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Review
. 2016 Apr;1(1):19-29.
doi: 10.1002/jin2.6. Epub 2016 Apr 18.

Polymer therapeutics in surgery: the next frontier

Ernest A Azzopardi  1 , R Steven Conlan  2 , Iain S Whitaker  1
Affiliations
Review

Polymer therapeutics in surgery: the next frontier

Ernest A Azzopardi et al. J Interdiscip Nanomed. 2016 Apr.

Abstract

Polymer therapeutics is a successful branch of nanomedicine, which is now established in several facets of everyday practice. However, to our knowledge, no literature regarding the application of the underpinning principles, general safety, and potential of this versatile class to the perioperative patient has been published. This study provides an overview of polymer therapeutics applied to clinical surgery, including the evolution of this demand-oriented scientific field, cutting-edge concepts, its implications, and limitations, illustrated by products already in clinical use and promising ones in development. In particular, the effect of design of polymer therapeutics on biophysical and biochemical properties, the potential for targeted delivery, smart release, and safety are addressed. Emphasis is made on principles, giving examples in salient areas of demand in current surgical practice. Exposure of the practising surgeon to this versatile class is crucial to evaluate and maximise the benefits that this established field presents and to attract a new generation of clinician-scientists with the necessary knowledge mix to drive highly successful innovation.

Keywords: nanomedicine; nanotechnology; polymer.

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Figures

Figure 1
Figure 1
The five main subdisciplines of nanomedicine (European forward look consensus conference, 2004, and the relationship of polymer therapeutics to these subdisciplines).
Figure 2
Figure 2
Diagrammatic representation of different types of polymer therapeutics. The presence of a water‐soluble polymer is the common denominator. Examples are given in parentheses. (a) Polymeric drug; (b) polymeric drug modified by the addition of pendant groups; (c) polymer–protein conjugate; (d) polymer–drug conjugate; and (e) PEGylated micelles.
Figure 3
Figure 3
The polymer mask–unmask protein therapy principle. During transit, the polymer “masks” the bioactive from the body, at the same time shielding the body from potential toxicity. At the target site, the bioresponsive polymer is degraded (using various approaches) to release back the bioactive molecule, with its activity reinstated.
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