Toxicity of carbon-based nanomaterials: Reviewing recent reports in medical and biological systems

Carbon nanomaterials for cardiovascular theranostics: Promises and challenges

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Heart attack and stroke cause irreversible tissue damage. The currently available treatment options are limited to "damage-control" rather than tissue repair. The recent advances in nanomaterials have offered novel approaches to restore tissue function after injury. In particular, carbon nanomaterials (CNMs) have shown significant promise to bridge the gap in clinical translation of biomaterial based therapies. This family of carbon allotropes (including graphenes, carbon nanotubes and fullerenes) have unique physiochemical properties, including exceptional mechanical strength, electrical conductivity, chemical behaviour, thermal stability and optical properties. These intrinsic properties make CNMs ideal materials for use in cardiovascular theranostics. This review is focused on recent efforts in the diagnosis and treatment of heart diseases using graphenes and carbon nanotubes. The first section introduces currently available derivatives of graphenes and carbon nanotubes and discusses some of the key characteristics of these materials. The second section covers their application in drug delivery, biosensors, tissue engineering and immunomodulation with a focus on cardiovascular applications. The final section discusses current shortcomings and limitations of CNMs in cardiovascular applications and reviews ongoing efforts to address these concerns and to bring CNMs from bench to bedside.

Ex vivo exposure to different types of graphene-based nanomaterials consistently alters human blood secretome

The biomedical applications of graphene-based nanomaterials (GBN) have significantly grown in the last years. Many of these applications suppose their intravenous exposure and, in this way, GBN could encounter blood cells triggering an immunological response of unknown effects. Consequently, understanding the relationships between GBN and the immune system response should be a prerequisite for its adequate use in biomedicine. In the present study, we have conducted a little explored ex vivo exposure method in order to study the complexity of the secretome given by the interactions between GBN and blood cells. Blood samples from different healthy donors were exposed to three different types of GBN widely used in the biomedical field. In this sense, graphene oxide (GO), graphene nanoplatelets (GNPs), graphene nanoribbons (GNRs) and a panel of 105 proteins representatives of the blood secretome were evaluated. The results show broad changes in both the cytokines number and the expression levels, with important changes in inflammatory response markers. Furthermore, the indirect soft-agar assay was used as a tool to unravel the global functional impact of the found secretome changes. Our results indicate that the GBN-induced altered secretome can modify the natural anchorage-independent growth capacity of HeLa cells, used as a model. As a conclusion, this study describes an innovative approach to study the potential harmful effects of GBN, providing relevant data to be considered in the biomedical context when GBN are planned to be used in patients.

Self-Assembling Peptides and Carbon Nanomaterials Join Forces for Innovative Biomedical Applications

Self-assembling peptides and carbon nanomaterials have attracted great interest for their respective potential to bring innovation in the biomedical field. Combination of these two types of building blocks is not trivial in light of their very different physico-chemical properties, yet great progress has been made over the years at the interface between these two research areas. This concise review will analyze the latest developments at the forefront of research that combines self-assembling peptides with carbon nanostructures for biological use. Applications span from tissue regeneration, to biosensing and imaging, and bioelectronics.

Smart Hydrogels Meet Carbon Nanomaterials for New Frontiers in Medicine

Carbon nanomaterials include diverse structures and morphologies, such as fullerenes, nano-onions, nanodots, nanodiamonds, nanohorns, nanotubes, and graphene-based materials. They have attracted great interest in medicine for their high innovative potential, owing to their unique electronic and mechanical properties. In this review, we describe the most recent advancements in their inclusion in hydrogels to yield smart systems that can respond to a variety of stimuli. In particular, we focus on graphene and carbon nanotubes, for applications that span from sensing and wearable electronics to drug delivery and tissue engineering.

Protein nanoparticles in molecular, cellular, and tissue imaging

The quest to develop ideal nanoparticles capable of molecular, cellular, and tissue level imaging is ongoing. Since certain imaging probes and nanoparticles face drawbacks such as low aqueous solubility, increased ROS generation leading to DNA damage, apoptosis, and high cellular/organ toxicities, the development of versatile and biocompatible nanocarriers becomes necessary. Protein nanoparticles (PNPs) are one such promising class of nanocarriers that possess most of the desirable properties of an ideal nanocarrier for bioimaging applications. PNPs demonstrate high aqueous solubility, minimal cytotoxicity, and multi-cargo loading capacity. They are also amenable to surface-functionalization, as well as modulation of their hydrophobicity and hydrophilicity. The use of PNPs for bioimaging applications has made rapid advancements in the past two decades. Being comparatively less explored, the field opens up a plethora of opportunities and focus areas to engineer ideal bioimaging protein nanocarriers. The use of PNPs as carriers of their natural ligands as well as other heavy metals and fluorescent probes, along with drug molecules for combined theranostic applications has been reported. In addition, surface functionalization to impart specificity of targeting the PNPs has been shown to reduce nonspecific cellular interactions, thus reducing systemic toxicity. PNPs have been explored for their application in imaging of numerous cancers, cardiovascular diseases as well as imaging of the brain using near infrared fluorescence (NIRF) imaging, magnetic resonance imaging (MRI), X-ray computed tomography (CT), positron emission tomography (PET), single-photon emission computed tomography (SPECT), ultrasound (US), and photoacoustic (PA) imaging. This article is categorized under: Biology-Inspired Nanomaterials > Protein and Virus-Based Structures Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.

Green Approaches to Carbon Nanostructure-Based Biomaterials

The family of carbon nanostructures comprises several members, such as fullerenes, nano-onions, nanodots, nanodiamonds, nanohorns, nanotubes, and graphene-based materials. Their unique electronic properties have attracted great interest for their highly innovative potential in nanomedicine. However, their hydrophobic nature often requires organic solvents for their dispersibility and processing. In this review, we describe the green approaches that have been developed to produce and functionalize carbon nanomaterials for biomedical applications, with a special focus on the very latest reports.

Advances in Drug Delivery Nanosystems Using Graphene-Based Materials and Carbon Nanotubes

Carbon is one of the most abundant elements on Earth. In addition to the well-known crystallographic modifications such as graphite and diamond, other allotropic carbon modifications such as graphene-based nanomaterials and carbon nanotubes have recently come to the fore. These carbon nanomaterials can be designed to help deliver or target drugs more efficiently and to innovate therapeutic approaches, especially for cancer treatment, but also for the development of new diagnostic agents for malignancies and are expected to help combine molecular imaging for diagnosis with therapies. This paper summarizes the latest designed drug delivery nanosystems based on graphene, graphene quantum dots, graphene oxide, reduced graphene oxide and carbon nanotubes, mainly for anticancer therapy.

PEGylated single-walled carbon nanotubes as co-adjuvants enhance expression of maturation markers in monocyte-derived dendritic cells

Aim: This study investigated the application of phospholipid-PEGylated single-walled carbon nanotubes (PL-PEG-SWCNTs) as a safe co-adjuvant for the commercial recombinant hepatitis B virus vaccine to enhance induction of monocyte-derived dendritic cells (MDDCs) differentiation and activation in vitro as an immune response initiator cell to prompt a long-term immune response after a single dose injection. Methods: Immature MDDCs were exposed to PL-PEG-SWCNTs alone and in combination with hepatitis B vaccine. Results & conclusion: Study results confirm the enhanced expression of maturation markers in human immature MDDCs after PL-PEG-SWCNT exposure. The results suggest that PL-PEG-SWCNT is an efficient co-adjuvant for the commercial recombinant hepatitis B virus vaccine to enhance dendritic cell response stimulation in vitro.

Hexavalent chromium amplifies the developmental toxicity of graphene oxide during zebrafish embryogenesis

Combined toxicity is a critical issue in risk assessment of contaminants. However, very little is known about the joint effects of graphene oxide (GO, a crucial 2-dimensional carbon material) and hexavalent chromium (Cr⁶⁺, a widespread heavy metal), particularly with respect to the critical period of embryogenesis. In this study, the combined toxicity of GO and Cr⁶⁺ was evaluated through embryo-larval toxicity test in Danio rerio (zebrafish). Results indicated that the co-exposure of Cr⁶⁺ (1 mg/L) and GO (0.01 mg/L) inhibited hatching and spontaneous movement of embryos, but no significant changes were found in the single Cr⁶⁺ or GO group. Compared with the single GO or Cr⁶⁺ exposure, their co-exposure (GO+Cr⁶⁺) significantly enhanced the teratogenicity in a concentration-dependent pattern, and the spinal curvature was observed as the main deformity. GO+Cr⁶⁺ changed the protein secondary structures of embryos result of the generation of ROS and oxidative stress. The degradations of vertical myosepta and cartilages were observed in co-exposure group, suggesting that GO+Cr⁶⁺ disrupted the development of musculoskeletal system. The genes col11a1a, col2a1a and postnb were down-regulated but the genes acta1b and mmp9 were up-regulated by GO+Cr⁶⁺. The interactions between Cr⁶⁺ and GO demonstrated that the morphology, structure, and surface properties of GO were modified by Cr⁶⁺. The enhanced defects and O-containing groups of GO could trap more β-sheets, induced oxidative stress, disturbed the development of skeletal muscles and cartilages in zebrafish. These data suggested that GO+Cr⁶⁺ enhanced their joint toxicity due to the variation of nanoparticle properties. This finding is important for assessing the ecological risk of graphene family nanomaterials in the natural environment.

Emerging nano-structured innovative materials as adsorbents in wastewater treatment

Water supply around the globe is struggling to meet the rapidly increasing demand by the population, drastic changes in climate and degrading water quality. Even though, many large-scale methods are employed for wastewater treatment they display several negative impacts owing to the presence of pollutants. Technological innovation is required for integrated water management with different groups of nanomaterials for the removal of toxic metal ions, microbial disease, organic and inorganic solutes. The method of manipulating atoms on a nanoscale is nanotechnology. Nanomembranes are used in nanotechnology to soften water and eliminate physical, chemical and biological pollutants. The present review concentrates on various nanotechnological approaches in wastewater remedy, mechanisms involved to promote implementation, benefits and limitations in comparison with current processes, properties, barriers and commercialization research needs. Also the review identifies opportunities for further exploiting the exclusive features for green water management by following the advances in nanotechnology.

Investigating biological effects of multidimensional carboxylated carbon-based nanomaterials on human lung A549 cells revealed via non-targeted metabolomics approach

The biological responses of multidimensional carboxylated carbon-based nanomaterials (c-CBNs), including carboxylated graphene, carbon nanotube, and fullerene, on human lung A549 cells were investigated by using metabolomics technology. The structure and components of c-CBNs were characterized, and their biological effects were evaluated through cell apoptosis and viability analysis. Additionally, the metabolomics analysis of the nanomaterial-cell interaction system was performed using the established platform combining liquid chromatography-mass spectrometry (LC-MS) with the bioinformatics system. Results revealed that all tested c-CBNs demonstrated some biological effects in our cell model. However, significant metabolomic alterations induced by c-CBNs were also observed mainly in amino acids, organic acids, glycerophospholipids, and glycerolipids. Further, under the tested concentrations, the multiple dimensions of c-CBNs played a major role in determining the metabolic process in various interaction modes. This study provides an advanced alternative for evaluating metabolic effects of multidimensional nanomaterials through metabolomics technology considering the association between dimension and metabolic characteristics.

Multi-walled carbon nanotubes decrease neuronal NO synthase in 3D brain organoids

Multi-walled carbon nanotubes (MWCNTs) might induce the dysfunction of neuronal NO synthase (nNOS) and impair the function of brains. But to the best of our knowledge, this conclusion was made by using laboratory animals or conventional nerve cell cultures; however, these models might not reflect the complex conditions of human brains. Recently, the development of 3D brain organoids (also known as organotypic cultures) derived from human induced pluripotent stem cells (iPSCs) provides a platform to investigate the behaviors of human brains in vitro. In this study, we investigated the toxicity of MWCNTs to 3D brain organoids which expressed the cortical layer markers. It was shown that MWCNTs induced cytotoxicity to 3D brain organoids but not in dose-dependent manner. Exposure to high level of MWCNTs (64 μg/mL) reduced the levels of intracellular NO but increased superoxide. As the mechanism, 64 μg/mL MWCNTs significantly reduced the protein level of nNOS. The nNOS regulators nuclear factor kappa-B (NF-κB) proteins were significantly induced by MWCNTs, whereas Kruppel-like factor 4 (KLF4) proteins were reduced particularly after exposure to low level of MWCNTs (16 μg/mL). The results from fluorescence micro-optical sectioning tomography (MOST) confirmed the decrease of nNOS proteins, not only at the out-layers that directly contacted MWCNTs, but also at the inner-layers. Combined, our results suggested that MWCNTs could decrease nNOS activity by inducing oxidative stress and modulating NF-κB-KLF4 pathway. This study also showed the potential of 3D brain organoids in mechanism-based toxicology studies.

Recent Developments in the Application of Nanomaterials in Agroecosystems

Nanotechnology implies the scientific research, development, and manufacture, along with processing, of materials and structures on a nano scale. Presently, the contamination of metalloids and metals in the soil has gained substantial attention. The consolidation of nanomaterials and plants in ecological management has received considerable research attention because certain nanomaterials could enhance plant seed germination and entire plant growth. Conversely, when the nanomaterial concentration is not properly controlled, toxicity will definitely develop. This paper discusses the role of nanomaterials as: (1) nano-pesticides (for improving the plant resistance against the biotic stress); and (2) nano-fertilizers (for promoting the plant growth by providing vital nutrients). This review analyzes the potential usages of nanomaterials in agroecosystem. In addition, the adverse effects of nanomaterials on soil organisms are discussed. We mostly examine the beneficial effects of nanomaterials such as nano-zerovalent iron, iron oxide, titanium dioxide, nano-hydroxyapatite, carbon nanotubes, and silver- and copper-based nanomaterials. Some nanomaterials can affect the growth, survival, and reproduction of soil organisms. A change from testing/using nanomaterials in plants for developing nanomaterials depending on agricultural requirements would be an important phase in the utilization of nanomaterials in sustainable agriculture. Conversely, the transport as well as ecological toxicity of nanomaterials should be seriously examined for guaranteeing its benign usage in agriculture.

Application of Carbon Nanoparticles in Tracing Lymph Nodes and Locating Tumors in Colorectal Cancer: A Concise Review

Background

Accurate lymph node (LN) staging has considerably prognostic and therapeutic value in patients with colorectal cancer (CRC). The purpose of this study is to evaluate the feasibility of applying carbon nanoparticles (CNPs) to track LN metastases in CRC.

Methods

Two researchers independently screened publications in PubMed, EMBASE, Cochrane and Ovid MEDLINE databases. The keywords were (carbon nanoparticles OR activated carbon nanoparticles) AND (colon cancer OR rectal cancer OR colorectal cancer). Titles and abstracts of the articles were meticulously read to rule out potential publications. Next, full texts of the ultimately obtained eligible publications were retrieved and analyzed in detail.

Results

The search produced 268 publications, and 140 abstracts were identified after a bibliographic review. Finally, 20 studies relevant to our subject were obtained; however, only 14 papers met our inclusion criteria and were included for final review. All studies included have compared the control group with carbon nanoparticles group (control group, defined as nontattooed group; and carbon nanoparticles group, defined as administering carbon nanoparticles during surgery) for their efficacy in intraoperative detecting and positioning. After analysis, appreciably less amount of bleeding (3/5 trials), shorter operation time (2/4 trials), and shorter time to detect lesions and dissect LNs (2/2 trials) were revealed in CNPs group compared to control group. Thirteen studies have recorded the numbers of the harvested LNs in both groups; meanwhile, CNPs group shows superiority to control group in LN retrieval as well (11/13 trials), which also could effectively aid in locating and harvesting more LNs with diameter below 5 mm.

Conclusion

The tracing technique for CNPs is a safe and useful strategy both in localizing tumor and tracing LNs in CRC surgery. But there is still a need for more randomized controlled trials to further establish its contribution to patient survival.

Advances in Biodegradable 3D Printed Scaffolds with Carbon-Based Nanomaterials for Bone Regeneration

Bone possesses an inherent capacity to fix itself. However, when a defect larger than a critical size appears, external solutions must be applied. Traditionally, an autograft has been the most used solution in these situations. However, it presents some issues such as donor-site morbidity. In this context, porous biodegradable scaffolds have emerged as an interesting solution. They act as external support for cell growth and degrade when the defect is repaired. For an adequate performance, these scaffolds must meet specific requirements: biocompatibility, interconnected porosity, mechanical properties and biodegradability. To obtain the required porosity, many methods have conventionally been used (e.g., electrospinning, freeze-drying and salt-leaching). However, from the development of additive manufacturing methods a promising solution for this application has been proposed since such methods allow the complete customisation and control of scaffold geometry and porosity. Furthermore, carbon-based nanomaterials present the potential to impart osteoconductivity and antimicrobial properties and reinforce the matrix from a mechanical perspective. These properties make them ideal for use as nanomaterials to improve the properties and performance of scaffolds for bone tissue engineering. This work explores the potential research opportunities and challenges of 3D printed biodegradable composite-based scaffolds containing carbon-based nanomaterials for bone tissue engineering applications.

Learning from Nature: Bioinspired Chlorin-Based Photosensitizers Immobilized on Carbon Materials for Combined Photodynamic and Photothermal Therapy

Chlorophylls, which are chlorin-type photosensitizers, are known as the key building blocks of nature and are fundamental for solar energy metabolism during the photosynthesis process. In this regard, the utilization of bioinspired chlorin analogs as photosensitizers for photodynamic therapy constitutes an evolutionary topic of research. Moreover, carbon nanomaterials have been widely applied in photodynamic therapy protocols due to their optical characteristics, good biocompatibility, and tunable systematic toxicity. Herein, we review the literature related to the applications of chlorin-based photosensitizers that were functionalized onto carbon nanomaterials for photodynamic and photothermal therapies against cancer. Rather than a comprehensive review, we intended to highlight the most important and illustrative examples over the last 10 years.

Conductive Biomaterials as Substrates for Neural Stem Cells Differentiation towards Neuronal Lineage Cells

The injuries and defects in the central nervous system are the causes of disability and death of an affected person. As of now, there are no clinically available methods to enhance neural structural regeneration and functional recovery of nerve injuries. Recently, some experimental studies claimed that the injuries in brain can be repaired by progenitor or neural stem cells located in the neurogenic sites of adult mammalian brain. Various attempts have been made to construct biomimetic physiological microenvironment for neural stem cells to control their ultimate fate. Conductive materials have been considered as one the best choices for nerve regeneration due to the capacity to mimic the microenvironment of stem cells and regulate the alignment, growth, and differentiation of neural stem cells. The review highlights the use of conductive biomaterials, e.g., polypyrrole, polyaniline, poly(3,4-ethylenedioxythiophene), multi-walled carbon nanotubes, single-wall carbon nanotubes, graphene, and graphite oxide, for controlling the neural stem cells activities in terms of proliferation and neuronal differentiation. The effects of conductive biomaterials in axon elongation and synapse formation for optimal repair of central nervous system injuries are also discussed.

Carbon nanomaterials against pathogens; the antimicrobial activity of carbon nanotubes, graphene/graphene oxide, fullerenes, and their nanocomposites

Recently, antibiotic resistance of pathogens has grown given the excessive and inappropriate usage of common antimicrobial agents. Hence, producing novel antimicrobial compounds is a necessity. Carbon nanomaterials (CNMs) such as carbon nanotubes, graphene/graphene oxide, and fullerenes, as an emerging class of novel materials, can exhibit a considerable antimicrobial activity, especially in the nanocomposite forms suitable for different fields including biomedical and food applications. These nanomaterials have attracted a great deal of interest due to their broad efficiency and novel features. The most important factor affecting the antimicrobial activity of CNMs is their size. Smaller particles with a higher surface to volume ratio can easily attach onto the microbial cells and affect their cell membrane integrity, metabolic procedures, and structural components. As these unique characteristics are found in CNMs, a wide range of possibilities have raised in terms of antimicrobial applications. This study aims to cover the antimicrobial activities of CNMs (both as individual forms and in nanocomposites) and comprehensively explain their mechanisms of action. The results of this review will present a broad perspective, summarizes the most remarkable findings, and provides an outlook regarding the antimicrobial properties of CNMs and their potential applications.

A critical perspective on guidelines for responsible and trustworthy artificial intelligence

Artificial intelligence (AI) is among the fastest developing areas of advanced technology in medicine. The most important qualia of AI which makes it different from other advanced technology products is its ability to improve its original program and decision-making algorithms via deep learning abilities. This difference is the reason that AI technology stands out from the ethical issues of other advanced technology artifacts. The ethical issues of AI technology vary from privacy and confidentiality of personal data to ethical status and value of AI entities in a wide spectrum, depending on their capability of deep learning and scope of the domains in which they operate. Developing ethical norms and guidelines for planning, development, production, and usage of AI technology has become an important issue to overcome these problems. In this respect three outstanding documents have been produced:1. The Montréal Declaration for Responsible Development of Artificial Intelligence2. Ethics Guidelines for Trustworthy AI3. Asilomar Artificial Intelligence PrinciplesIn this study, these three documents will be analyzed with respect to the ethical principles and values they involve, their perspectives for approaching ethical issues, and their prospects for ethical reasoning when one or more of these values and principles are in conflict. Then, the sufficiency of these guidelines for addressing current or prospective ethical issues emerging from the existence of AI technology in medicine will be evaluated. The discussion will be pursued in terms of the ambiguity of interlocutors and efficiency for working out ethical dilemmas occurring in practical life.

Commonalities and Differences in the Transcriptional Response of the Model Fungus Saccharomyces cerevisiae to Different Commercial Graphene Oxide Materials

Graphene oxide has become a very appealing nanomaterial during the last years for many different applications, but its possible impact in different biological systems remains unclear. Here, an assessment to understand the toxicity of different commercial graphene oxide nanomaterials on the unicellular fungal model organism Saccharomyces cerevisiae was performed. For this task, an RNA purification protocol was optimized to avoid the high nucleic acid absorption capacity of graphene oxide. The developed protocol is based on a sorbitol gradient separation process for the isolation of adequate ribonucleic acid levels (in concentration and purity) from yeast cultures exposed to the carbon derived nanomaterial. To pinpoint potential toxicity mechanisms and pathways, the transcriptome of S. cerevisiae exposed to 160 mg L-1 of monolayer graphene oxide (GO) and graphene oxide nanocolloids (GOC) was studied and compared. Both graphene oxide products induced expression changes in a common group of genes (104), many of them related to iron homeostasis, starvation and stress response, amino acid metabolism and formate catabolism. Also, a high number of genes were only differentially expressed in either GO (236) or GOC (1077) exposures, indicating that different commercial products can induce specific changes in the physiological state of the fungus.

The Puzzling Potential of Carbon Nanomaterials: General Properties, Application, and Toxicity

Being a member of the nanofamily, carbon nanomaterials exhibit specific properties that mostly arise from their small size. They have proved to be very promising for application in the technical and biomedical field. A wide spectrum of use implies the inevitable presence of carbon nanomaterials in the environment, thus potentially endangering their whole nature. Although scientists worldwide have conducted research investigating the impact of these materials, it is evident that there are still significant gaps concerning the knowledge of their mechanisms, as well as the prolonged and chronic exposure and effects. This manuscript summarizes the most prominent representatives of carbon nanomaterial groups, giving a brief review of their general physico-chemical properties, the most common use, and toxicity profiles. Toxicity was presented through genotoxicity and the activation of the cell signaling pathways, both including in vitro and in vivo models, mechanisms, and the consequential outcomes. Moreover, the acute toxicity of fullerenol, as one of the most commonly investigated members, was briefly presented in the final part of this review. Thinking small can greatly help us improve our lives, but also obliges us to deeply and comprehensively investigate all the possible consequences that could arise from our pure-hearted scientific ambitions and work.

Cellular Responses of Human Lymphatic Endothelial Cells to Carbon Nanomaterials

One of the greatest challenges to overcome in the pursuit of the medical application of carbon nanomaterials (CNMs) is safety. Particularly, when considering the use of CNMs in drug delivery systems (DDSs), evaluation of safety at the accumulation site is an essential step. In this study, we evaluated the toxicity of carbon nanohorns (CNHs), which are potential DDSs, using human lymph node endothelial cells that have been reported to accumulate CNMs, as a comparison to fibrous, multi-walled carbon nanotubes (MWCNTs) and particulate carbon black (CB). The effect of different surface characteristics was also evaluated using two types of CNHs (untreated and oxidized). In the fibrous MWCNT, cell growth suppression, as well as expression of inflammatory cytokine genes was observed, as in previous reports. In contrast, no significant toxicity was observed for particulate CB and CNHs, which was different from the report of CB cytotoxicity in vascular endothelial cells. These results show that (1) lymph endothelial cells need to be tested separately from other endothelial cells for safety evaluation of nanomaterials, and (2) the potential of CNHs as DDSs.

Functionalized Carbon Nanostructures Versus Drug Resistance: Promising Scenarios in Cancer Treatment

Carbon nanostructures (CN) are emerging valuable materials for the assembly of highly engineered multifunctional nanovehicles for cancer therapy, in particular for counteracting the insurgence of multi-drug resistance (MDR). In this regard, carbon nanotubes (CNT), graphene oxide (GO), and fullerenes (F) have been proposed as promising materials due to their superior physical, chemical, and biological features. The possibility to easily modify their surface, conferring tailored properties, allows different CN derivatives to be synthesized. Although many studies have explored this topic, a comprehensive review evaluating the beneficial use of functionalized CNT vs G or F is still missing. Within this paper, the most relevant examples of CN-based nanosystems proposed for MDR reversal are reviewed, taking into consideration the functionalization routes, as well as the biological mechanisms involved and the possible toxicity concerns. The main aim is to understand which functional CN represents the most promising strategy to be further investigated for overcoming MDR in cancer.

Cytotoxic or Not? Disclosing the Toxic Nature of Carbonaceous Nanomaterials through Nano-Bio Interactions

The cytotoxic influence of two different carbonaceous nanomaterials on human mesenchymal stem cells (MSCs) cultured in vitro was compared in the short (1-3 days) and long term (up to 60 days). Amorphous carbon and single-walled carbon nanotubes were chosen and evaluated due to their contrasting physicochemical properties. Both materials, though supposed similarly low-toxic in basic short-term cytotoxicity assays, demonstrated dramatically different properties in the long-term study. The surface chemistry and biomolecule-adsorption capacity turned out to be crucial factors influencing cytotoxicity. We proved that amorphous carbon is able to weakly bind a low-affinity protein coat (so-called soft corona), while carbon nanotubes behaved oppositely. Obtained results from zeta-potential and adsorption measurements for both nanomaterials confirmed that a hard protein corona was present on the single-walled carbon-nanotube surface that aggravated their cytotoxic influence. The long-term exposure of the mesenchymal stem cells to carbon nanotubes, coated by the strongly bound proteins, showed a significant decrease in cell-growth rate, followed by cell senescence and death. These results are of great importance in the light of increasing nanomaterial applications in biomedicine and cell-based therapies. Our better understanding of the puzzling cytotoxicity of carbonaceous nanomaterials, reflecting their surface chemistry and interactions, is helpful in adjusting their properties when tailored for specific applications.

Carbon dots as versatile nanoarchitectures for the treatment of neurological disorders and their theranostic applications: A review

The development of novel methods plays a fundamental role in early diagnosis and controlling of neurological disorders (NDs). Blood-brain barrier (BBB) is the most challenging barrier for the development of neuro drug delivery systems due to its inhibiting ability to enter drugs and agents into central nervous system (CNS). Carbon dots (CDs) have shown to be very promising and outstanding agents for various biomedical applications (bio imaging studies, treatment of NDs and brain tumors). They exhibit remarkable properties such as biocompatibility, small size (less than 10 nm, enabling penetration into BBB), tunable optical properties, photostability and simple synthetic procedures, allowing them to act as ideal candidates in various fields of science. Therefore, the objective of this review is to overview the recent studies on CDs for the development of neuro drug delivery systems to reach CNS via crossing of BBB. Primarily, this review briefly outlines the unique optical properties and toxicity of CDs. The development of novel neuro drug delivery systems for various neurological disorders using CDs as carriers is described. This review also covers the potential applications of CDs in brain tumors imaging and treatment of neurodegenerative diseases. Finally, the sensing applications and future prospects of CDs are summarized.

Hemocompatibility of Carbon Nanostructures

Carbon nanostructures (CNs), such as carbon nanotubes, fullerenes, carbon dots, nanodiamonds as well as graphene and its derivatives present a tremendous potential for various biomedical applications, ranging from sensing to drug delivery and gene therapy, biomedical imaging and tissue engineering. Since most of these applications encompass blood contact or intravenous injection, hemocompatibility is a critical aspect that must be carefully considered to take advantage of CN exceptional characteristics while allowing their safe use. This review discusses the hemocompatibility of different classes of CNs with the purpose of providing biomaterial scientists with a comprehensive vision of the interactions between CNs and blood components. The various complex mechanisms involved in blood compatibility, including coagulation, hemolysis, as well as the activation of complement, platelets, and leukocytes will be considered. Special attention will be paid to the role of CN size, structure, and surface properties in the formation of the protein corona and in the processes that drive blood response. The aim of this review is to emphasize the importance of hemocompatibility for CNs intended for biomedical applications and to provide some valuable insights for the development of new generation particles with improved performance and safety in the physiological environment.

Smart orthopaedic implants: A targeted approach for continuous postoperative evaluation in the spine

Real-time health monitoring systems are emerging in diverse medical fields, tracking biological and physiological signals for direct feedback to the user. Orthopaedics is yet to adapt to innovative trends in health monitoring. Despite an evident entry point during orthopaedic surgeries, clinicians remain unable to objectively examine the structural integrity and biomechanics in the operated region through implantable sensors. As such, postoperative advice can be non-specific and poorly guided. This perspective discusses the clinical need for load-sensing implants that address biomechanical postoperative monitoring, taking the example of spinal interbody cages. Research has attempted to establish sensing approaches in different orthopaedic settings; however, they fail to meet mechanical sensing requirements or lack in vivo translatability, especially in the spine. Polymeric flexible sensors and Microelectromechanical Systems (MEMS) have favourable attributes aligned to the required features for in vivo load-sensing, although these approaches are yet to be tested extensively in orthopaedics. While inductive powering is promising, wireless energy transfer and telemetry are areas of ongoing research. This perspective proposes a thorough understanding of the relevant biomechanics to identify the pertinent sensing parameters, concurrent treatment of sensing and powering aspects, and utilisation of energy harvesting for sensing and data transmission. While sensing advancements have contributed to the rise of real-time health monitoring in other fields of medicine, orthopaedics has so far been overlooked. It is the application of these innovations that will lead to the development of a new generation of 'smart' implants for continuous postoperative evaluation.

Toxicological response of the model fungus Saccharomyces cerevisiae to different concentrations of commercial graphene nanoplatelets

Graphene nanomaterials have attracted a great interest during the last years for different applications, but their possible impact on different biological systems remains unclear. Here, an assessment to understand the toxicity of commercial polycarboxylate functionalized graphene nanoplatelets (GN) on the unicellular fungal model Saccharomyces cerevisiae was performed. While cell proliferation was not negatively affected even in the presence of 800 mg L-1 of the nanomaterial for 24 hours, oxidative stress was induced at a lower concentration (160 mg L-1), after short exposure periods (2 and 4 hours). No DNA damage was observed under a comet assay analysis under the studied conditions. In addition, to pinpoint the molecular mechanisms behind the early oxidative damage induced by GN and to identify possible toxicity pathways, the transcriptome of S. cerevisiae exposed to 160 and 800 mg L-1 of GN was studied. Both GN concentrations induced expression changes in a common group of genes (337), many of them related to the fungal response to reduce the nanoparticles toxicity and to maintain cell homeostasis. Also, a high number of genes were only differentially expressed in the GN800 condition (3254), indicating that high GN concentrations can induce severe changes in the physiological state of the yeast.

Quantitative Flow Cytometric Evaluation of Oxidative Stress and Mitochondrial Impairment in RAW 264.7 Macrophages after Exposure to Pristine, Acid Functionalized, or Annealed Carbon Nanotubes

Conventional nanotoxicological assays are subjected to various interferences with nanoparticles and especially carbon nanotubes. A multiparametric flow cytometry (FCM) methodology was developed here as an alternative to quantify oxidative stress, mitochondrial impairment, and later cytotoxic and genotoxic events. The experiments were conducted on RAW264.7 macrophages, exposed for 90 min or 24 h-exposure with three types of multiwalled carbon nanotubes (MWCNTs): pristine (Nanocyl™ CNT), acid functionalized (CNTf), or annealed treatment (CNTa). An original combination of reactive oxygen species (ROS) probes allowed the simultaneous quantifications of broad-spectrum ROS, superoxide anion (O₂^•-), and hydroxyl radical (•OH). All MWCNTs types induced a slight increase of broad ROS levels regardless of earlier antioxidant catalase activity. CNTf strongly stimulated the O₂^•- production. The •OH production was downregulated for all MWCNTs due to their scavenging capacity. The latter was quantified in a cell-free system by electron paramagnetic resonance spectroscopy (EPR). Further FCM-based assessment revealed early biological damages with a mitochondrial membrane potential collapse, followed by late cytotoxicity with chromatin decondensation. The combined evaluation by FCM analysis and cell-free techniques led to a better understanding of the impacts of MWCNTs surface treatments on the oxidative stress and related biological response.

International landscape of limits and recommendations for occupational exposure to engineered nanomaterials

The increasing concern of possible adverse effects on human health derived from occupational engineered nanomaterials (ENMs) exposure is an issue addressed by entities related to provide guidelines and/or protocols for ENMs regulation. Here we analysed 17 entities from America, Europe and Asia, and some of these entities provide limits of exposure extrapolated from the non-nanosized counterparts of ENMs. The international landscape shows that recommendations are mostly made for metal oxide based ENMs and tonnage is one of the main criteria for ENMs registration, however, sub-nanometric ENMs are emerging and perhaps a novel category of ENMs will appear soon. We identify that besides the lack of epidemiological evidence of ENMs toxicity in humans and difficulties in analysing the toxicological data derived from experimental models, the lack of information on airborne concentrations of ENMs in occupational settings is an important limitation to improve the experimental designs. The development of regulations related to ENMs exposure would lead to provide safer work places for ENMs production without delaying the nanotechnology progress but will also help to protect the environment by taking opportune and correct measures for nanowaste, considering that this could be a great environmental problem in the coming future.

Graphenic Materials for Biomedical Applications

Graphene-based nanomaterials have been intensively studied for their properties, modifications, and application potential. Biomedical applications are one of the main directions of research in this field. This review summarizes the research results which were obtained in the last two years (2017-2019), especially those related to drug/gene/protein delivery systems and materials with antimicrobial properties. Due to the large number of studies in the area of carbon nanomaterials, attention here is focused only on 2D structures, i.e. graphene, graphene oxide, and reduced graphene oxide.