If you arent familiar, peptides are short strings of amino acids produced by your body linked via peptide bonds. Amino acids are the building blocks of proteins, but a peptide doesn't have as many amino acids as a protein does. When organized in complex structures (typically consisting of 50 or more amino acids), peptides then become proteins. We have utilized peptides at The Institute for a number of years because they have so many functions, namely, they engage with various receptors throughout the body, promoting therelease of hormones and other messaging compounds that may influence your health, body composition, exercise performance and recovery. The body produces a wide range of peptide hormones that circulate in the blood and bind to receptors on targeted organs and tissues. In fact, our patches contain a variety of peptides and peptide hormones. These are mixed with penetrating molecules to enable the peptides to reach a particular joint. We have recently decided to incorporate additional peptides into our practice because they can also stimulate the growth and health of our mitochondria and at the same time increase the length of our telomeres. Many peptides have to be taken by injection, while others can be administered orally. Our patches are a transdermal option, but often a combination of peptide delivery mechanisms will be used. Revolutionary New Peptides Were Using BPC-157 is a partial form of the protein known as body protection compound (BPC). BPC 157 is a synthetically produced peptide based off of the naturally occurring body protection compound (BPC) protein that was isolated from human gastric contents. This short peptide has been shown to have both anti-inflammatory and wound healing effect. The good news is that BPC is not just active in intestinal repair and healing, but appears to produce similar effects in a number of tissues. Scientific studies based on animal test subjects has shown that its healing actions are at least partially linked to growth hormone (GH) which is found in the velvet deer antler product that our patients get. Peptides for Wound HealingBPC-157 significantly accelerates reticulin and collagen formation as well as angiogenesis (the formation of new blood vessels) together with stimulation of macrophages and fibroblasts infiltration, representing a potential therapeutic tool in wound healing management. We must realize that in regenerative medicine most entities, be it osteoarthritis, tendon injuries, or other soft tissue injuries, are considered wounds. To that end, BPC-157 plays a significant role in fibroblast recruitment. Fibroblasts are the major cells responsible for the production of collagen, glycosaminoglycans, and proteoglycans. These compounds are considered the primary source of extracellular matrix (ECM) proteins, which, in addition to providing a scaffold for cells, play key roles in determining cell type and function. At present we will use an oral version of BPC-157. An oral route is not a problem since in a natural state BPC-157 is found in gastric juice. 14 Potential Benefits of BPC-157Accelerated wound healing (muscle, ligament, tendon, nerve)Anti-inflammatoryHas been shown to decrease pain in damaged areasBPC-157 increases growth hormone receptorsPromotes the outgrowth of tendon fibroblasts, cell survival under stress, and the migration of tendon fibroblastsImproves digestive functionMay improve blood pressure and NO productionProtects and heals inflamed intestinal epithelium (leaky gut)Has also been shown to help in inflammatory bowel diseaseProtects liver from toxic insults (alcohol, antibiotics, etc) and promotes healingAdvanced Benefits of BPC-157 include:In tendons, BPC-157 increases fibroblast growth via phosphorylation levels of both FAK and paxillin (dose dependently)In collagen repair, BPC-157 stimulates EGR-1 which induces cytokine and growth factor generation and early extracellular matrix (collagen) formationEGR-1 also increases its co-repressors such as nerve growth factor 1-A binding protein-2 (NAB2)BPC-157 can increase B4 (LTB4), thromboxane B2 (TXB2), and myeloperoxidase (MPO) in the serum and inflamed tissues and increase macrophages activity The Small Peptide: Thymosin Beta 4 Thymosin is a hormone secreted from the thymus. Its primary function is to stimulate the production of T cells, which are an important part of the immune system. Thymosin also assists in the development of B cells to plasma cells to produce antibodies. The predominant form of thymosin, thymosin beta 4, is an actin, meaning its a cell building protein. This cell-building protein is an essential component of cell structure and movement, which leads to its role in tissue repair. T4 has been found to play an important role in protection, regeneration, and remodeling of injured or damaged tissues. After an injury, T4 is released by platelets and numerous other types of cells to protect the most damaged cells and tissues, reducing inflammation and microbial growth. 14 Benefits of Thymosin Beta 4:Reduced inflammation of tissue in jointsIncreased exchange of substances between cellsEncourages the growth of new blood cells in tissueCalms muscle spasmImproved muscle toneEncourages tissue repairStretches connective tissueHelps maintain flexibilityIncreased endurance and strengthPrevents the formation of adhesions and fibrous bands in muscles, tendons, and ligamentsReduces the infarct size and improves heart contractile performanceTherapeutic effect on corneal injury and dry eye syndromeAntifibrotic effect on the liverAccelerates hair growthRecent studies have revealed that the first gene to be upregulated after an injury is a T4 gene. As the body begins the recovery process, T4 aids in the creation of new vessels in the injured area, which carry blood, nutrients, and reparative substances to the site. T4 also has anti-inflammatory properties and works to decrease the number of inflammatory cells. We will utilize an oral version in our treatments.While we currently offer BPC-157 and TB4 peptide treatments, we will likely be adding several more in the future, including the following: Mitochondrial Peptides We will also expand our repertoire to include a number of other interesting peptides as well, some of which will increase the health of our mitochondria. One such peptide is MOTS-c. MOTS-c has been shown to target the skeletal muscle and enhance glucose metabolism. As such, MOTS-c has implications in the regulation of obesity, diabetes, exercise, and longevity, representing an entirely novel mitochondrial signaling mechanism to regulate metabolism within and between cells. Remember, most diseases are in some way related to mitochondrial malfunction. Sermorelin, Ipamorelin and Other Stimulators of Growth Hormone Another set of peptides that we may utilize include sermorelin and ipamorelin, which can be used to increase the growth hormone levels in the body. Growth hormone can have many far-reaching effects, including treatment for a variety of conditions, from weight loss to increasing muscle mass and helping repair and recover from injuries. Another similar peptide is CJC-1295. CJC-1295 and ipamorelin are typically combined in therapy because they are known to work well together. These peptides allow your pituitary gland to produce the growth hormone. When one takes actual growth hormone it will diminish the production of growth hormone by the pituitary gland. IGR1-LR3 is a breakthrough peptide that has shown great results without many of the side effects or risks of other more commonly prescribed fat loss medications. IGF-1 LR3 inhibits the movement of glucose into the body's cells which facilitates fat burning and the use of fat in the body for the production of energy. It functions differently in different types of tissues. For instance, in muscle tissue, it makes the muscle more sensitive to insulins effects, such as a reduction in fat storage. Epithalon Telomere Enhancer Epithalon (also known as epitalon or epithalone) is the synthetic version of the polypeptide epithalamin, which is naturally produced in the pineal gland. Epithalons primary role is to increase the natural production of telomerase, a natural enzyme that helps cells reproduce telomeres, which are the protective parts of our DNA. This allows the replication of our DNA so the body can grow new cells and rejuvenate old ones.Each cell contains DNA as an instruction manual for how to divide and grow and the DNA inside of each cell is shielded by proteins called telomeres.During cellular division, a new cell must take some telomeres from its originating cell to shield the DNA of the new cell. The telomeres shorten after every cell division because the new cell can only take a portion of the telomeres from the previous cell, or else the previous cells DNA will become completely unprotected.Once there are no leftover telomeres to take, the cell stops dividing. This happens after a single cell divides and grows about 64 other cells, which is known as the Hayflick limit. This limit exists because cells without shield material are more vulnerable to DNA damage.If the DNA of a cell becomes damaged, the cell will follow broken instructions. If the instructions within the DNA of the cell are damaged, then the cell may not be able to eliminate itself through the process of apoptosis like it is supposed to. As time goes on we will add more and more peptides to our armamentarium. I look forward to making exciting new updates to this article on a regular basis! Dr. P NOTE: Some people are curious as to whether peptides are steroids. The answer is no. Peptides have far fewer side effects than steroids.

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The Institute of Regenerative Medicine | Non-Surgical, Cell-Based ...

Five patients with lupus who were treated with a form of immunotherapy known as CAR T-cell therapy reportedly achieved complete remission within months of their treatment.

A study published in Nature Medicine reports that four women and one man with active systemic lupus erythematosus (SLE) remained in drug-free remission for between three and 17 months following treatment.

These data suggest that CD19 CAR T-cell transfer is feasible, tolerable, and highly effective in SLE, the study authors wrote.

However, longer follow-ups in larger cohorts of patients will be necessary to confirm sustained absence of autoimmunity and resolution of inflammation in patients with SLE who have received CAR T-cell therapy, they added.

CAR T-cell therapy is a form of immunotherapy typically used in cancer treatment.

During CAR T-cell therapy, blood is taken from a person to collect T cells, a type of immune system cell. These cells work by traveling around the body to destroy cells that are defective, such as cancer cells.

In CAR T-cell therapy, some of these cells are taken and modified in the laboratory so that they can attack a new target. They are then put back into a person via an infusion.

In lupus, immune cells called B cells make autoantibodies that attack healthy tissues. In the new study, T cells were modified so that when they were re-infused into the patients body they targeted a protein called CD19, which is present on the B cells that were attacking healthy tissues.

The researchers reported that CAR T-cell therapy was highly effective at destroying the B cells that were previously attacking healthy tissues, with the B cells disappearing entirely on the second day following CAR T-cell therapy.

The participants in the study had previously not responded to a number of other immunosuppressive therapies.

However, with the CAR T-cell therapy, they experienced an improvement in a number of severe symptoms and were able to stop their lupus medications.

Even when B cells reappeared after treatment, the participants continued to be disease free with no lupus flares, the researchers reported. The researchers reported that the reappearing B cells were naive, meaning that they werent yet specific for an antigen (target) like the previous B cells were.

Dr. Chris Wincup, a consulting rheumatologist at Kings College Hospital London and a Clinical Research Fellow at University College London, says although further study on a larger cohort is needed, the results are significant.

The fact that this treatment worked, firstly, is very interesting, as these were patients who have had pretty strong and conventional treatment already, he told Healthline. The fact that it did actually bring them into remission, is really quite something. So is the fact that they were able to get in complete remission within three months having been refractory to so many of the strong and conventional treatments we use.

It really does show the possibility that this could potentially be a new therapeutic option for patients with lupus with very severe and refractory disease, Wincup added.

It is estimated that 1.5 million people in the United States have lupus, with 90% of them being women. System lupus erythematosus (SLE) is the most common form of lupus.

Lupus causes the immune system to attack tissues in the body, resulting in inflammation and damage to tissues in organs. The blood vessels, joints, lungs, kidneys, brain, and skin can all be affected by lupus.

There is no cure for lupus and experts say more treatment options are needed.

Theres a huge unmet need for better treatments for people with lupus, Dr. Sean ONeill, an associate professor of rheumatology at Royal North Shore Hospital and the University of Sydney in Australia, told Healthline. The current options when it comes to standard care include medications like prednisone, steroid medications that bring a lot of side effects, and people are typically on them for a very long time. So they get a lot of problems, like osteoporosis and high blood sugar and cardiovascular disease related to their steroids.

While they can be very effective for some people, there are many, many patients with lupus with active disease despite those treatments, or with some mildly active disease and toxicity from their treatments, ONeill added.

The researchers said that further study is required with larger cohorts of participants and longer follow-up periods to ensure the efficacy and safety of CAR T-cell therapy for people with lupus.

The experts who spoke with Healthline say while the study represents an exciting new avenue of exploration, it will take time for something like CAR T-cell therapy to become a standard treatment for people with lupus.

Both noted that the expense of CAR T-cell therapy is likely to be significant, which may limit the pool of people for whom the treatment is appropriate.

One of the tricky things about CAR T-cell therapy is its extremely expensive, said Wincup. So, to have that available widely when we have other cheaper drugs that may be effective in many cases means that this may only be used in the more severe patients who have not responded to some of the treatments we already have available.

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CAR T-Cell Therapy Shows Promise in Treating Lupus - Healthline

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ProKidney to Present at the Jefferies Cell and Genetic Medicine Summit - El Paso Inc.

SOUTH SAN FRANCISCO, Calif., Sept. 23, 2022 (GLOBE NEWSWIRE) -- Allogene Therapeutics, Inc. (Nasdaq: ALLO), a clinical-stage biotechnology company pioneering the development of allogeneic CAR T (AlloCAR T) products for cancer, today announced that management plans to present at the Jefferies Cell and Genetic Medicine Summit on Friday, September 30, 2022 at 6:30AM Pacific Time/9:30AM Eastern Time.

The webcast will be posted to the Company's website atwww.allogene.com under the Investors tab in the News and Events section. Following a live webcast, a replay will be available on the Company's website for approximately 30 days.

About Allogene TherapeuticsAllogene Therapeutics, with headquarters in South San Francisco, is a clinical-stage biotechnology company pioneering the development of allogeneic chimeric antigen receptor T cell (AlloCAR T) products for cancer. Led by a management team with significant experience in cell therapy, Allogene is developing a pipeline of off-the-shelf CAR T cell candidates with the goal of delivering readily available cell therapy on-demand, more reliably, and at greater scale to more patients. For more information, please visit http://www.allogene.com, and follow @AllogeneTx on Twitter and LinkedIn.

Cautionary Note on Forward-Looking Statements for AllogeneThis press release contains forward-looking statements for purposes of the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. The press release may, in some cases, use terms such as "predicts," "believes," "potential," "proposed," "continue," "estimates," "anticipates," "expects," "plans," "intends," "may," "could," "might," "will," "should" or other words that convey uncertainty of future events or outcomes to identify these forward-looking statements. Forward-looking statements include statements regarding intentions, beliefs, projections, outlook, analyses or current expectations concerning, among other things: the ability to develop allogeneic CAR T products for cancer and the potential benefits of AlloCAR T. Various factors may cause differences between Allogenes expectations and actual results as discussed in greater detail in Allogenes filings with the Securities and Exchange Commission (SEC), including without limitation in its Form 8-K filed on September 21, 2022 and Form 10-Q for the quarter ended June 30, 2022. Any forward-looking statements that are made in this press release speak only as of the date of this press release. Allogene assumes no obligation to update the forward-looking statements whether as a result of new information, future events or otherwise, after the date of this press release.

AlloCAR T is a trademark of Allogene Therapeutics, Inc.

Allogene Media/Investor Contact:Christine CassianoChief Communications Officer(714) 552-0326Christine.Cassiano@allogene.com

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Allogene Therapeutics Announces Participation in the Jefferies Cell and Genetic Medicine Summit - GlobeNewswire

Mitochondria are structures within the cell that convert energy from food into energy the cell can use. Each cell contains hundreds to thousands of mitochondria. Although most DNA is found inside the cells nucleus, mitochondria also contain a small amount of DNA, known as mitochondrial DNA.

In the early 2000s, researchers realized that short sections of mitochondrial DNA encode small (less than 100 amino acids long), biologically active proteins, now referred to as mitochondrial microproteins. The first mitochondrial microprotein to be discovered was called humanin.

There is growing evidence that humanin and other similar mitochondrial microproteins play a role in several age-related conditions, including Alzheimers disease.

Alzheimers disease is the most common type of dementia, characterized by progressive mental deterioration. According to the CDC, as many as 5.8 million Americans were living with Alzheimers disease in 2020.

The Cohen Laboratory at the University of Southern California (USC), one of the three laboratories that independently discovered humanin in 2003, has discovered a new microprotein connected to the risk of Alzheimers disease.

Their latest research, published in the journal of Molecular Psychiatry, revealed that a mutation in the newly discovered SHMOOSE microprotein is associated with a higher risk for Alzheimers disease across four cohorts. According to the researchers, nearly 1 in 4 individuals with European ancestry have the mutated version of the protein.

Dr. Pinchas Cohen, professor of gerontology, medicine, and biological sciences and senior author of the study, told Medical News Today:

The implications are not immediate, but we believe that [relatively soon], the SHMOOSE SNP [single nucleotide polymorphism] genetic variant that is found in over 20% of Europeans may guide both the classification of individuals that are at risk for Alzheimers that may benefit from certain preventive measures and also could inform the selection of medical interventions that will become available in the near future. A bit further ahead, SHMOOSE [protein] analogues may become available as therapeutics for individuals who carry the SNP and develop dementia, in a precision medicine approach.

Brendan Miller, Ph.D., first author of the study, studied mitochondrial DNA sequences from the Alzheimers Disease Neuroimaging Initiative (ADNI) database, searching for small variations in the genes called single nucleotide polymorphisms or SNPs. He found that a mutation in one particular mitochondrial SNP (rs2853499) was associated with a greater risk of Alzheimers disease and brain atrophy.

Dr. Miller and his colleagues then discovered that the mutated SNP causes a change in a mitochondrial microprotein, which they called SHMOOSE. The researchers used a technique called immunoprecipitation to isolate the SHMOOSE microprotein from the mitochondria of nerve cells.

When they analyzed this sample using mass spectrometry, they detected and identified two unique protein fragments from the SHMOOSE microprotein. The researchers reported that this is the first unique mass spectrometry-based detection of a mitochondrial-encoded microprotein to date.

Having identified a microprotein associated with a higher risk of Alzheimers disease, the researchers followed up on their discovery by carrying out studies in rats and cell culture experiments.

They found that the SHMOOSE microprotein accumulates in the mitochondria of neurons (nerve cells), where it binds to the inner mitochondrial membrane protein mitofilin. The SHMOOSE microprotein appears to act on the brain by influencing mitochondrial gene expression and boosting mitochondrial oxygen consumption. The researchers noted that mutated SHMOOSE microprotein was less effective at boosting oxygen consumption and impacted gene expression differently.

Dysregulated mitochondrial associated brain energetics is one of the multiple pathways thought to be important for Alzheimers disease, Andrew Saykin, PsyD, ABCN, Professor and Director of the Center for Neuroimaging and Indiana Alzheimers Disease Research Center, told MNT.

George Perry, Ph.D., Professor and Semmes Foundation Distinguished University Chair in Neurobiology at the University of Texas at San Antonio, told MNT that this study is very important as it links risk of [Alzheimers disease] to cellular metabolism. There are numerous cell biology and biochemical studies that highlight this [] and finding genetic data further support[s] this view.

Dr. Saykin observed that with further development and validation there could be implications of this and other microproteins for early detection, longitudinal monitoring, and potentially for therapeutic targeting.

MNT also discussed the studys findings with Tal Nuriel, Ph.D., Assistant Professor of Pathology and Cell Biology at Columbia University Irving Medical Center. Dr. Nuriel told MNT that most Alzheimers disease-related gene mutations discovered in the past are either very rare variants or common variants that confer a very small risk.

He said the mutation, or variant, in the SHMOOSE microprotein appears to confer a moderate risk for Alzheimers disease and is relatively common in the population and [this] alone makes it interesting.

Dr. Nuriel added that the fact that this is a microprotein that can theoretically be administered as a therapeutic agent is valuable. He cautioned that there will be a very long road ahead before any therapy derived from this microprotein could become a reality. Importantly, its unclear whether this SHMOOSE microprotein would enter the brain if given subcutaneously or intravenously. And if it doesnt enter the brain, this would greatly limit its ability to be used therapeutically.

When asked about the next step in the research following this discovery, Dr. Cohen told MNT, Our immediate plan is to treat mice that have been engineered to develop Alzheimers disease with SHMOOSE over several months and assess the improvement in their symptoms and performance. We will also work on developing longer acting analogues of the pep[t]ide.

The researchers noted in the study that SHMOOSE is yet another microprotein of a growing number that modify mitochondrial biology. According to a recent review, thousands of DNA sequences with microprotein-coding potential are currently unverified or functionally uncharacterized.

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Alzheimer's disease risk linked to newly discovered protein mutation - Medical News Today

Weill Cornell Medicine investigators have identified definitive biological links between African ancestry and disease processes that affect an aggressive cancer type called triple-negative breast cancer (TNBC). Their analysis of TNBC tumors from a diverse patient population yielded a large set of genes whose expression differed in patients with African ancestry compared with patients with European ancestry.

In the study, published Sept. 19 in Cancer Discovery, a journal of the American Association for Cancer Research, the scientists identify the expression of 613 genes associated with African ancestry and more than 2,000 genes associated with regional African ancestry in patients with TNBC. They also describe distinct patterns of immune responses in patients of African descent that may explain patterns of disease progression and outcomes. Together, these findings provide a foundation for future research into better treatment options for this cancer, which has the worst survival outcomes of all breast cancer types.

Many people are not aware of the geographic origins of their ancestors nor how much of their DNA was inherited from each source, known as genetic ancestry. Previous studies of racial differences in TNBC analyzed data from African American patients and relied on self-reported race, said senior author Dr. Melissa B. Davis, associate professor of cell and developmental biology research in surgery and director of health equity in the Englander Institute for Precision Medicine at Weill Cornell Medicine. Our study is the first to determine each individuals ancestry not only by African descent but also by specific regions within Africa.

TNBC tumor cells have no estrogen or progesterone receptors and scant amounts of HER2/neu protein on their surface, making them challenging to treat as they dont respond to hormone therapies or anti-HER2 drugs that block cell proliferation. The subtype represents about 33 percent of breast cancer diagnoses in African countries compared with less than 20 percent in other nations. African American women have twice the risk of developing TNBC and a higher risk of mortality than white Americans of European ancestry.

For their current study, the investigators performed ancestry estimation on breast tissue samples from 132 patients and RNA sequencing on a subset of 26 cases provided by the Englander Institute of Precision Medicine at Weill Cornell Medicine; the University of Alabama at Birmingham; and The International Center for the Study of Breast Cancer Subtypes (ICSBCS), now headquartered at Weill Cornell Medicine. The ICSBCS was established in 2004 and features partners across different regions of Africa as well as the Caribbean and Central America. This study drew samples from ICSBCS founding member The Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, as well as the Millennium Medical College St. Pauls Hospital in Addis Ababa, Ethiopia.

After identifying the expression of genes associated with African ancestry at the country and regional levels, the researchers examined the affected biological pathways and estimated proportions of immune cells in tumors. They discovered that women with TNBC with a high degree of African ancestry, primarily East Africans from Ethiopia, had significantly higher immune cell populations infiltrating tumors, than women with a lower degree of African ancestry who were mainly African Americans and West Africans from Ghana. Increased immune responses in TNBC tumors in women of regional African descent will be particularly interesting to researchers studying the benefits of immunotherapies, said lead author Dr. Rachel Martini, a postdoctoral associate in surgery at Weill Cornell Medicine.

This recent discovery gives us hope that we will continue to find answers and contribute to solutions for a disease which has long afflicted all ancestries, but shows greater burden in Africa, said Dr. Ernest Adjei, consulting pathologist at KATH. The ICSBCS provides a great platform for strong research collaborations into the future as we work together for improved outcomes in breast cancer management.

The investigators also found that several African ancestry-associated genes detected in normal breast tissue switched expressions in tumor tissue. These findings suggest that some ancestry-specific differences in gene expression may be in response to malignancies, said Dr. Martini.

Finally, the researchers examined the data by self-reported race and found some of the same pathways they had associated with ancestry. However, they also found others imprinted on tumors relating to diabetes and obesity that were not associated with ancestry. This finding suggests its essential to look at both race and ancestry when exploring disparities in TNBC development and outcomes, said Dr. Davis, who is an ethnicity scholar at the New York Genome Center and also serves as scientific director of ICSBCS. For example, we could potentially harness aspects of the diabetes or obesity pathways in tumors as targets to treat cancer patients with comorbidities.

The teams most recent findings add to a robust legacy of studies utilizing the ICSBCS biorepository that are clarifying the role of genetic ancestry related to breast cancer risk, added co-author Dr. Lisa Newman, chief of the Section of Breast Surgery at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center, professor of surgery at Weill Cornell Medicine and ICSBCS medical director and founder.

The investigators are now looking more deeply at gene expression differences to determine the master regulators of the pathways they identified and performing single cell analysis to learn more about the tumor microenvironment. We want to get to the bottom of the molecular features driving disparities in TNBC before we move our work into the clinical space, Dr. Davis said.

Excerpt from:
Biological Links Identified Between an Aggressive Breast Cancer Type and African Ancestry - Weill Cornell Medicine Newsroom

Researchers have emphasised nanotechnology as an outstanding technological trend in the last few decades, and it is characterized by the fast proliferation of electronics for applications in communication, known as nanomedicine, and environmental monitoring. Studies are now being conducted on the scientific bottlenecks that affect the lifespan of the living, particularly humans. Among these constraints are illnesses with few or no alternatives for treatment and healing. A drug delivery system (DDS) refers to an alternative diagnosis and/or therapy that has been shown in the medical fraternity [1,2]. Nanorobots are nanoelectromechanical systems (NEMS), a recently developed chapter in miniaturisation, similar to microelectromechanical systems (MEMS), which is already a multibillion-dollar business. Designing, architecting, producing, programming, and implementing such biomedical nanotechnology are all part of nanorobotics and NEMS research. Any scale of robotics includes calculations, commands, actuation and propulsion, power, data-sharing, interface, programming, and coordination. There is heavy stress on actuation, which is a key prerequisite for robotics [1]. The similarity in size of nanorobots to that of organic human cells and organelles brings up a huge variety of its possible uses in the field of health care and environmental monitoring of microorganisms. Other potential uses, such as cell healing, may be possible if nanorobots are tiny enough to reach the cells. Furthermore, it is still to be realised that the tiny sensors and actuators' square measures are necessary for the growing concept of a strongly connected ascending information technology infrastructure; the envision of artificial cells (nanorobots) that patrol the cardiovascular system, thus, detecting and destroying infections in minute quantities. This might be a programmable system with approachable ramifications in medicine, creating a revolutionary replacement from therapy to bar [1]. Chemotherapeutic substances employed in cancer treatment measure disseminates non-specifically throughout the body, where they exert an influence on both malignant and normal cells, restricting the drug quantity feasible within the growth and also resulting in unsatisfactory medication due to excessive toxic hazards of the chemotherapy drugs on normal cells of the body. It is safe to say that molecularly focused medical care has evolved as a collaborative method to overcome the lack of specificity of traditional cancer therapy drugs [3]. With the help of nanotechnology, intercellular aggregation of the drugs in cancer cells can be increased while minimising the risk of unwanted drug toxicity in normal cells by utilising various drug targeting mechanisms [4].

This review article focuses on the recent advancements, technological growth, and expansion in the field of nanorobotics and nanotechnology and its application in the discipline of bio-healthcare systems, principally for the DDS in the medication of cancer. Existing research literature and relevant studies regarding the topic of concern were read and a detailed analysis was undertaken in the indexes of PubMed, Science Direct, MEDLINE, Scopus, and Google Scholar. Hardly any language or time constraints were applied. To obtain a detailed search, more articles, synonyms, and derivatives of the phrases were employed; the following evaluation phrases were used: "drug delivery", "cancer", "neoplasms", and "cancer therapy".

Nanorobots are miniaturised machines that have the ability to perform work at par with that of current existing machines, having applications in the aspects of medicine, industry, and other areas like the development of nanomotors employed for the conservation of energy; nanorobots havealso proved to be serviceable inreducing infertility problems by acting as an engine and giving a boost to the sperm motility when attached to them [2]. Organic and inorganic nanorobots are by far the most commonly studied. Organic nanorobots, also known as bio-nanorobots, are created by combining virus and bacterium DNA cells. This type of nanorobot is less harmful to the organism. Diamond structures, synthetic proteins, and other materials are used to make inorganic nanobots, which are more hazardous than organic nanobots. To overcome this hurdle of toxicity, researchers have devised a way involving encapsulating the robot, thusdecreasing its chances of being destructed by the body's self-defence mechanism[5,6]. Scientists can gain an understanding of how to energise micro and nano-sized devices using reactionary processes if they understand the biological motors of live cells [7]. The Chemistry Institute of the Federal Fluminense University created a nano valve, which is made up of a tank covered with a shutter in which dye molecules are housed and may leave in auniform fashion whenever the cover is opened. This gadget is also natural, made of silica (SiO2), beta-cyclodextrins, and organo-metallic molecules, and shall be used in therapeutic applications [1]. Proteins are employed in certain studies to feed nanomotors that can move huge objects, as well as the use of DNA hybridisation and antibody protein in the development of nanorobots. DNA hybridisation is defined as a process by which two complementary single-stranded DNA and/or RNA molecules bond together to form a double-stranded molecule.A nanorobot can be functionalized using a variety of chemical compounds [8]. It has been investigated in nanomedicine in DDS, which operates directly on targeted cells of the human body. Researchers create devices that can administer medications to precise places while simultaneously adjusting the dose and amount of release. This DDS using nanorobots can be used to treat joint disorders, dental problems, diabetes, cancer, hepatitis and other conditions [2,9-12]. One of the benefits of this technology is the potential to diagnose and treat illnesses with minimal impact on normal tissues, minimizing the likelihood of negative effects and guiding healing and remodelling therapy at the cellular and sub-cellular levels [13,14].

New advances in medication delivery have resulted in greater quality in targeted drug delivery that uses nanosensors to detect particular cells and regulate discharges through the use of smart medicines [1]. Traditional chemotherapeutic drugs act by eliminating swiftly replicating cells, which is a primary feature of malignant cells. Most anticancer medications have a limited therapeutic boundary, often resulting in cytotoxicity to normal stem cells that proliferate quickly, such as bone marrow, macrophages, gastrointestinal tract (GIT), and hair follicles, causing adverse effects like myelosuppression (lower synthesis of WBCs, producing immunosuppression), mucositis (inflammation of the GIT lining), alopecia (hair loss), organ malfunction, thrombocytopenia/anaemia, and haematological side effects, among other things. Doxorubicin is used to treat numerous forms of cancer, including Hodgkin's disease, when it is combined with other antineoplastic medicines to minimize its toxicity [15,16]. Paclitaxel is a drug that is injected intravenously and is used to treat breast cancer. Some of the significant side effects include bone marrow suppression and progressive neurotoxicity. Cisplatin is an alkylating drug that results in the intra-DNA binding filament. Its negative effects include giddiness and severe vomiting, and it can be nephrotoxic [1]. Camptothecin is applied to treat neoplasiaby inhibiting type 1 topoisomerases, an enzyme required for cellular duplication of genetic information. Numerous initiatives have been launched with the goal of employing nanotechnology to build DDS that can reduce the negative impacts of traditional therapy. On the surface of single-walled carbon nanotubes (SWNTs), doxorubicin was layered [17]. Doxorubicin was used in metastatic tumour cells as a polymer prodrug/collagen hybrid. The use of polymeric pro-drug nanotechnology in the therapy of rapidly dividing abnormal cells is a novel advance in the field [18]. Nanotechnology is continually looking for biocompatible materials that may be used as a DDS. The nanoparticle hydroxyapatite (HA), a significant component of bone and teeth, was employed to deliver paclitaxel, an anti-neoplastic medication, and the out-turn implies that therapy should begin with hydrophobic medicines [19]. Various initiatives have been launched with the goal of employing nanotechnology to build DDS, which can reduce the negative influence of traditional chemotherapy. The limitation of conservative chemotherapeutics is that it is unable to target malignant cells exclusively. These above-listed adverse effects often result in a delay in treatment, reduced drug dose or intermittent stopping of the therapy [20]. Given the ability of nanorobots to travel as blood-borne devices, they can aid in crucial therapy procedures such as early diagnostics and smart medication administration [21]. A nanorobot can aid with smart chemotherapy for medication administration and give an efficient early dissolution of cancer by targeting only the neoplastic-specific cells and tissues and preventing the surrounding healthy cells from the toxicity of the chemotherapy drugs so being used. Nanorobots as drug transporter for timely dose administration allow chemical compounds to be kept in the bloodstream for as long as essential, giving expected pharmacokinetic characteristics for chemotherapy in the therapies for anti-cancer as shown in Figure 1 [22-25]. The clinical use of nanorobots for diagnostic, therapy, and surgery can be accomplished by injecting them via an intravenous route. The nanorobots may be getting intravenously injected into the body of the recipient. The chemotherapy pharmacokinetics comprises uptake, metabolism, and excretion, as well as a rest period to allow the body to re-establish itself ahead of the succeeding chemotherapy session. For tiny tumours, patients are often treated in two-week cycles [26]. As a primary time threshold for medical purposes, nanorobots can be used to assess and diagnose the tumour within a short span of time using proteomic-based sensors. The magnetic resonance contrast-agent uptake kinetics of a very small molecular weight can forecast the transport of protein medicines to solid tumours [27]. Testing and diagnostics are critical components of nanorobotics study. It provides speedy testing diagnosis at the initial visit, eliminating the need for a follow-up appointment following the lab result, and illness identification at an earlier stage. The demand for energy for propulsion is a restriction in the usage of nanorobots in vivo. Because small inertia and strong viscous forces are associated with less productivity and less convective motion, higher quantities of energy are required [28]. Drug retention in the tumour will decide the medication's effectiveness after nanorobots pass cellular membranes for targeted administration. Depending on its structure, medication transport pathways from plasma to tissue impact chemotherapy to achieve more effective tumour chemotherapy [27]. According to the latest research, nanotechnology, DNA production of molecular-scale devices with superior control over shape, and site-specific functionalisation assures interesting benefits in the advancement of nanomedicine. However, biological milieu uncertainty and innate immune activation continue to be barriers to in vivo deployment. Thus, the primary benefit of nanorobots for cancer medicine administration is that they reduce chemotherapeutic side effects. The nanorobot design integrates carbon nanotubes and DNA, which are current contenders for the latest types of nanoelectronics, as the optimum method [29]. As a compound bio-sensor with sole-chain antigen-binding proteins, a complementary metal oxide semiconductor (CMOS) is used for building circuits with characteristic sizes in tens of nanometres [30]. For medicament release, this approach employs stimulation elicited upon proteomics and bioelectronics signals. As a result, nanoactuators are engaged to adjust medication delivery whenever the nanorobot detects predetermined modifications in protein gradients [1,31]. Thermal and chemical signal changes are relevant circumstances directly connected to significant medical target identification. Nitric oxide synthase (NOS), E-cadherin, and B cell lymphoma-2 (Bcl-2) are some instances of fluctuating protein aggregation within the body near a medical target under diseased conditions. Furthermore, temperature changes are common in tissues with inflammation [32]. The framework integrates chemical and thermal characteristics as the most essential clinical and therapeutic recommendations for nanorobot template analysis. It also integrates chemical and thermal characteristics as the most essential diagnostic and therapeutic recommendations for nanorobot framework evaluation. The simulation in a three-dimensional real-time setting attempts to provide a viable model for nanorobot foraging within the body. One of the breakthroughs describes a hardware structure rooted in nano-bioelectronics for the use of nanorobots in neoplasia therapy [33,34]. The continuous venture in building medical micro-robots has led to the initial conceptual framework research of a full medical nanorobot until now issued in a peer-reviewed publication, "Respirocytes", detailed a theoretical unnatural mechanical red blood cell, or "Respiro-cytes", consisting of 18 billion perfectly ordered architectural atoms proficient in delivering 236 times extra oxygen to the tissues and cells of the body per unit volume than normal red blood cells [35]. Microbivores, or unnatural phagocytes, might monitor the circulation, searching for and eliminating pathogens such as bacteria, viruses, or fungi. These nanobots may use up to 200 pW continuously. This capability is employed to break down germs that have been entrapped. Microbivores have biological phagocytic defences that are either organic or antibiotic-assisted, and they can operate up to 1,000 times quicker. Even the most serious septicaemic diseases will be eliminated by microbivores within a short span of time. Because virulent microorganisms are entirely digested into harmless sugars and amino acids, which are the nanorobots sole discharge, the nanorobots reject the advanced possibility of sepsis or septic shock [36,37].

To bring in combination the required collaborative skills to produce these unique technologies, numerous conventional streams of science, such as medicine, chemistry, physics, materials science, and biology, have come together to form the expanding field of nanotechnology. Nanotechnology has a vast span of possible applications (Figure 2) [39],from improvements to current practices to the creation of entirely new tools and skills. The last few years have observed an exponential increase of interest in the topic of nanotechnology and research, which has led to the identification of novel applications for nanotechnology in medicine and the emergence of an advanced branch called nanomedicine. It includes the science and technology of diagnosing, treating, andpreventing illness, traumatic injury, and alleviating pain; conserving and enhancing human health using nanoscale architectured materials, biotechnology, and genetic engineering; eventually, complex machine systems and nanorobots, known as "nanomedicine" (Figure 3) [40,41].

In vivo diagnostics, nanomedicine might create technologies that can act within the human body to diagnose ailments earlier and identify and measure toxic chemicalsand tumour cells. In the surgical aspect,when launched into the body through the intravenous route or cavities, a surgical nanorobot controlled or led by a human surgeon might work as a semi-autonomous on-site surgeon. An inbuilt computer might manage the device's operations, such as looking for disease and identifying and fixing injury by nanomanipulation while maintaining communication with the supervising surgeon via coded ultrasonic signals [37]. By transforming mechanical energy from bodily movement, muscle stretching, or water flow into electricity, scientists were able to design a new generation of self-sustained implanted medical devices, sensors, and portable gadgets [39]. Nanogenerators generate electricity by bending and then releasing piezoelectric and semiconducting zinc oxide nanowires. Nanowires may be produced on polymer-based films, and the utilization of flexible polymer substrates may one day allow portable gadgets to be powered by their users' movement [39]. Fluorescent biological labelling, medication and gene delivery, pathogen identification, protein sensing, DNAstructure probing, tissue engineering, tumour identification, separation and purification of biological molecules and cells, MRI contrast enhancement, and phagokinetic research are among the uses. The extended duration effect of nanomedicine study is to describe quantitative molecular-scale components called nanomachinery. Accurate command and manipulation of nanomachinery in cells can lead to a more diverse and advanced gain in the interpretation of cellular processes in organic cells, as well as the creation of new technologies for disease detection and medication. The advantage of this research is the formation of a platform technology that will affect nanoscale imaging methodologies aimed to investigate molecular pathways in organic cells [40,42].

The main target of writing this review was to provide an outline of the technological development of nanotechnology in medicine by making a nanorobot and introducing it in the medication of cancer as a new mode of drug delivery. Cancer is described as a collection of diseases characterised by the unregulated development and spread of malignant cells in the body, and the number of people diagnosed every year keeps adding up. Cancer treatment is most likely the driving force behind the creation of nanorobotics; it can be auspiciously treated using existing medical technology and therapeutic instruments, with the major help of nanorobotics. To decide the prognosis and chances of survival in a cancer patient, consider the following factors: better prognosis can be achieved if the evolution of the disease is time-dependent and a timely diagnosis is made. Another important aspect is to reduce the side effects of chemotherapy on the patients by forming efficient targeted drug delivery systems. Programmable nanorobotic devices working at the cellular and molecular level would help doctors to carry out precise treatment. In addition to resolving gross cellular insults caused by non-reversible mechanisms or to the biological tissues stored cryogenically, mechanically reversing the process of atherosclerosis, enhancing the immune system, replacing or re-writing the DNA sequences in cells at will, improving total respiratory capacity, and achieving near-instant homeostasis, medically these nanorobots have been put forward for use in various branches of dentistry, research in pharmaceuticals, and aid and abet clinical diagnosis. When nanomechanics becomes obtainable, the ideal goal of physicians, medical personnel, and every healer throughout known records would be realized. Microscale robots with programmable and controllable nanoscale components produced with nanometre accuracy would enable medical physicians to perform at the cellular and molecular levels to heal and carry out rehabilitating surgeries. Nanomedical doctors of the 21st century will continue to make effective use of the body's inherent therapeutic capacities and homeostatic systems, since, all else being equal, treatments that intervene the least are the best.

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The Use of Nanorobotics in the Treatment Therapy of Cancer and Its Future Aspects: A Review - Cureus