Abstract
Background:
Nanotechnology involves the engineering of structures on a molecular level. Nanomedicine and nano delivery systems have been designed to deliver therapeutic agents to a target site or organ in a controlled manner, maximising efficacy while minimising off-target effects of the therapeutic agent administered. In both reproductive medicine and obstetrics, developing innovative therapeutics is often tempered by fears of damage to the gamete, embryo or developing fetus, or of negatively impacting a woman’s reproductive potential. Thus nanomedicine delivery systems may provide alternative targeted intervention strategies; treating the source of the disease and minimising long-term consequences for the mother and/or her fetus.
Objective and rationale:
This review summarises the current state of nanomedicine technology in reproductive medicine and obstetrics, including safety, potential applications, future directions and the hurdles for translation.
Search methods:
A comprehensive electronic literature search of PubMed and Web of Science databases was performed to identify studies published in English up until February 2020. Relevant keywords were used to obtain information regarding use of nanoparticle technology in fertility and gene therapy, early pregnancy complications (ectopic pregnancy, gestational trophoblastic disease), and obstetric complications (preeclampsia, fetal growth restriction, preterm birth, gestational diabetes and selective treatment of the mother or fetus). Safety of specific nanoparticles to the gamete, embryo and fetus was also elicited.
Outcomes:
Pre-clinical research in the development of nanoparticle therapeutic delivery is being undertaken in many fields of reproductive medicine. Non-hormonal targeted nanoparticle therapy for fibroids and endometriosis may provide fertility-sparing medical management. Delivery of interventions via nanotechnology provides opportunities for gene manipulation and delivery in mammalian gametes. Targeting cytotoxic treatments to early pregnancy tissue provides an alternative approach to manage ectopic pregnancies and gestational trophoblastic disease. In pregnancy, nanotherapeutic delivery offers options to stably deliver silencing RNA and microRNA inhibitors to the placenta to regulate gene expression, opening doors to novel genetic treatments for preeclampsia and fetal growth restriction. Restricting delivery of teratogenic drugs to the maternal compartment (such as warfarin) may reduce risks to the fetus. Alternatively, targeted delivery of drugs to the fetus (such as those to treat fetal arrythmias) may minimise side effects for the mother.
Wider implications:
We expect that further development of targeted therapies using nanoparticles in a reproductive setting has promise to eventually allow safe and directed treatments for conditions impacting on women’s health and reproductive capacity, the management of pregnancy and serious pregnancy complications.
Nanotechnology involves the engineering of structures on a molecular level. Nanomedicine and nano delivery systems have been designed to deliver therapeutic agents to a target site or organ in a controlled manner, maximising efficacy while minimising off-target effects of the therapeutic agent administered. In both reproductive medicine and obstetrics, developing innovative therapeutics is often tempered by fears of damage to the gamete, embryo or developing fetus, or of negatively impacting a woman’s reproductive potential. Thus nanomedicine delivery systems may provide alternative targeted intervention strategies; treating the source of the disease and minimising long-term consequences for the mother and/or her fetus.
Objective and rationale:
This review summarises the current state of nanomedicine technology in reproductive medicine and obstetrics, including safety, potential applications, future directions and the hurdles for translation.
Search methods:
A comprehensive electronic literature search of PubMed and Web of Science databases was performed to identify studies published in English up until February 2020. Relevant keywords were used to obtain information regarding use of nanoparticle technology in fertility and gene therapy, early pregnancy complications (ectopic pregnancy, gestational trophoblastic disease), and obstetric complications (preeclampsia, fetal growth restriction, preterm birth, gestational diabetes and selective treatment of the mother or fetus). Safety of specific nanoparticles to the gamete, embryo and fetus was also elicited.
Outcomes:
Pre-clinical research in the development of nanoparticle therapeutic delivery is being undertaken in many fields of reproductive medicine. Non-hormonal targeted nanoparticle therapy for fibroids and endometriosis may provide fertility-sparing medical management. Delivery of interventions via nanotechnology provides opportunities for gene manipulation and delivery in mammalian gametes. Targeting cytotoxic treatments to early pregnancy tissue provides an alternative approach to manage ectopic pregnancies and gestational trophoblastic disease. In pregnancy, nanotherapeutic delivery offers options to stably deliver silencing RNA and microRNA inhibitors to the placenta to regulate gene expression, opening doors to novel genetic treatments for preeclampsia and fetal growth restriction. Restricting delivery of teratogenic drugs to the maternal compartment (such as warfarin) may reduce risks to the fetus. Alternatively, targeted delivery of drugs to the fetus (such as those to treat fetal arrythmias) may minimise side effects for the mother.
Wider implications:
We expect that further development of targeted therapies using nanoparticles in a reproductive setting has promise to eventually allow safe and directed treatments for conditions impacting on women’s health and reproductive capacity, the management of pregnancy and serious pregnancy complications.
| Original language | English |
|---|---|
| Journal | Human Reproduction Update |
| Publication status | Accepted/In press - 8 Oct 2020 |
