Visions for the Future

Loss of mobility and therefore independence is critical in the onset of decay and isolation for many older people, and one area in the developed world where people are very dependent for mobility is in the use of a car. Confidence and cognizance decline for many people as they age; in the car of the future there is the possibility to see the true convergence of NBIC in extending independence and warding off part of the decline in the older person. Higher-speed, higher-density computers and effective sensors driven by nanotechnology may combine with on-board artificial intelligence in the car, helping the driver plan routes and avoid hazards and difficult traffic situations. Nanobiotechnology may also be present in on-board minimally invasive biosensors to monitor the driver's health, both in terms of physical stress and physiological condition, to be fed back to the car's computer. In a further interpretation, since the possibility of implanted devices to stimulate or improve cognizance are emerging, the driver may be also benefit from neuronal stimulation designed to keep him or her alert and performing optimally during the trip.

The convergence of NBIC in the field of life extension will lead to implanted devices such as sensors and drug delivery systems being developed to replace or monitor body function. Implanted devices, whether macro or micro in scale, present a problem today in terms of biocompatibility. Implantation of a heart valve in a patient means that a drug regime for anti-coagulation is mandatory — usually through administration of warfarin. Since inflammatory response and immunogenic response take place in vivo, many of the devices being discussed and designed today to improve human performance incorporating nanotechnology will not be implantable because of biocompatibility issues. A further complication will be how to keep a nanodevice biologically or electronically active (or both) during sustained periods of operation in vivo. Sustained exposure to physiological fluid, with its high salt and water content, destroys most electronic devices. Likewise, devices that emit biological molecules or are coated with biological molecules to ensure initial biocompatibility must have their biological components renewed or be destined to become nonfunctional some time after implantation. Little attention is being given to these problems, which may prove major stumbling blocks in the next 10 to 30 years to the successful application of nanotechnology in a range of medical conditions.

A "holistic human project" could bring together the best research clinicians, biomedical engineers, and biomedical scientists to discuss the main life-shortening diseases and conditions and current progress or problems in their treatment or eradication. Together with the nanotechnologists, areas where conventional medicine has not been successful could be identified as strategic targets for nanobiotechnology. Specific project calls could follow in these areas, with the condition that the applicants' teams must show sufficient interdisciplinary interaction to provide a comprehensive understanding of the nature of the problem. The opportunities are immense, but the resources available are not unlimited, and only strategic planning for project groups and project themes will realize the maximum benefit for biomedicine and society.

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