Nanotechnology: improving clinical testing?

The modern-day clinical laboratory has evolved in response to clinical demands and a need to adopt a steady stream of new technologies. Among the technological innovations that have had a large impact are computing and informatics, automation, antibody-based analytical methods, nucleic acid sequencing and probing techniques, sensor technology, and luminescence-based sensing techniques, such as chemiluminescence and fluorescence. The changing landscape of healthcare provides a continuing stimulus to the evolution of clinical testing, both in central laboratories and at the point of care. Progress in miniaturization has created devices with micrometer-sized features designed to perform a range of assays and that integrate all of the steps in an assay onto a single small device—the so-called lab-on-a-chip. The next step in miniaturization is the descent from the micrometer scale to the nanometer scale and the exploitation of nanotechnology—nanosized structures in the interval from 1 to 100 nm. Nanotechnology is now a major area of research and development. Many applications for nanosized materials (e.g., nanoparticles) have emerged in in vitro diagnostics, imaging, and therapeutics. In common with many types of new development, the arrival of nanotechnology has been heralded by considerable hype about its potential and future promise, but these high expectations have been tempered by concerns over the technology’s safety (1 ). This new technological area is multifaceted and already has found extensive applications in 1000 consumer products (http://sis.nlm.nih.gov/enviro/nanotechnology. html; http://www.nanotechproject.org/inventories/ consumer/). In clinical testing, 2 avenues of exploitation that have emerged are the use of nanoscale materials as reagents (e.g., nanoparticle labels and therapeutic agents) (2, 3) and the development of nanoscale devices (e.g., nanopores) (4 ). The latter is a distant prospect, and most work has centered on the former application.