Understanding the Pathological Basis of Neurological Diseases Through Diagnostic Platforms Based on Innovations in Biomedical Engineering: New Concepts and Theranostics Perspectives

Abstract

The pace of advancement of genomics and proteomics together with the recent understanding of the molecular basis behind rare diseases could lead in the near future to significant advances in the diagnosing and treating of many pathological conditions. Innovative diagnostic platforms based on biomedical engineering (microdialysis and proteomics, biochip analysis, non-invasive impedance spectroscopy, etc.) are introduced at a rapid speed in clinical practice: this article primarily aims to highlight how such platforms will advance our understanding of the pathological basis of neurological diseases. An overview of the clinical challenges and regulatory hurdles facing the introduction of such platforms in clinical practice, as well as their potential impact on patient management, will complement the discussion on foreseeable theranostic perspectives. Indeed, the techniques outlined in this article are revolutionizing how we (1) identify biomarkers that better define the diagnostic criteria of any given disease, (2) develop research models, and (3) exploit the externalities coming from innovative pharmacological protocols (i.e., those based on monoclonal antibodies, nanodrugs, etc.) meant to tackle the molecular cascade so far identified.

Keywords: biomarkers; nanotechnology; neurosurgery; precision medicine; proteomics.

Figure 1

Schematic assembly of a lab-on-a-chip device. The initial cell sorting allows for the identification of relevant cells, such as cancer stem cells (CSCs), thanks to the recognition of superficial antigens; following immobilization of those cells into microwells, the step of biomarkers identification is obtained through functionalized arrays positioned on top of each microwells.

Figure 2

Protease-activated drug delivery. Following identification of their targets, the release of a prodrug encapsulated in theranostic agents, based for instance on nanospheres of hyaluronic acid or quantum dot gelatin nanoparticles, is obtained through cleavage of their scaffold by enzymes highly expressed in tumors (such as hyaluronidase or matrix metalloproteinase 2).