Creating a magic bullet that can selectively kill cancer cells while sparing nearby healthy cells remains one of the most ambitious objectives in pharmacology. Nanomedicine, which relies on the use of nanotechnologies to fight disease, was envisaged to fulfill this coveted goal. Despite substantial progress, the structural complexity of therapeutic vehicles impedes their broad clinical application. Novel modular manufacturing approaches for engineering programmable drug carriers may be able to overcome some fundamental limitations of nanomedicine. We discuss how bottom-up synthetic biology principles, empowered by microfluidics, can palliate current drug carrier assembly limitations, and we demonstrate how such a magic bullet could be engineered from the bottom up to ultimately improve clinical outcomes for patients.
Drug-Delivery Challenges: Opportunities for Bottom-Up Synthetic BiologyPaul Ehrlich, considered to be the pioneer and founder of modern chemotherapy, envisaged a therapeutic capable of directly interreacting with its intended disease-causing cellular structure while remaining harmless to the surrounding healthy cell population. Depicted as a magic bullet, his idea has greatly influenced and fascinated various fields of science for more than a century [1]. Among them, the field of nanomedicine (see Glossary)which relies on nanotechnologies to improve passive and active accumulation of drugs nearby target pathogens or cell populationswas expected to achieve this highly coveted goal. Despite its major focus on oncology, nanomedicine has also triggered the engineering of an arsenal of novel nanotechnologies and functionalization strategies. Overall, these innovations have resulted in a variety of enhanced bio-and physico-chemical properties for inorganic-, polymer-, and lipid-based nanometric carriers.Despite recent progress, nanomedicine is often synonymous with modest clinical translation and remains the focus of significant debate (as reviewed extensively [2-4]). Isolated examples of success, namely Doxil® [5,6], Abraxane® [7], and most recently Onpattro® [8], are few, and greater success in the design of nanoformluated drugs in the near future remains unlikely because several barriers will need to be overcome to achieve effective and specific delivery of drug-loaded carriers.Targeted delivery of therapeutics may be organized into different levels, referred to as primary, secondary, and tertiary targeting. These levels are defined by the degree of target specificity and control over release dynamics, which increase along the chain [9]. This targeting hierarchy is summarized and illustrated in Boxes 1 and 2, and also in Figure 1. Briefly, primary targeting, or the targeting of specific organs, is highly size-dependent since smaller nanomaterials are expected to transit through the blood-brain barrier [10][11][12], or navigate through the fenestrated vessels in the liver endothelium or tumor environment more easily [13]. However, this size discrimination may be circumvented by meticulously engineering t...