High-Resolution SPECT Imaging of Stimuli-Responsive Soft Microrobots

Propulsion mechanisms of micro/nanorobots: a review

Micro/nanomotors (MNMs) are intelligent, efficient and promising micro/nanorobots (MNR) that can respond to external stimuli (e.g., chemical energy, temperature, light, pH, ultrasound, magnetic, biosignals, ions) and perform specific tasks. The MNR can adapt to different external stimuli and transform into various functional forms to match different application scenarios. So far, MNR have found extensive application in targeted therapy, drug delivery, tissue engineering, environmental remediation, and other fields. Despite the promise of MNR, there are few reviews that focus on them. To shed new light on the further development of the field, it is necessary to provide an overview of the current state of development of these MNR. Therefore, this paper reviews the research progress of MNR in terms of propulsion mechanisms, and points out the pros and cons of different stimulus types. Finally, this paper highlights the current challenges faced by MNR and proposes possible solutions to facilitate the practical application of MNR.

Magnetic Microrobot Swarms with Polymeric Hands Catching Bacteria and Microplastics in Water

The forefront of micro- and nanorobot research involves the development of smart swimming micromachines emulating the complexity of natural systems, such as the swarming and collective behaviors typically observed in animals and microorganisms, for efficient task execution. This study introduces magnetically controlled microrobots that possess polymeric sequestrant "hands" decorating a magnetic core. Under the influence of external magnetic fields, the functionalized magnetic beads dynamically self-assemble from individual microparticles into well-defined rotating planes of diverse dimensions, allowing modulation of their propulsion speed, and exhibiting a collective motion. These mobile microrobotic swarms can actively capture free-swimming bacteria and dispersed microplastics "on-the-fly", thereby cleaning aquatic environments. Unlike conventional methods, these microrobots can be collected from the complex media and can release the captured contaminants in a second vessel in a controllable manner, that is, using ultrasound, offering a sustainable solution for repeated use in decontamination processes. Additionally, the residual water is subjected to UV irradiation to eliminate any remaining bacteria, providing a comprehensive cleaning solution. In summary, this study shows a swarming microrobot design for water decontamination processes.

Tracking and navigation of a microswarm under laser speckle contrast imaging for targeted delivery

Micro/nanorobotic swarms consisting of numerous tiny building blocks show great potential in biomedical applications because of their collective active delivery ability, enhanced imaging contrast, and environment-adaptive capability. However, in vivo real-time imaging and tracking of micro/nanorobotic swarms remain a challenge, considering the limited imaging size and spatial-temporal resolution of current imaging modalities. Here, we propose a strategy that enables real-time tracking and navigation of a microswarm in stagnant and flowing blood environments by using laser speckle contrast imaging (LSCI), featuring full-field imaging, high temporal-spatial resolution, and noninvasiveness. The change in dynamic convection induced by the microswarm can be quantitatively investigated by analyzing the perfusion unit (PU) distribution, offering an alternative approach to investigate the swarm behavior and its interaction with various blood environments. Both the microswarm and surrounding environment were monitored and imaged by LSCI in real time, and the images were further analyzed for simultaneous swarm tracking and navigation in the complex vascular system. Moreover, our strategy realized real-time tracking and delivery of a microswarm in vivo, showing promising potential for LSCI-guided active delivery of microswarm in the vascular system.

Ultrasound robotics for precision therapy

In recent years, the application of microrobots in precision therapy has gained significant attention. The small size and maneuverability of these micromachines enable them to potentially access regions that are difficult to reach using traditional methods; thus, reducing off-target toxicities and maximizing treatment effectiveness. Specifically, acoustic actuation has emerged as a promising method to exert control. By harnessing the power of acoustic energy, these small machines potentially navigate the body, assemble at the desired sites, and deliver therapies with enhanced precision and effectiveness. Amidst the enthusiasm surrounding these miniature agents, their translation to clinical environments has proven difficult. The primary objectives of this review are threefold: firstly, to offer an overview of the fundamental acoustic principles employed in the field of microrobots; secondly, to assess their current applications in medical therapies, encompassing tissue targeting, drug delivery or even cell infiltration; and lastly, to delve into the continuous efforts aimed at integrating acoustic microrobots into in vivo applications.

Current status and future application of electrically controlled micro/nanorobots in biomedicine

Using micro/nanorobots (MNRs) for targeted therapy within the human body is an emerging research direction in biomedical science. These nanoscale to microscale miniature robots possess specificity and precision that are lacking in most traditional treatment modalities. Currently, research on electrically controlled micro/nanorobots is still in its early stages, with researchers primarily focusing on the fabrication and manipulation of these robots to meet complex clinical demands. This review aims to compare the fabrication, powering, and locomotion of various electrically controlled micro/nanorobots, and explore their advantages, disadvantages, and potential applications.

Preparation, Stimulus-Response Mechanisms and Applications of Micro/Nanorobots

Micro- and nanorobots are highly intelligent and efficient. They can perform various complex tasks as per the external stimuli. These robots can adapt to the required functional form, depending on the different stimuli, thus being able to meet the requirements of various application scenarios. So far, microrobots have been widely used in the fields of targeted therapy, drug delivery, tissue engineering, environmental remediation and so on. Although microbots are promising in some fields, few reviews have yet focused on them. It is therefore necessary to outline the current status of these microbots' development to provide some new insights into the further evolution of this field. This paper critically assesses the research progress of microbots with respect to their preparation methods, stimulus-response mechanisms and applications. It highlights the suitability of different preparation methods and stimulus types, while outlining the challenges experienced by microbots. Viable solutions are also proposed for the promotion of their practical use.

A Multidrug Delivery Microrobot for the Synergistic Treatment of Cancer

Multidrug combination therapy provides an effective strategy for malignant tumor treatment. This paper presents the development of a biodegradable microrobot for on-demand multidrug delivery. By combining magnetic targeting transportation with tumor therapy, it is hypothesized that loading multiple drugs on different regions of a single magnetic microrobot can enhance a synergistic effect for cancer treatment. The synergistic effect of using two drugs together is greater than that of using each drug separately. Here, a 3D-printed microrobot inspired by the fish structure with three hydrogel components: skeleton, head, and body structures is demonstrated. Made of iron oxide (Fe3 O4 ) nanoparticles embedded in poly(ethylene glycol) diacrylate (PEGDA), the skeleton can respond to magnetic fields for microrobot actuation and drug-targeted delivery. The drug storage structures, head, and body, made by biodegradable gelatin methacryloyl (GelMA) exhibit enzyme-responsive cargo release. The multidrug delivery microrobots carrying acetylsalicylic acid (ASA) and doxorubicin (DOX) in drug storage structures, respectively, exhibit the excellent synergistic effects of ASA and DOX by accelerating HeLa cell apoptosis and inhibiting HeLa cell metastasis. In vivo studies indicate that the microrobots improve the efficiency of tumor inhibition and induce a response to anti-angiogenesis. The versatile multidrug delivery microrobot conceptualized here provides a way for developing effective combination therapy for cancer.

Medical Imaging Technology for Micro/Nanorobots

Due to their enormous potential to be navigated through complex biological media or narrow capillaries, microrobots have demonstrated their potential in a variety of biomedical applications, such as assisted fertilization, targeted drug delivery, tissue repair, and regeneration. Numerous initial studies have been conducted to demonstrate the biomedical applications in test tubes and in vitro environments. Microrobots can reach human areas that are difficult to reach by existing medical devices through precise navigation. Medical imaging technology is essential for locating and tracking this small treatment machine for evaluation. This article discusses the progress of imaging in tracking the imaging of micro and nano robots in vivo and analyzes the current status of imaging technology for microrobots. The working principle and imaging parameters (temporal resolution, spatial resolution, and penetration depth) of each imaging technology are discussed in depth.

Stimuli-Responsive Functional Micro-/Nanorobots: A Review

Stimuli-responsive functional micro-/nanorobots (srFM/Ns) are a class of intelligent, efficient, and promising microrobots that can react to external stimuli (such as temperature, light, ultrasound, pH, ion, and magnetic field) and perform designated tasks. Through adaptive transformation into the corresponding functional forms, they can perfectly match the demands depending on different applications, which manifest extremely important roles in targeted therapy, biological detection, tissue engineering, and other fields. Promising as srFM/Ns can be, few reviews have focused on them. It is therefore necessary to provide an overview of the current development of these intelligent srFM/Ns to provide clear inspiration for further development of this field. Hence, this review summarizes the current advances of stimuli-responsive functional microrobots regarding their response mechanism, the achieved functions, and their applications to highlight the pros and cons of different stimuli. Finally, we emphasize the existing challenges of srFM/Ns and propose possible strategies to help accelerate the study of this field and promote srFM/Ns toward actual applications.

Micro-/nanoscale robotics for chemical and biological sensing

The field of micro-/nanorobotics has attracted extensive interest from a variety of research communities and witnessed enormous progress in a broad array of applications ranging from basic research to global healthcare and to environmental remediation and protection. In particular, micro-/nanoscale robots provide an enabling platform for the development of next-generation chemical and biological sensing modalities, owing to their unique advantages as programmable, self-sustainable, and/or autonomous mobile carriers to accommodate and promote physical and chemical processes. In this review, we intend to provide an overview of the state-of-the-art development in this area and share our perspective in the future trend. This review starts with a general introduction of micro-/nanorobotics and the commonly used methods for propulsion of micro-/nanorobots in solution, along with the commonly used methods in their fabrication. Next, we comprehensively summarize the current status of the micro/nanorobotic research in relevance to chemical and biological sensing (e.g., motion-based sensing, optical sensing, and electrochemical sensing). Following that, we provide an overview of the primary challenges currently faced in the micro-/nanorobotic research. Finally, we conclude this review by providing our perspective detailing the future application of soft robotics in chemical and biological sensing.

Two-photon microscopy for microrobotics: Visualization of micro-agents below fixed tissue

Optical microscopy is frequently used to visualize microrobotic agents (i.e., micro-agents) and physical surroundings with a relatively high spatio-temporal resolution. However, the limited penetration depth of optical microscopy techniques used in microrobotics (in the order of 100 μm) reduces the capability of visualizing micro-agents below biological tissue. Two-photon microscopy is a technique that exploits the principle of two-photon absorption, permitting live tissue imaging with sub-micron resolution and optical penetration depths (over 500 μm). The two-photon absorption principle has been widely applied to fabricate sub-millimeter scale components via direct laser writing (DLW). Yet, its use as an imaging tool for microrobotics remains unexplored in the state-of-the-art. This study introduces and reports on two-photon microscopy as an alternative technique for visualizing micro-agents below biological tissue. In order to validate two-photon image acquisition for microrobotics, two-type micro-agents are fabricated and employed: (1) electrospun fibers stained with an exogenous fluorophore and (2) bio-inspired structure printed with autofluorescent resin via DLW. The experiments are devised and conducted to obtain three-dimensional reconstructions of both micro-agents, perform a qualitative study of laser-tissue interaction, and visualize micro-agents along with tissue using second-harmonic generation. We experimentally demonstrate two-photon microscopy of micro-agents below formalin-fixed tissue with a maximum penetration depth of 800 μm and continuous imaging of magnetic electrospun fibers with one frame per second acquisition rate (in a field of view of 135 × 135 μm2). Our results show that two-photon microscopy can be an alternative imaging technique for microrobotics by enabling visualization of micro-agents under in vitro and ex ovo conditions. Furthermore, bridging the gap between two-photon microscopy and the microrobotics field has the potential to facilitate in vivo visualization of micro-agents.

Nanomaterial-decorated micromotors for enhanced photoacoustic imaging

Micro-and nanorobots have the potential to perform non-invasive drug delivery, sensing, and surgery in living organisms, with the aid of diverse medical imaging techniques. To perform such actions, microrobots require high spatiotemporal resolution tracking with real-time closed-loop feedback. To that end,  photoacoustic imaging has appeared as a promising technique for imaging microrobots in deep tissue with higher molecular specificity and contrast. Here, we present different strategies to track magnetically-driven micromotors with improved contrast and specificity using dedicated contrast agents (Au nanorods and nanostars). Furthermore, we discuss the possibility of improving the light absorption properties of the employed nanomaterials considering possible light scattering and coupling to the underlying metal-oxide layers on the micromotor's surface. For that, 2D COMSOL simulation and experimental results were correlated, confirming that an increased spacing between the Au-nanostructures and the increase of thickness of the underlying oxide layer lead to enhanced light absorption and preservation of the characteristic absorption peak. These characteristics are important when visualizing the micromotors in a complex in vivo environment, to distinguish them from the light absorption properties of the surrounding natural chromophores.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12213-023-00156-7.

Radiopaque Nanorobots as Magnetically Navigable Contrast Agents for Localized In Vivo Imaging of the Gastrointestinal Tract

Magnetic nanorobots offer wireless navigation capability in hard-to-reach areas of the human body for targeted therapy and diagnosis. Though in vivo imaging is required for guidance of the magnetic nanorobots toward the target areas, most of the imaging techniques are inadequate to reveal the potential locomotion routes. This work proposes the use of radiopaque magnetic nanorobots along with microcomputed tomography (microCT) for localized in vivo imaging applications. The nanorobots consist of a contrast agent, barium sulfate (BaSO₄ ), magnetized by the decoration of magnetite (Fe₃ O₄ ) particles. The magnetic features lead to actuation under rotating magnetic fields and enable precise navigation in a microfluidic channel used to simulate confined spaces of the body. In this channel, the intrinsic radiopacity of the nanorobots also provides the possibility to reveal the internal structures by X-ray contrast. Furthermore, in vitro analysis indicates nontoxicity of the nanorobots. In vivo experiments demonstrate localization of the nanorobots in a specific part of the gastrointestinal (GI) tract upon the influence of the magnetic field, indicating the efficient control even in the presence of natural peristaltic movements. The nanorobots reported here highlight that smart nanorobotic contrast agents can improve the current imaging-based diagnosis techniques by providing untethered controllability in vivo.

Medical micro- and nanomotors in the body

Attributed to the miniaturized body size and active mobility, micro- and nanomotors (MNMs) have demonstrated tremendous potential for medical applications. However, from bench to bedside, massive efforts are needed to address critical issues, such as cost-effective fabrication, on-demand integration of multiple functions, biocompatibility, biodegradability, controlled propulsion and in vivo navigation. Herein, we summarize the advances of biomedical MNMs reported in the past two decades, with particular emphasis on the design, fabrication, propulsion, navigation, and the abilities of biological barriers penetration, biosensing, diagnosis, minimally invasive surgery and targeted cargo delivery. Future perspectives and challenges are discussed as well. This review can lay the foundation for the future direction of medical MNMs, pushing one step forward on the road to achieving practical theranostics using MNMs.

Lighting up Micro-/Nanorobots with Fluorescence

Micro-/nanorobots (MNRs) can be autonomously propelled on demand in complex biological environments and thus may bring revolutionary changes to biomedicines. Fluorescence has been widely used in real-time imaging, chemo-/biosensing, and photo-(chemo-) therapy. The integration of MNRs with fluorescence generates fluorescent MNRs with unique advantages of optical trackability, on-the-fly environmental sensitivity, and targeting chemo-/photon-induced cytotoxicity. This review provides an up-to-date overview of fluorescent MNRs. After the highlighted elucidation about MNRs of various propulsion mechanisms and the introductory information on fluorescence with emphasis on the fluorescent mechanisms and materials, we systematically illustrate the design and preparation strategies to integrate MNRs with fluorescent substances and their biomedical applications in imaging-guided drug delivery, intelligent on-the-fly sensing and photo-(chemo-) therapy. In the end, we summarize the main challenges and provide an outlook on the future directions of fluorescent MNRs. This work is expected to attract and inspire researchers from different communities to advance the creation and practical application of fluorescent MNRs on a broad horizon.

Contrast-enhanced ultrasound tracking of helical propellers with acoustic phase analysis and comparison with color Doppler

Medical microrobots (MRs) hold the potential to radically transform several interventional procedures. However, to guarantee therapy success when operating in hard-to-reach body districts, a precise and robust imaging strategy is required for monitoring and controlling MRs in real-time. Ultrasound (US) may represent a powerful technology, but MRs' visibility with US needs to be improved, especially when targeting echogenic tissues. In this context, motions of MRs have been exploited to enhance their contrast, e.g., by Doppler imaging. To exploit a more selective contrast-enhancement mechanism, in this study, we analyze in detail the characteristic motions of one of the most widely adopted MR concepts, i.e., the helical propeller, with a particular focus on its interactions with the backscattered US waves. We combine a kinematic analysis of the propeller 3D motion with an US acoustic phase analysis (APA) performed on the raw radio frequency US data in order to improve imaging and tracking in bio-mimicking environments. We validated our US-APA approach in diverse scenarios, aimed at simulating realistic in vivo conditions, and compared the results to those obtained with standard US Doppler. Overall, our technique provided a precise and stable feedback to visualize and track helical propellers in echogenic tissues (chicken breast), tissue-mimicking phantoms with bifurcated lumina, and in the presence of different motion disturbances (e.g., physiological flows and tissue motions), where standard Doppler showed poor performance. Furthermore, the proposed US-APA technique allowed for real-time estimation of MR velocity, where standard Doppler failed.

Visualization of micro-agents and surroundings by real-time multicolor fluorescence microscopy

Optical microscopy techniques are a popular choice for visualizing micro-agents. They generate images with relatively high spatiotemporal resolution but do not reveal encoded information for distinguishing micro-agents and surroundings. This study presents multicolor fluorescence microscopy for rendering color-coded identification of mobile micro-agents and dynamic surroundings by spectral unmixing. We report multicolor microscopy performance by visualizing the attachment of single and cluster micro-agents to cancer spheroids formed with HeLa cells as a proof-of-concept for targeted drug delivery demonstration. A microfluidic chip is developed to immobilize a single spheroid for the attachment, provide a stable environment for multicolor microscopy, and create a 3D tumor model. In order to confirm that multicolor microscopy is able to visualize micro-agents in vascularized environments, in vitro vasculature network formed with endothelial cells and ex ovo chicken chorioallantoic membrane are employed as experimental models. Full visualization of our models is achieved by sequential excitation of the fluorophores in a round-robin manner and synchronous individual image acquisition from three-different spectrum bands. We experimentally demonstrate that multicolor microscopy spectrally decomposes micro-agents, organic bodies (cancer spheroids and vasculatures), and surrounding media utilizing fluorophores with well-separated spectrum characteristics and allows image acquisition with 1280 [Formula: see text] 1024 pixels up to 15 frames per second. Our results display that real-time multicolor microscopy provides increased understanding by color-coded visualization regarding the tracking of micro-agents, morphology of organic bodies, and clear distinction of surrounding media.

Switching from Chemical to Electrical Micromotor Propulsion across a Gradient of Gastric Fluid via Magnetic Rolling

To address and extend the finite lifetime of Mg-based micromotors due to the depletion of the engine (Mg-core), we examine electric fields, along with previously studied magnetic fields, to create a triple-engine hybrid micromotor for driving these micromotors. Electric fields are a facile energy source that is not limited in its operation time and can dynamically tune the micromotor mobility by simply changing the frequency and amplitude of the field. Moreover, the same electrical fields can be used for cell trapping and transport as well as drug delivery. However, the limitations of these propulsion mechanisms are the low pH (and high conductivity) environment required for Mg dissolution, while the electrical propulsion is quenched at these conditions as it requires low conductivity mediums. In order to translate the micromotor between these two extreme medium conditions, we use magnetic rolling as means of self-propulsion along with magnetic steering. Interestingly, electrical propulsion also necessitates at least the partial consumption of the Mg, resulting in a sufficient geometrical asymmetry of the micromotor. We have successfully demonstrated the rapid propulsion switching capability of the micromotor, from chemical to electrical motions, via magnetic rolling within a microfluidic device with the concentration gradient of the simulated gastric fluid. Such triple-engine micromotor propulsion holds considerable promise for in vitro studies mimicking gastric conditions and performing various bioassay tasks.

Micro/Nanorobots for Medical Diagnosis and Disease Treatment

Micro/nanorobots are functional devices in microns, at nanoscale, which enable efficient propulsion through chemical reactions or external physical field, including ultrasonic, optical, magnetic, and other external fields, as well as microorganisms. Compared with traditional robots, micro/nanorobots can perform various tasks on the micro/nanoscale, which has the advantages of high precision, strong flexibility, and wide adaptability. In addition, such robots can also perform tasks in a cluster manner. The design and development of micro/nanorobots and the integration of surface functionalization, remote drive system, and imaging tracking technology will become a key step for their medical applications in organisms. Thus, micro/nanorobots are expected to achieve more efficient and accurate local diagnosis and treatment, and they have broad application prospects in the biomedical field. This paper aims to introduce relevant driving methods of micro/nanorobots preparation in detail, summarizes the progress of research in medical applications, and discusses the challenges it faces in clinical applications and the future direction of development.

Multimodal Locomotion and Active Targeted Thermal Control of Magnetic Agents for Biomedical Applications

Magnetic microrobots can be miniaturized to a nanometric scale owing to their wireless actuation, thereby rendering them ideal for numerous biomedical applications. As a result, nowadays, there exist several mechano-electromagnetic systems for their actuation. However, magnetic actuation is not sufficient for implementation in biomedical applications, and further functionalities such as imaging and heating are required. This study proposes a multimodal electromagnetic system comprised of three pairs of Helmholtz coils, a pair of Maxwell coils, and a high-frequency solenoid to realize multimodal locomotion and heating control of magnetic microrobots. The system produces different configurations of magnetic fields that can generate magnetic forces and torques for the multimodal locomotion of magnetic microrobots, as well as generate magnetic traps that can control the locomotion of magnetic swarms. Furthermore, these magnetic fields are employed to control the magnetization of magnetic nanoparticles, affecting their magnetic relaxation mechanisms and diminishing their thermal properties. Thus, the system enables the control of the temperature increase of soft-magnetic materials and selective heating of magnetic microrobots at different positions, while suppressing the heating properties of magnetic nanoparticles located at undesired areas.

Quantification and 3D localization of magnetically navigated superparamagnetic particles using MRI in phantom and swine chemoembolization models

OBJECTIVE

Superparamagnetic nanoparticles (SPIONs) can be combined with tumor chemoembolization agents to form magnetic drug-eluting beads (MDEBs), which are navigated magnetically in the MRI scanner through the vascular system. We aim to develop a method to accurately quantify and localize these particles and to validate the method in phantoms and swine models.

METHODS

MDEBs were made of Fe₃O₄ SPIONs. After injected known numbers of MDEBs, susceptibility artifacts in three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences were acquired in glass and Polyvinyl alcohol (PVA) phantoms, and two living swine. Image processing of VIBE images provided the volume relationship between MDEBs and their artifact at different VIBE acquisitions and post-processing parameters. Simulated hepatic-artery embolization was performed in vivo with an MRI-conditional magnetic-injection system, using the volume relationship to locate and quantify MDEB distribution.

RESULTS

Individual MDEBs were spatially identified, and their artifacts quantified, showing no correlation with magnetic-field orientation or sequence bandwidth, but exhibiting a relationship with echo time and providing a linear volume relationship. Two MDEB aggregates were magnetically steered into desired liver regions while the other 19 had no steering, and 25 aggregates were injected into another swine without steering. The MDEBs were spatially identified and the volume relationship showed accuracy in assessing the number of the MDEBs, with small errors (8.8%).

CONCLUSION AND SIGNIFICANCE

MDEBs were able to be steered into desired body regions and then localized using 3D VIBE sequences. The resulting volume relationship was linear, robust, and allowed for quantitative analysis of the MDEB distribution.

Dynamic tracking of a magnetic micro-roller using ultrasound phase analysis

Microrobots (MRs) have attracted significant interest for their potentialities in diagnosis and non-invasive intervention in hard-to-reach body areas. Fine control of biomedical MRs requires real-time feedback on their position and configuration. Ultrasound (US) imaging stands as a mature and advantageous technology for MRs tracking, but it suffers from disturbances due to low contrast resolution. To overcome these limitations and make US imaging suitable for monitoring and tracking MRs, we propose a US contrast enhancement mechanism for MR visualization in echogenic backgrounds (e.g., tissue). Our technique exploits the specific acoustic phase modulation produced by the MR characteristic motions. By applying this principle, we performed real-time visualization and position tracking of a magnetic MR rolling on a lumen boundary, both in static flow and opposing flow conditions, with an average error of 0.25 body-lengths. Overall, the reported results unveil countless possibilities to exploit the proposed approach as a robust feedback strategy for monitoring and tracking biomedical MRs in-vivo.

Dual Ultrasound and Photoacoustic Tracking of Magnetically Driven Micromotors: From In Vitro to In Vivo

The fast evolution of medical micro- and nanorobots in the endeavor to perform non-invasive medical operations in living organisms has boosted the use of diverse medical imaging techniques in the last years. Among those techniques, photoacoustic imaging (PAI), considered a functional technique, has shown to be promising for the visualization of micromotors in deep tissue with high spatiotemporal resolution as it possesses the molecular specificity of optical methods and the penetration depth of ultrasound. However, the precise maneuvering and function's control of medical micromotors, in particular in living organisms, require both anatomical and functional imaging feedback. Therefore, herein, the use of high-frequency ultrasound and PAI is reported to obtain anatomical and molecular information, respectively, of magnetically-driven micromotors in vitro and under ex vivo tissues. Furthermore, the steerability of the micromotors is demonstrated by the action of an external magnetic field into the uterus and bladder of living mice in real-time, being able to discriminate the micromotors' signal from one of the endogenous chromophores by multispectral analysis. Finally, the successful loading and release of a model cargo by the micromotors toward non-invasive in vivo medical interventions is demonstrated.

A mobile magnetic pad with fast light-switchable adhesion capabilities

Octopus suckers that possess the ability to actively control adhesion through muscle actuation have inspired artificial adhesives for safe manipulation of thin and delicate objects. However, the design of adhesives with fast adhesion switching speed to transport cargoes in confined spaces remains an open challenge. Here, we present an untethered magnetic adhesive pad combining the functionality of fast adhesion switching and remotely controlled locomotion. The adhesive pad can be activated from low-adhesion state to high-adhesion state by near infrared laser within 30 s, allowing to fulfill a high-throughput task of retrieving and releasing objects. Moreover, under the guidance of external magnetic field, the proposed pad is demonstrated to transport thin and fragile electronic components across a tortuous path, thus indicating its potential for dexterous delivery in complex working environments.

Biosafety, Functionalities, and Applications of Biomedical Micro/nanomotors

Due to their unique ability to actively move, micro/nanomotors offer the possibility of breaking through the limitations of traditional passive drug delivery systems for the treatment of many diseases, and have attracted the increasing attention of researchers. However, at present, the realization of many advantages of micro/nanomotors in disease treatment in vivo is still in its infancy, because of the complexity and particularity of diseases in different parts of human body. In this Minireview, we first focus on the biosafety and functionality of micro/nanomotors as a biomedical treatment system. Then, we address the treatment difficulties of various diseases in vivo (such as ophthalmic disease, orthopedic disease, gastrointestinal disease, cardiovascular disease, and cancer), and then review the research progress of biomedical micro/nanomotors in the past 20 years, Finally, we propose the challenges in this field and possible future development directions.

A Microstirring Pill Enhances Bioavailability of Orally Administered Drugs

Majority of drugs are administered orally, yet their efficient absorption is often difficult to achieve, with a low dose fraction reaching the blood compartment. Here, a microstirring pill technology is reported with built-in mixing capability for oral drug delivery that greatly enhances bioavailability of its therapeutic payload. Embedding microscopic stirrers into a pill matrix enables faster disintegration and dissolution, leading to improved release profiles of three widely used model drugs, aspirin, levodopa, and acetaminophen, without compromising their loading. Unlike recently developed drug-carrying nanomotors, drug molecules are not associated with the microstirrers, and hence there is no limitation on the loading capacity. These embedded microstirrers are fabricated through the asymmetric coating of titanium dioxide thin film onto magnesium microparticles. In vitro tests illustrate that the embedded microstirrers lead to substantial enhancement of local fluid transport. In vivo studies using murine and porcine models demonstrate that the localized stirring capability of microstirrers leads to enhanced bioavailability of drug payloads. Such improvements are of considerable importance in clinical scenarios where fast absorption and high bioavailability of therapeutics are critical. The encouraging results obtained in porcine model suggest that the microstirring pill technology has translational potential and can be developed toward practical biomedical applications.

Magnetically Driven Micro and Nanorobots

Manipulation and navigation of micro and nanoswimmers in different fluid environments can be achieved by chemicals, external fields, or even motile cells. Many researchers have selected magnetic fields as the active external actuation source based on the advantageous features of this actuation strategy such as remote and spatiotemporal control, fuel-free, high degree of reconfigurability, programmability, recyclability, and versatility. This review introduces fundamental concepts and advantages of magnetic micro/nanorobots (termed here as “MagRobots”) as well as basic knowledge of magnetic fields and magnetic materials, setups for magnetic manipulation, magnetic field configurations, and symmetry-breaking strategies for effective movement. These concepts are discussed to describe the interactions between micro/nanorobots and magnetic fields. Actuation mechanisms of flagella-inspired MagRobots (i.e., corkscrew-like motion and traveling-wave locomotion/ciliary stroke motion) and surface walkers (i.e., surface-assisted motion), applications of magnetic fields in other propulsion approaches, and magnetic stimulation of micro/nanorobots beyond motion are provided followed by fabrication techniques for (quasi-)spherical, helical, flexible, wire-like, and biohybrid MagRobots. Applications of MagRobots in targeted drug/gene delivery, cell manipulation, minimally invasive surgery, biopsy, biofilm disruption/eradication, imaging-guided delivery/therapy/surgery, pollution removal for environmental remediation, and (bio)sensing are also reviewed. Finally, current challenges and future perspectives for the development of magnetically powered miniaturized motors are discussed.

Engineering microrobots for targeted cancer therapies from a medical perspective

Systemic chemotherapy remains the backbone of many cancer treatments. Due to its untargeted nature and the severe side effects it can cause, numerous nanomedicine approaches have been developed to overcome these issues. However, targeted delivery of therapeutics remains challenging. Engineering microrobots is increasingly receiving attention in this regard. Their functionalities, particularly their motility, allow microrobots to penetrate tissues and reach cancers more efficiently. Here, we highlight how different microrobots, ranging from tailor-made motile bacteria and tiny bubble-propelled microengines to hybrid spermbots, can be engineered to integrate sophisticated features optimised for precision-targeting of a wide range of cancers. Towards this, we highlight the importance of integrating clinicians, the public and cancer patients early on in the development of these novel technologies.

Medical Micro/Nanorobots in Precision Medicine

Advances in medical robots promise to improve modern medicine and the quality of life. Miniaturization of these robotic platforms has led to numerous applications that leverages precision medicine. In this review, the current trends of medical micro and nanorobotics for therapy, surgery, diagnosis, and medical imaging are discussed. The use of micro and nanorobots in precision medicine still faces technical, regulatory, and market challenges for their widespread use in clinical settings. Nevertheless, recent translations from proof of concept to in vivo studies demonstrate their potential toward precision medicine.

Human spermbots for patient-representative 3D ovarian cancer cell treatment

Cellular micromotors are attractive for locally delivering high concentrations of drug, and targeting hard-to-reach disease sites such as cervical cancer and early ovarian cancer lesions by non-invasive means. Spermatozoa are highly efficient micromotors perfectly adapted to traveling up the female reproductive system. Indeed, bovine sperm-based micromotors have shown potential to carry drugs toward gynecological cancers. However, due to major differences in the molecular make-up of bovine and human sperm, a key translational bottleneck for bringing this technology closer to the clinic is to transfer this concept to human material. Here, we successfully load human sperm with Doxorubicin (DOX) and perform treatment of 3D cervical cancer and patient-representative ovarian cancer cell cultures, resulting in strong anticancer cell effects. Additionally, we define the subcellular localization of the chemotherapeutic drug within human sperm, using high-resolution optical microscopy. We also assess drug effects on sperm motility and viability over time, employing sperm samples from healthy donors as well as assisted reproduction patients. Finally, we demonstrate guidance and release of human drug-loaded sperm onto cancer tissues using magnetic microcaps, and show the sperm microcap loaded with a second anticancer drug, camptothecin (CPT), which unlike DOX is not suitable for directly loading into sperm due to its hydrophobic nature. This co-drug delivery approach opens up novel targeted combinatorial drug therapies for future applications.

Development of Magnet-Driven and Image-Guided Degradable Microrobots for the Precise Delivery of Engineered Stem Cells for Cancer Therapy

Precise delivery of therapeutic cells to the desired site in vivo is an emerging and promising cellular therapy in precision medicine. This paper presents the development of a magnet-driven and image-guided degradable microrobot that can precisely deliver engineered stem cells for orthotopic liver tumor treatment. The microrobot employs a burr-like porous sphere structure and is made with a synthesized composite to fulfill degradability, mechanical strength, and magnetic actuation capability simultaneously. The cells can be spontaneously released from the microrobots on the basis of the optimized microrobot structure. The microrobot is actuated by a gradient magnetic field and guided by a unique photoacoustic imaging technology. In preclinical experiments on nude mice, microrobots carrying cells are injected via the portal vein and the released cells from the microrobots can inhibit the tumor growth greatly. This paper reveals for the first time of using degradable microrobots for precise delivery of therapeutic cells in vascular tissue and demonstrates its therapeutic effect in preclinical test.

Medical Imaging of Microrobots: Toward In Vivo Applications

Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications.

Micro/nanoscale magnetic robots for biomedical applications

Magnetic small-scale robots are devices of great potential for the biomedical field because of the several benefits of this method of actuation. Recent work on the development of these devices has seen tremendous innovation and refinement toward ​improved performance for potential clinical applications. This review briefly details recent advancements in small-scale robots used for biomedical applications, covering their design, fabrication, applications, and demonstration of ability, and identifies the gap in studies and the difficulties that have persisted in the optimization of the use of these devices. In addition, alternative biomedical applications are also suggested for some of the technologies that show potential for other functions. This study concludes that although the field of small-scale robot research is highly innovative ​there is need for more concerted efforts to improve functionality and reliability of these devices particularly in clinical applications. Finally, further suggestions are made toward ​the achievement of commercialization for these devices.

Sperm Cell Driven Microrobots-Emerging Opportunities and Challenges for Biologically Inspired Robotic Design

With the advent of small-scale robotics, several exciting new applications like Targeted Drug Delivery, single cell manipulation and so forth, are being discussed. However, some challenges remain to be overcome before any such technology becomes medically usable; among which propulsion and biocompatibility are the main challenges. Propulsion at micro-scale where the Reynolds number is very low is difficult. To overcome this, nature has developed flagella which have evolved over millions of years to work as a micromotor. Among the microscopic cells that exhibit this mode of propulsion, sperm cells are considered to be fast paced. Here, we give a brief review of the state-of-the-art of Spermbots - a new class of microrobots created by coupling sperm cells to mechanical loads. Spermbots utilize the flagellar movement of the sperm cells for propulsion and as such do not require any toxic fuel in their environment. They are also naturally biocompatible and show considerable speed of motion thereby giving us an option to overcome the two challenges of propulsion and biocompatibility. The coupling mechanisms of physical load to the sperm cells are discussed along with the advantages and challenges associated with the spermbot. A few most promising applications of spermbots are also discussed in detail. A brief discussion of the future outlook of this extremely promising category of microrobots is given at the end.

Nano-and Micromotors Designed for Cancer Therapy

Research on nano- and micromotors has evolved into a frequently cited research area with innovative technology envisioned for one of current humanities' most deadly problems: cancer. The development of cancer targeting drug delivery strategies involving nano-and micromotors has been a vibrant field of study over the past few years. This review aims at categorizing recent significant results, classifying them according to the employed propulsion mechanisms starting from chemically driven micromotors, to field driven and biohybrid approaches. In concluding remarks of section 2, we give an insight into shape changing micromotors that are envisioned to have a significant contribution. Finally, we critically discuss which important aspects still have to be addressed and which challenges still lie ahead of us.