A lot of earlier work on drug design aimed to find ways to attach the drug to a particular target. Your work seems to be much
more about time.
There are diseases in which there is a certain chronobiological response that needs to be taken into consideration. So as
we're developing intelligent systems that respond to internal conditions, we are also looking at whether particular patients
might need a drug to be released only at specific times of the day.
For example, it is well documented that heart attacks happen primarily early in the morning, and so we are interested in developing
systems that can be taken by the patient the previous evening and that will be triggered and release the drug at about six
o'clock in the morning.
But our work is much more general than that. Our work really has the major vision that you can trigger a process of release
if you identify the undesirable compound that is responsible for a disease. For example, we're working a lot now with high
blood pressure and we know that angiotensin II is present in high blood pressure situations. We're trying to see how we can
use that information to detect very early changes in the blood pressure and immediately respond by providing an appropriate
Some of these systems seem to blur the line between drugs and diagnostics.
True. As you know, it is impossible for a doctor to be checking an individual patient all the time, and if we had a system
that could automatically check for particular functions and report to the doctor's office, that would be a much improved system.
In some conditions, the progress of the disease takes place over six months, a year, two years. Yet because of the way our
insurance system is run, we don't have the ability to test the patient continuously. Multiple sclerosis, for example, is an
autoimmune disease that can develop over the period of several years. One of its major exhibitions is the formation of lesions
characterized by demyelinization of the nerves. Sometimes the patient will have symptoms—for example, numbness or neuropathy.
But often it is not obvious to the patient that the number of lesions has been increasing.
If we could come up with nanoparticles that detect minute amounts of a chemical compound involved in the demyelinization,
and if, let's say, we could read that information through a wristwatch that the patient would wear to the doctor's office,
the doctor would know if there is deterioration in the patient in real time and not have to wait for an annual MRI.
When we talk about intelligent therapeutics and smart delivery, we're talking at the same time of some form of telemedicine.
And that's why organizations like NASA and NIH are very interested supporting this type of work.
Are there applications of intelligent therapeutics in oral drugs?
Yes. For example, we are working on systems to recognize undesirable activities in the stomach or upper small intestine. We're
interested for example in how celiac disease [a digestive disease in which the body has an autoimmune reaction to a protein
found in wheat and other grains] could be treated.
Chaitan Khosla at Stanford University has identified a 33–amino acid compound that seems to be the main compound responsible
for starting the autoimmune response. We are looking at ways to use that as a triggering mechanism, so as soon as the stomach
of the celiac patient detects this compound, immediately something will come in and break it down.
These nice ideas, but at the same time I want to remind you, when you play with the immune system, there have to be a lot
of studies before anything will be approved. We're talking about systems that probably our kids will be working with 20 years
Nicholas Peppas is the Fletcher Stuckey Pratt Chair in engineering at the University of Texas at Austin. He is the author of 900 publications
and 25 books and holds 20 US and international patents. Products that he has developed, patented, or commercialized include
intraocular lenses for cataract patients; improved materials for cartilage replacement; biogels for epidermal release of growth
factors to improve wound healing; new materials for artificial heart linings; materials for vocal cord replacement or reconstruction;
and oral delivery systems of insulin to type I diabetic patients. He received the 2005 Founders Award of the Society for Biomaterials
for "seminal and pioneering contributions to the field of biomaterials," and in June, he was inducted into the French Academy