Nanomedicine Strategies in the Management of Inflammatory Bowel Disease and Colorectal Cancer

Abstract

The gut microbiota has emerged as a key area of biomedical research due to its integral role in maintaining host health and its involvement in the pathogenesis of many systemic diseases. Growing evidence supports the notion that gut dysbiosis contributes significantly to diseases and their progression. An example would be inflammatory bowel disease (IBD), a group of conditions that cause inflammation and swelling of the digestive tract, with the principal types being ulcerative colitis (UC) and Crohn's disease (CD). Another notable disease with significant association to gut dysbiosis would be colorectal cancer (CRC), a malignancy which typically begins as polyps in the colon or rectum, but has the potential to metastasise to other parts of the body, including the liver and lungs, among others. Concurrently, advances in nanomedicine, an evolving field that applies nanotechnology for disease prevention, diagnosis, and treatment, have opened new avenues for targeted and efficient therapeutic strategies. In this paper, we provide an overview of the gut microbiota and the implications of its dysregulation in human disease. We then review the emerging nanotechnology-based approaches for both therapeutic and diagnostic purposes, with a particular focus on their applications in IBD and CRC.

Keywords: colorectal cancer; drug delivery systems; gut dysbiosis; inflammatory bowel disease; nanodiagnostics; nanomedicine; nanotherapeutics.

Figure 1

A comparison between a healthy gut and the diseased guts observed in IBD and CRC. Abbreviations: CRC: colorectal cancer; IBD: inflammatory bowel disease; SCFA: short chain fatty acid.

Figure 2

(A–C) Nanomedicine-enabled diagnostics for (A) general dysbiosis, (B) inflammatory bowel disease and (C) colorectal cancer. Abbreviations: Ag: silver; aSlex: anti-Slex; AuNP: gold nanoparticle; CRC: colorectal cancer; Dex-CeNP: dextran coated cerium oxide nanoparticle; HCFA: hypoxia-activatable and cytoplasmic protein-powered fluorescence cascade amplifier; IBD: inflammatory bowel disease; In2O3: indium (111) oxide; MGF: mechano-growth factor; PANAM: poly(amidoamine); SPION: superparamagnetic iron oxide nanoparticle.

Figure 3

Targeted drug delivery systems are a form of nanotherapeutics for IBD. Abbreviations: 5-ASA: 5-aminosalicylic acid; B-ATK-T: Bud-ATK-Tem; Csn: chitosan; IBD: inflammatory bowel disease; PPNP: polyphenols and polymers self-assembled nanoparticle.

Figure 4

Nanotherapeutics for CRC. Abbreviations: 5-FU: fluorouracil; AuNP: gold nanoparticle; CRC: colorectal cancer; Csn: chitosan; DOX: doxorubicin; EGF: epidermal growth factor; EpCAM: epithelial cell adhesion molecule; GNC: gold nanocages; MNP: magnetic nanoparticle; PEG: polyethylene glycol; PFC: perfluorocarbon; PLGA: poly (lactic-co-glycolic acid); PSiNP: porous silicon nanoparticle; PTT: photothermal therapy; SPION: superparamagnetic iron oxide nanoparticle.

Figure 5

Nanotechnology-based microbiome modulators offer novel therapeutic avenues in IBD and CRC. Abbreviations: Ag-LNP: silver/Lactobacillus rhamnosus GG nanoparticle; AuNP: gold nanoparticle; CRC: colorectal cancer; Csn: chitosan; CuONP: copper oxide nanoparticle; LP: lactobacillus plantarum; Pcn: pectin; PG: poly(L-glutamic acid); PL: poly(L-lysine); PLGA: poly (lactic-co-glycolic acid); PPN: phthalyl pullulan nanoparticle.

Figure 6

Nanotherapeutics in inflammatory bowel disease include nanoparticles with anti-inflammatory and antioxidant properties and microbiome modulation. Abbreviations: Ag: silver; DSPE: 1,2-distearoyl-sn-glycero-3-phosphoethanolamine; GLP-1-SSM: GLP-1 in sterically stabilised phospholipid micelles; HABN: hyaluronic acid-bilirubin nanomedicine; MON-PEI: polyethylenimine-mesoporous organosilica; OxbCD: β-cyclodextrin-derived material; PEG: polyethylene glycol; TACS: Ta2C modified with chondroitin sulfate.

Figure 7

Nanotherapeutics in CRC include microbiome modulation. Abbreviation: CRC: colorectal cancer.

Figure 8

Roadmap for clinical translation of nanomedicine in IBD and CRC.