Nama : AMALIA CHOIRNI SOVAWI

NIM : 4311412056
Silver Nanoparticles in Medicine

Introduction
The field of nanotechnology has grown rapidly over the past few years and
has even ventured into the field of clinical medicine. Out of all kinds of
nanoparticles, silver nanoparticles (Ag NPs) seem to have attracted the most
interests in terms of their potential application. Indeed, the widespread use of this
precious metal in nano-size form from household paints (Holtz, et al., 2012) to
artificial prosthetic devices has imparted significant effects on our daily lives.
Since the first issue in March 2005, this journal has published many quality papers
on silver nanoparticles, both in basic science as well as in more clinically oriented
subjects. In this virtual issue, several important papers over these past few years
have been selected, which will provide readers with further and up-to-date
understanding of synthesis, biological actions, and present applications silver
nanoparticles in medicine.
Synthesis of silver nanoparticles
The first step in obtaining Ag NPs of different sizes is to produce them.
Although their traditional preparation is chemical synthesis based on the chemical
reduction of silver nitrate (Guzman, et al., 2012), Ag NPs can also be synthesized
using biological methods. As seen from the articles by Shahverdi (2007) and
Nanda (2009), Ag NPs can be made by reduction of aqueous Ag ion with the
culture supernatants of bacteria such as Klebsiella pneumoniae or Staphylococcus
aureus. Furthermore, many others even reported the use of fungus to produce Ag
NPs (Gajbhiye, et al., 2009). The overall message here is that various methods
exist for the synthesis of Ag NPs and various preparation methods may result in
nanoparticles containing different substrates on their surface that are exposed to
the biologic environment. No study has been done to compare the efficacy of
different types of Ag NPs made by different methods.
Biological actions of silver nanoparticles
It has been known for a long time that silver compounds are very effective
antibacterial agents against both aerobic and anaerobic bacteria. The use of silver
in nanoparticle form (as compared to its ionic form) seems to have reduced
cellular toxicity but not antibacterial efficacy (Kim, et al., 2007). Indeed, in one of
the journals most cited articles, Kim et al (2007) demonstrated clearly that the
superior antibacterial properties of Ag NPs, are due to the formation of free
radicals from the surface of Ag. The antibacterial spectrum even extended to
antibiotic resistant organisms (Mohanty, et al., 2012). Furthermore, the addition of
antibiotics to Ag NPs has been shown to have synergistic effects against micro-
organisms (Dar, et al., 2013). Strydom et al (2013) also demonstrated that
modification of silver sulphadiazine using dendrimers increased the anti-bacterial
efficacy.
Apart from being an excellent anti-bacterial agent, Ag NPs appears to have
anti-inflammatory properties as well. Nadworny et al explored the effect of Ag
NPs using a porcine model of contact dermatitis. Here, it was confirmed that Ag
NPs had direct anti-inflammatory effects and improved the healing process
significantly when compared with controls (Nadworny, et al., 2008). Addition of
Ag NPs reduced the production of pro-inflammatory cytokines such as
interleukin-6, tumor necrosis factor-alpha and interferon-gamma, although the
intracellular pathways involved still remains largely not elucidated.
Applications of silver nanoparticles in medicine
The availability of silver nanoparticles has ensured a rapid adoption in
medical practice. Their application can be broadly divided into diagnostic and
therapeutic uses. Early diagnosis to any disease condition is vital to ensure that
early treatment is started and perhaps resulting in a better chance of cure. This is
particularly true for cancer. Lin, et al (2011) reported silver nanoparticle based
Surface-enhanced Raman spectroscopy (SERS) in non-invasive cancer detection.
This approach is highly promising and may prove to be an indispensable tool for
the future.
In terms of therapeutics, one of the most well documented and commonly
used application of silver nanoparticles is in wound healing. Compared with other
silver compounds, many studies have demonstrated the superior efficacy of Ag
NPs in healing time, as well as achieving better cosmetic after healing. Although
the exact mechanisms for these biological effects has not yet been elucidated, an
article by Kwan, et al (2011) did shed some light on this subject. Here, it was
shown that in wounds treated with Ag NPs, there was better collagen alignment
after healing when compared to controls, which resulted in better mechanical
strength.
For oncology, Tse et al (2011) presented a novel method to selectively
destroy cancer cells. Human epidermoid cancer cell line was targeted with folated
silver-dendrimer composite nanodevices and the labeled cancer cells were
subsequently destroyed by the microbubbles generated through increased uptake
of laser light energy by Ag Nps.
Are silver nanoparticles toxic?
With the use of silver nanoparticles in many clinical conditions, potential
toxicity remains a concern. Indeed , hypersensitivity reactions have been reported
in a small proportion of burn patients who received ionic silver treatment. A few
in-vitro studies have also showed some evidence of nanoparticles being harmful
to some cell lines. The toxicity seems to correlate with smaller particle size
(Gutierrez, et al., 2012). In contrast, others have shown the relative non-toxic
nature of Ag NPs, and the overall significance and toxicity in the in vivo setting,
and the applicability to human are not known (Brandt, et al., 2012).
Currently, silver nanoparticle based wound dressings are used in the clinics
and these have been commonly used for many years with no reported systemic
toxicity to the FDA thus far. Taken together, it would seem that silver
nanoparticles would be safe to use at low doses.
Conclusion
In this virtual issue, we have seen that the advance in nanotechnology has
enabled us to synthesize silver nanoparticles, which would appear to satisfy many
beneficial aspects for clinical use. Nonetheless, it is still far too early to say that
the panacea is already here. The exact cellular pathways are not known and
without further elucidation and study, we cannot guarantee there would not be any
complications for the silver nanoparticles after prolonged use. This will only be
resolved by further efforts through research.
References
Holtz, R.D., Lima BA, Souza Filho AG, Brocchi M, Alves OL. 2012.
Nanostructured silver vanadate as a promising antibacterial additive to
water-based paints. Nanomedicine: Nanotechnology, Biology and Medicine;
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Guzman, M., Dille J, Stphane Godet S. 2012. Synthesis and antibacterial activity
of silver nanoparticles against gram-positive and gram-negative
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Shahverdi, A.R., Fakhimi A, Shahverdi HR, Minaian S. 2007. Synthesis and effect
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