeated bans on shellfish harvest, consumption and sale. Out of public health and economic concerns, Chilean scientists have built up an expertise in monitoring coastal waters and isolating and purifying the toxins.

But some scientists, like Alberto Rodríguez-Navarro, also a physician at Padre Hurtado Hospital in Santiago, saw pharmacologic potential. “We wondered what we could do with these compounds,” he says.

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