Many scientists are designing microscopic devices that can move through the body to diagnose conditions, carry drugs, or perform surgery. These devices are made of synthetic rods, tubes, helices, spheres or cages, sometimes as small as a cell. To date, these experiments are being studied in vitro, in conditions very different from the human body. While scientists are making progress in the petri dish, they are finding that the devices are much more difficult to control in the mix of proteins and cells that flow through the human body.

This month’s issue of Nature¹ provides an update on these microscopic devices. Microbiotics researchers are trying to figure out how to see and control the tiny devices well enough to test them in clinical trials. Current imaging techniques are not yet adequate to overcome this hurdle. The devices also need to be biocompatible and be able to be removed or stabilized after use. The materials need to be safe for humans, and the devices must be able to perform a wide range of tasks, such as detecting and responding to their environment, and storing and delivering molecules or cells when stimulated by physical cues or by certain molecules, disease biomarkers, temperatures, or levels of acidity. Imaging techniques, such as radiology, ultrasound, infrared and magnetic resonance imaging, are not sensitive enough to track these tiny devices in the body. Researchers are making progress in manipulating light, sound, and electromagnetic waves to minimize blurring, and in the application of chemical agents that darken the devices or cells so they will be easier to see.

Regulatory agencies have some experience testing and evaluating these materials and devices. For example, silver nanoparticles are used as antibacterial wound dressings. Some professionals in the field say that the imaging techniques might be good enough in the next two years to begin testing these microscopic devices in live animals. With a coordinated effort, these devices could introduce an era of non-invasive therapies within the next decade.

Analysis: The Deloitte Center for Health Solutions’ paper, Top 10 health care innovations: Achieving more for less, features biosensors including rapidly shrinking wearables and medical devices as innovations that will help the health care system achieve “more for less” in the coming years. These biosensors have the potential to allow consumers and clinicians to monitor and track more aspects of patients’ health, enabling earlier intervention – and even prevention – in a way that is much less intrusive to patients’ lives. While many of us rely on smart phones and smart watches to monitor our exercise, nutrition, sleep, and certain vital signs, these next generation devices could track changes in the human body such as medication levels, blood, hormone, protein levels, and device performance. Increased biosensing could improve patient engagement, medication adherence, disease monitoring and, ultimately, health outcomes. The collected data could be used by clinicians to intervene earlier and more often, and by researchers to better understand treatment effectiveness.

_{¹ Mariana Medina-Sánchez and Oliver G. Schmidt, Medical microbots need better imaging and control, Nature, May 24, 2017}

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