Bioelectric Medicine: Magicall Tools for Treatment of Many Diseases
Department of Pharmaceutics, Gourishankar Education Society's, Satara College of Pharmacy,
Satara, Maharashtra, India.
Bioelectronic medicine is a relatively new area that focuses on developing methods for treating diseases that do not need medications. Bioelectronic medicine treatments are now possible thanks to a small embedded system that produces and delivers frequent digital doses to nerve bundles, resulting in a disease-fighting effect that can last hours or days and is based on mechanisms similar to drug therapies. Although this may sound like science fiction, electronic brain and nerve stimulators are now presence applicable to treat so many of ailments, including epilepsy, Parkinson's disease, and bladder control. Progress in treating such disorders has opened up possibilities for boosting memory, improving eyesight, strengthening a shaky gait, and even improving a golfer's swing. Those self-improvement dreams may be a long way off, but bioelectronic medicine is gaining traction as a new way to treat difficult diseases. What distinguishes bioelectronic medicine is its biological effect on the body, which goes beyond symptom management to treat the underlying condition by using the body's own mechanisms. With promising early results in many trials and further trials ongoing, bioelectronic therapies are likely to be accepted for clinical use within the next few years. To make this advancement possible, forward-thinking scientists, engineers, doctors, and innovators with specialised talents combined old and new discoveries in ways no one had before.
Devices that use electricity to control biological processes, cure diseases, or restore lost functionality are referred to as bioelectronic medicine. BEMS have three different ways of interacting with excitable tissue: they can stimulate, obstruct, and sense electrical activity. The peripheral nervous system, in particular, will be at the forefront of this advancement, as it has a wide range of functions in chronic disease.
The aim for bioelectronic medicines is one of the tiny, implantable devices that can be attached to specific peripheral nerves.Such instruments would be able to translate and control neuronal signalling patterns, resulting in a healing outcome that is unique to a specific organ's signal feature. With the introduction of more multifaceted devices and new constituents that have been planned down to the nanoscale, the bioelectronic sector has been able to advance recently. These ground-breaking advances in our ability to miniaturise system components result in more compact and biocompatible materials, as well as more effective and expandable computing and power components, reducing side effects, miniaturisation, and cost. Bioelectronic medicinal system must be able to target different parts of the humanoid frame and function in a closed loop.1,2,3
Bioelectronic devices are now used in a variety of medical applications. Electronic medical devices have progressed to the point that they are in this day a wide-ranging technology. Deep-brain stimulations, for example, are used to treat Parkinson's disease.4
Nanomaterials for nervous prosthetic device have sparked widespread interest as a result of recent developments in nanotechnology. An perfect nervous boundary must integrate seamlessly with the nervous system and function consistently over time. As a result, several nanoscale constituents that weren't designed for neural interfaces are now promising candidates for detecting and stimulating neurons. This systematic examination begins with an overview of existing microelectrode technologies, with a focus on the material properties of these microdevices. Conducting polymers, carbon nanotubes, graphene, silicon nanowires, and hybrid organic-inorganic nanomaterials are among the developments in electro active nanomaterials for neurological recording, stimulation, and growth. Finally, the technological and scientific difficulties that these nanomaterials face in terms of automatic, biocompatibility mismatch, and electric properties are addressed in order to create long-lasting functional neural interfaces.5
Interfaces are used in bioelectronic medicine to gain access to the nerves of the periphery, which are listed below.
Electrode: Metal oxide semiconductor with complementary properties with silicon-based penetrating electrodes and polymer-based fine, time, life, and cuff electrode arrays.
Material: Metal of great worth , Platinum, Alloys, Platinum-iridium, Gold, Laser-patterned Gold or Platinum- iridium foil (12 micrometre), lithographically patterned gold or Platinum-iridium foil (300 nm), Thermally evaporated films on polyamide or polylene Ultra Thin (35nm)
Polymer: Polyimide liquid Crystal polymer, Polydimethyl siloxane (PDMS) parylene, SU-8 photoresist, Polyurethane, Sheet or film (polyimide).
Light: Receiving components for without wire Power transfer, antenns, such as inductors, and ultrasonic transducers, emitting diodes for optogenetic stimulation.
Antihypertensive drug treatment is only effective to an extent, with a large percentage of patients in the United States having blood pressure readings above the guidelines while being treated with at least three agents at maximally tolerated doses, indicating resistant hypertension. In times of stress and sickness, the sympathetic nervous system is a key homeostatic mechanism for adjusting hemodynamics.6 Unfortunately, in certain patients, this pathway escapes physiologic regulation by the carotid sinus, leading to resistant hypertension via a variety of mechanisms.
A carotid sinus lead and a pulse generator are used to give baroreflex activation therapy in hypertension (Barostim neo system, CVRx, Inc., Minneapolis, Minnesota). A 40-cm lead body terminates in a 7-mm circular backer with a 2 mm iridium oxide–coated platinum–iridium disc electrode centred on it. The generator of pulses is inserted in the same way as a pacemaker is, by creating a subcutaneous infraclavicular chest wall pocket to accommodate it.
The carotid sinus is surgically exposed by a transverse cervical incision over the carotid bifurcation until the electrodes are implanted. Sensitivity is determined by analysing hemodynamic changes associated with acute baroreflex activation, such as heart rate and/or blood pressure decreases associated with increased parasympathetic and/or decreased sympathetic traffic, respectively.
The electrode is directly affixed to the backer and adventitia after the correct location has been determined. Six sutures are evenly spaced across the circumference of the electrode backer via the backer and adventitia. Via a subcutaneous tunnel, the opposite end of the lead is carried to the pulse generator pocket and connected to the pulse generator. The operation is then finished by closing all incisions. In the absence of side effects such as elevated heart rate or blood pressure decreases, therapy is started at a moderate stage.7,8,9,10
Finally, our research and development of biocompatible neural interfaces that do not compromise tissue physiological conditions has caused in a various of new ultrathin and versatile structures that can be implanted and stabilised in soft tissue for long periods of time.
These devices open up new possibilities for high-resolution research on physiological information processing and learning-dependent long-term changes in functionally specified networks (Schouenborg, 2008), as well as for distinguishing pathologic alterations in network functions that occur in diseases like neurodegeneration.
In addition, the novel embedding technology, which allows for the simultaneous implantation of complex nanostructured electrodes and compartmentalised local drug release, opens up new avenues in advanced pharmacology and drug production.
However, a thorough and time-consuming assessment of the impact of various types of electrode architecture, surface structures, embedding media, and local drug administration on glia and neurons, as well as other tissue constituents such as blood vessels and the blood–brain barrier, is required.
This is critical not only for providing high-quality research instruments that induce minimal information processing distortion in the neural circuits under investigation, but also for clinical use in humans, which demands a high level of safety and durability.
Finally, it's worth noting that there have been few attempts to combine chronic recordings in awake animals with neuroanatomical techniques like tracers. This may be due in part to the above-mentioned issues with recording instability from embedded neural interfaces, which prevents detailed histological identification.
As a result, neuronal recordings in awake animals have generally been attained from neurons that are unknown in terms of their functional associations in the CNS and histological identity.
As a result, achieving stable long-term recordings under physiological conditions from histologically and functionally characterised neural networks will be an essential challenge in future research.11,12,13.
3. Rheumatoid Arthritis and Bioelectronics: Rheumatoid arthritis (RA) is a chronic inflammatory condition marked by joint pain, swelling, and stiffness caused by synovial inflammation. The persistence of synovial inflammation in the joints during active disease contributes to bone erosions and eventually joint deformities. Bioelectronic medicine is increasingly being used in clinical trials.
Patients with rheumatoid arthritis who had a vagus nerve stimulator implanted to stimulate the inflammatory reflex showed considerable improvement in clinical signs and symptoms, even in those who had previously been therapy-resistant. Signals from the vagus nerve are transmitted through the nerve and cause inflammatory cells to become less active.
This is due to a decrease in the development of systemic inflammatory mediators. Inflammation, joint injury, and joint pain were also reduced when circulating immune cells were less activated.14,15,16,17.
4. Spinal Cord Bioelectronics: Patients with spinal cord injuries (SCI) place a high emphasis on regaining muscle control.
A wide range of automated gagets that communicate with the either the brain or the spinal cord are being developed for use in nervous prosthetics and neuro restoration. Brain-machine interfaces that decipher motor intentions from cortical signals are allowing patients to monitor assistive devices including computers and robotic prostheses, whereas electrical stimulation of the spinal cord and muscles may help patients with SCI retrain motor circuits and boost residual abilities.
Brain Machine Interface is an example of a next-generation interface that combines recording and relaxing functionality in a closed-loop system (Brain-Machine Interfearance). Will expand the possibilities for neuroelectronic enhancement of damaged motor circuits. According to new research, integrating closed-loop interfaces into intentional motor patterns has therapeutic effects that outlast the use of these devices as prostheses.
Machine-brain Interfearance: Through the process of neurofeedback, brain-machine interfaces (BMIs) that record and decode signals from the brain facilitate volitional control of assistive devices and alter patterns of cortical activity.
The application of invasive BMIs to humans indicates that these technologies may be used to monitor functional electrical stimulation for the restoration of movement in paralysed limbs.
Functional limb movements that combine the synchronised action of multiple muscles and the activation of spinal circuitry with volitional purpose may have therapeutic benefits.18,19,20
In Europe, in 1994, and in the United States, in 1997, VNS (vagus nerve stimulation) therapy was licenced for the treatment of epilepsy. In the United States, it has also been licenced for the treatment of depression.
VNS is possible after neurosurgically implanting a vagus nerve stimulator; 100,000 vagus nerve stimulators were implanted in 2012. A pulse generator and an electrode-encrusted lead are the two pieces of the system.
The battery and stimulation device are housed in the pulse generator, which is located subcutaneously underneath the left clavicle on the pectoral muscle . The lead is attached to the left vagus nerve in the neck and has three helices at the end: one positive electrode, one negative electrode, and an anchor tetherThe three helices are wrapped around the vagus nerve to transmit the pulse generator's electrical pulse.
The vagus nerve is electrically stimulated during surgery to check the device's impedance and functionality, which can cause bradycardia and short-term systole VNS therapy can be started after implantation with a low dose of stimulation and an output current of 0.25mA Since toleration to the stimulus is built up with the use of the VNS system dosage is increased slowly with 0.25mA steps to a maximum output current of 3.5mA .
The three helices containing a positive electrode, a negative electrode, and an anchor tether were implanted on the left vagus nerve, . The electrodes are attached to a lead that is connected to the pulse generator.21,22,23,24.
Bioelectronic medicine is important in the treatment of retinal disorders. A device implanted in the retina is known as bioelectronic medicine.
It contains a retinal prosthesis that restores vision to the blind, enhancing the patient's quality of life dramatically. This implantation was used to treat blindness.
It works by capturing images with a small video camera, encoding them, and sending them to the eye implant (a silicon chip inserted into the eyeball) via a laser beam that also powers the chip's solar cell. Photo sensors transform light and images into electrical impulses, which charge a plate that stimulates neurons and delivers visual information to the brain.
The laser and camera can be readily put to spectacles, eliminating the need for heavy headgear. A small video camera would be put on the patient's goggles. After light reaches the camera, the image is transferred to a wireless wallet-sized computer for processing.
The laser and camera can be readily put to spectacles, eliminating the need for heavy headgear. A small video camera would be attached to the patient's goggles. The camera captures the image and sends it to a wireless wallet-sized computer for processing.
The user can match their present vision with the new information because the goggles are transparent; the gadget would cover about 10° of the wearer's field of view. In this invention, a small video camera is mounted to a pair of spectacles.
A bionic implant on the back of the eye receives compressed digital images from the camera. The bionic chip has thousands of tiny electrodes that stimulate the optic nerve, which sends a signal to the visual centre in the back of the brain, where it is translated into an image.25,26,27.
7. Bioelectronics in treatment of the aids:
Boosted osmogen concentration increased medication release from the system, according to the developed CPOP formulations. pH and agitation intensity had no effect on the improved formulation. Finally, the controlled porosity osmotic delivery system was found to be a potential technique for the treatment of AIDS since the release of the optimised formulation is greatly controlled.28.
8. Bioelectronics in treatment of the inflammation: The carotid bodies (CB) are located bilaterally at the carotid artery bifurcation. They are polymodal sensors capable of detecting various physiological stimuli – blood gas concentration and blood pressure. The carotid body, via its innervating nerve – the carotid sinus nerve (CSN), signals to the brain to modulate these physiological stimuli through efferent activity. Recent evidence has suggested that there is a relationship between the immune system and the carotid body. It has been shown that the carotid body detects inflammation and functionally responds. Additionally, there is in vivo data, demonstrating that bilateral removal of the CSN decreases survival to endotoxemic shock. We hypothesized that activation of the carotid body would attenuate inflammation. 29,30,31.
Bioelectronic Devices great tools in upcoming days because it used in tretment of various disease without causing any harmful side effect.
Bioelectronic medicine is advantegeous over the available current formulation, Ex- Tablet dosage form required dose monitoring. Parentral dosage form required dose calculation.
CONFLICT OF INTERESET:
The authors have no conflicts of interest regarding this investigation.
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Received on 31.05.2021 Modified on 18.06.2021
Accepted on 26.06.2021 ©Asian Pharma Press All Right Reserved