Biosensors and Nanotheranostics
Promise and Pitfalls of Nanotechnology in Healthcare: Applications, Safety, and Ethical Considerations
Yoghinni Manogaran 1*, Ahmed Ahmed Al-Akwaa 2
Biosensors and Nanotheranostics 5 (1) 1-8 https://doi.org/10.25163/biosensors.5110980
Submitted: 27 November 2025 Revised: 20 January 2026 Accepted: 28 January 2026 Published: 30 January 2026
Abstract
Few technologies have entered medicine with as much expectation as nanotechnology. By engineering materials between 1 and 100 nm, the scale of proteins and nucleic acids, researchers have built carriers that home in on tumours, contrast agents that reveal lesions invisible to conventional imaging, and lipid vehicles that made mRNA vaccination possible during the COVID-19 pandemic. Yet the properties that make these materials useful, namely their small size, large reactive surface, and ability to cross biological barriers, also make their behaviour in the body and the environment hard to predict. This integrative review deliberately brings together the clinical, toxicological, ethical, and regulatory literature, usually read in isolation. Peer-reviewed studies, reviews, and regulatory documents published between 2004 and 2026 were identified through structured database searching and citation tracking, then charted and synthesised thematically across four domains. The evidence suggests that clinical maturity is uneven: liposomal and albumin-bound chemotherapeutics, iron-oxide contrast agents, and mRNA-lipid nanoparticle vaccines are established, whereas theranostic, regenerative, and brain-targeted platforms remain largely preclinical. Toxicological concerns converge on oxidative stress, autophagic and lysosomal dysfunction, reticuloendothelial accumulation, and fibre-like pathogenicity of high-aspect-ratio carbon nanotubes, alongside poorly characterised occupational and ecological exposure. Ethically, nanomedicine seems less to create new dilemmas than to intensify familiar ones, notably informed consent under uncertainty, data privacy, enhancement, and a widening "nano-divide". Regulation remains fragmented between product-based and precautionary models. We argue that safety-by-design, mechanism-based alternative testing, harmonised definitions, and early public engagement are urgently needed if nanomedicine is to deliver its benefits safely and fairly.
Keywords: nanomedicine; engineered nanomaterials; targeted drug delivery; nanotoxicology; ecotoxicology; nanoethics; ELSI; regulatory science; alternative testing strategies
References
Allon, I., Ben-Yehudah, A., Dekel, R., Solbakk, J.-H., Weltring, K.-M., & Siegal, G. (2016). Ethical issues in nanomedicine: Tempest in a teapot? Medicine, Health Care and Philosophy, 19(4), 621–629. https://doi.org/10.1007/s11019-016-9706-9
Baran, A. (2016). Nanotechnology: Legal and ethical issues. Engineering Management in Production and Services, 8(1), 37–43. https://doi.org/10.1515/emj-2016-0005
Blanco, E., Shen, H., & Ferrari, M. (2015). Principles of nanoparticle design for overcoming biological barriers to drug delivery. Nature Biotechnology, 33(9), 941–951.
Butt, A., & Bach, H. (2024). Nanomedicine and clinical diagnostics part I: Applications in conventional imaging (MRI, X-ray/CT, and ultrasound). Nanomedicine, 20(2), 167–182. https://doi.org/10.1080/17435889.2024.2439776
Chaturvedi, V. K., Singh, A., Singh, V. K., & Singh, M. P. (2019). Cancer nanotechnology: A new revolution for cancer diagnosis and therapy. Current Drug Metabolism, 20(6), 416–429. https://doi.org/10.2174/1389200219666180918111528
Choi, J.-S. (2005). On the convergence of bio-, information-, environmental-, energy-, space- and nano-technologies. International Journal of Technology, Policy and Management, 5(4), 946–955.
Choi, J.-Y., & Ramachandran, G. (2009). Review of the OSHA framework for oversight of occupational environments. Journal of Law, Medicine & Ethics, 37(4), 633–650. https://doi.org/10.1111/j.1748-720X.2009.00436.x
Desai, C. (2012). Ethics in nanomedicine: Diagnostic and therapeutic implications. Indian Journal of Pharmaceutical Sciences, 74(3), 189–197.
Durgam, L. K., & Oroszi, T. L. (2025). Revolutionizing healthcare: The transformative potential of nanotechnology in medicine. Frontiers in Drug Delivery, 5, 1556426. https://doi.org/10.3389/fddev.2025.1556426
Ebbesen, M., Andersen, S., & Besenbacher, F. (2006). Ethics in nanotechnology. Small, 2(4), 450–458. https://doi.org/10.1002/smll.200500360
Ecovoiu, A. A., Ciobanu, D. A., Graur, M., & Burlibasa, L. (2016). In vivo assessment of nanoparticle toxicity using the Drosophila melanogaster model. International Journal of Molecular Sciences, 17(2), 36. https://doi.org/10.3390/ijms17020036
European Commission. (2011). Commission recommendation of 18 October 2011 on the definition of nanomaterial (2011/696/EU). Official Journal of the European Union, L 275, 38–40.
European Group on Ethics (Hermerén, G.). (2007). Ethical aspects of nanomedicine: A condensed version of the EGE Opinion 21. In Ethical Aspects of Nanomedicine (pp. 135–148). Springer.
Gao, L., Wang, J., & Bi, Y. (2025). Nanotechnology for neurodegenerative diseases: Recent progress in brain-targeted delivery, stimuli-responsive platforms, and organelle-specific therapeutics. International Journal of Nanomedicine, 20, 11015–11044.
Gordijn, B. (2006). Converging NBIC technologies for improving human performance: A critical assessment of the novelty and the prospects of the project. Journal of Law, Medicine & Ethics, 34(1), 2–8. https://doi.org/10.1111/j.1748-720X.2006.00002.x
Hannah, W. (2008). Assessing the health and environmental risks of nanotechnology. Health, Risk & Society, 10(2), 147–163. https://doi.org/10.1080/13698570802030787
Hogle, L. F. (2009). Science, ethics, and the “problems” of governing nanotechnologies. Journal of Law, Medicine & Ethics, 37(4), 749–758. https://doi.org/10.1111/j.1748-720X.2009.00445.x
IEEE. (2009). Ethical issues in nanotechnology development and research. IEEE GCC Conference Proceedings, 1–5. https://doi.org/10.1109/IEEEGCC.2009.5734236
Jia, J., Wu, X., Long, G., Yu, J., He, W., Zhang, H., & Liu, Y. (2023). Revolutionizing cancer treatment: Nanotechnology-enabled photodynamic therapy and immunotherapy with advanced photosensitizers. Frontiers in Immunology, 14, 1219785. https://doi.org/10.3389/fimmu.2023.1219785
Johnston, H. J., Verdon, R., Gillies, S., Brown, D. M., Fernandes, T. F., Henry, T. B., Rossi, A. G., Tran, L., Tucker, C., Tyler, C. R., & Stone, V. (2018). Adoption of in vitro systems and zebrafish embryos as alternative models for reducing rodent use in assessments of immunological and oxidative stress responses to nanomaterials. Critical Reviews in Toxicology, 48(3), 252–271. https://doi.org/10.1080/10408444.2017.1418280
Kato, Y. (2009). Elaborating the list of nanotech-related ethical issues. NanoEthics, 3(3), 211–219. https://doi.org/10.1007/s11569-009-0073-7
Kermisch, C. (2012). Do new ethical issues arise at each stage of nanotechnological development? NanoEthics, 6(1), 29–37. https://doi.org/10.1007/s11569-011-0137-z
Krewski, D., Acosta, D., Jr., Andersen, M., Anderson, H., Bailar, J. C., III, Boekelheide, K., Brent, R., Charnley, G., Cheung, V. G., Green, S., Jr., & Zeise, L. (2010). Toxicity testing in the 21st century: A vision and a strategy. Journal of Toxicology and Environmental Health, Part B, 13(2–4), 51–138. https://doi.org/10.1080/10937404.2010.483176
Lam, C. W., James, J. T., McCluskey, R., Arepalli, S., & Hunter, R. L. (2006). A review of carbon nanotube toxicity and assessment of potential occupational and environmental health risks. Critical Reviews in Toxicology, 36(3), 189–217. https://doi.org/10.1080/10408440600570233
Ma, X., Tian, Y., Yang, R., Wang, H., Allahou, L. W., Chang, J., Williams, G., Knowles, J. C., & Poma, A. (2024). Nanotechnology in healthcare, and its safety and environmental risks. Journal of Nanobiotechnology, 22(1), 715. https://doi.org/10.1186/s12951-024-02901-x
Mao, B. H., Tsai, J. C., Chen, C. W., Yan, S. J., & Wang, Y. J. (2016). Mechanisms of silver nanoparticle-induced toxicity and important role of autophagy. Nanotoxicology, 10(8), 1021–1040. https://doi.org/10.1080/17435390.2016.1189614
Maynard, A. D. (2006). Nanotechnology: Assessing the risks. Nano Today, 1(2), 22–33. https://doi.org/10.1016/S1748-0132(06)70044-8
Maynard, A. D., & Kuempel, E. D. (2005). Airborne nanostructured particles and occupational health. Journal of Nanoparticle Research, 7(6), 587–614. https://doi.org/10.1007/s11051-005-6770-9
Mehlich, J., & Thiele, F. (2014). Nanomedicine: Visions, risk, potential. European Journal of Nanomedicine, 6(1), 47–52. https://doi.org/10.1515/ejnm-2013-0012
Mills, K., & Fleddermann, C. (2005). Getting the best from nanotechnology: Approaching social and ethical issues openly and proactively. IEEE Technology and Society Magazine, 24(4), 18–26. https://doi.org/10.1109/MTAS.2005.1563539
Mitchell, M. J., Billingsley, M. M., Haley, R. M., Wechsler, M. E., Peppas, N. A., & Langer, R. (2021). Engineering precision nanoparticles for drug delivery. Nature Reviews Drug Discovery, 20(2), 101–124. https://doi.org/10.1038/s41573-020-0090-8
Naseri, N., Ajorlou, E., Asghari, F., & Pilehvar-Soltanahmadi, Y. (2018). An update on nanoparticle-based contrast agents in medical imaging. Artificial Cells, Nanomedicine, and Biotechnology, 46(6), 1111–1121. https://doi.org/10.1080/21691401.2017.1379014
National Research Council. (2007). Toxicity testing in the 21st century: A vision and a strategy. National Academies Press. https://doi.org/10.17226/11927
Occhiutto, M. L., Maranhão, R. C., Costa, V. P., & Konstas, A. G. (2020). Nanotechnology for medical and surgical glaucoma therapy—A review. Advances in Therapy, 37(1), 155–199. https://doi.org/10.1007/s12325-019-01163-6
Oftedal, G. (2014). The role of responsibility in Responsible Research and Innovation. Neuroethics, 7(3), 327–337. https://doi.org/10.1007/s12152-014-9212-0
Ok, Z. D., & Benneyan, J. C. (2009). A review of non-toxicological nano-EHS risk analysis literature. IEEE Transactions on Nanotechnology, 8(3), 258–264. https://doi.org/10.1109/TNANO.2008.2009525
Patel, A., Mukundan, S., Wang, W., Karumuri, A., Sant, V., Mukhopadhyay, S. M., & Sant, S. (2016). Carbon-based hierarchical scaffolds for myoblast differentiation: Synergy between nano-functionalization and alignment. Acta Biomaterialia, 32, 77–88. https://doi.org/10.1016/j.actbio.2016.01.004
Purohit, R., Sharma, P., & Yoganadam, K. (2017). Applications and effects of nanomaterials on society and environment. Materials Today: Proceedings, 4(4), 5461–5467. https://doi.org/10.1016/j.matpr.2017.06.001
Renn, O., & Roco, M. C. (2006). Nanotechnology and the need for risk governance. Journal of Nanoparticle Research, 8(2), 153–191. https://doi.org/10.1007/s11051-006-9092-7
Resnik, D. B. (2004). Financial interests and research bias. Accountability in Research, 11(3–4), 245–265.
Resnik, D. B., & Tinkle, S. S. (2007). Ethics in nanomedicine. Nanomedicine, 2(3), 345–350. https://doi.org/10.2217/17435889.2.3.345
Ruan, W. J., Xu, S. S., Xu, D. H., & Li, Z. P. (2024). Orthopedic revolution: The emerging role of nanotechnology. World Journal of Orthopedics, 15(10), 932–938. https://doi.org/10.5312/wjo.v15.i10.932
Sahoo, S., Parveen, S., & Panda, J. J. (2010). Socio-ethical issues and nanotechnology development: Perspectives from India. Journal of Nanoscience and Nanotechnology, 10(1), 1–8.
Schaeffer, D. M., & Olson, P. C. (2017). Current and future ethical issues in nanotechnology. IEEE International Conference on Nanotechnology, 1–6.
Schulte, P. A., & Salamanca-Buentello, F. (2007). Ethical and scientific issues of nanotechnology in the workplace. Ciência & Saúde Coletiva, 12(5), 1319–1332. https://doi.org/10.1590/S1413-81232007000500020
Setyawati, M. I., Yuan, X., Xie, J. P., & Leong, D. T. (2014). The influence of lysosomal stability of silver nanomaterials on their toxicity to human cells. Biomaterials, 35(25), 6707–6715. https://doi.org/10.1016/j.biomaterials.2014.04.108
Tegart, G. (2008). Environmental and ethical aspects of nanotechnologies. NanoEthics, 2, 1–7.
Uskokovic, V. (2021). Nanomedicine for the poor: A lost cause or an idea whose time has yet to come? Nanomedicine, 16(14), 1203–1218. https://doi.org/10.2217/nnm-2021-0089
van de Poel, I. (2008). How should we do nanoethics? A proposal for the ethical analysis of nanotechnology R&D. NanoEthics, 2(1), 25–38. https://doi.org/10.1007/s11569-008-0026-y
Vega-Alvarez, S., Herrera, A., Rinaldi, C., & Carrero-Martínez, F. A. (2014). Tissue-specific direct microtransfer of nanomaterials into Drosophila embryos as a versatile in vivo test bed for nanomaterial toxicity assessment. International Journal of Nanomedicine, 9, 2031–2041. https://doi.org/10.2147/IJN.S58359
Vinken, M., & Blaauboer, B. J. (2017). In vitro testing of basal cytotoxicity: An adverse outcome pathway perspective. Toxicology in Vitro, 40, 47–61. https://doi.org/10.1016/j.tiv.2016.12.008
Wilson, B., & Geetha, K. M. (2022). Lipid nanoparticles in the development of mRNA vaccines for COVID-19. Journal of Drug Delivery Science and Technology, 74, 103553. https://doi.org/10.1016/j.jddst.2022.103553
Wu, Y.-H., Wang, Y.-J., & Chuang, C.-C. (2020). Mechanism-based alternative testing strategies for nanomaterial safety assessment. International Journal of Molecular Sciences, 21(7), 2387. https://doi.org/10.3390/ijms21072387
Yeagle, J. (2007). Nanotechnology and the FDA. Virginia Journal of Law and Technology, 12(6), 2–20.
Zhao, Y., Howe, J. L., Yu, Z., Leong, D. T., Chu, J. J., Loo, J. S., & Ng, K. W. (2013). Exposure to titanium dioxide nanoparticles induces autophagy in primary human keratinocytes. Small, 9(3), 387–392. https://doi.org/10.1002/smll.201201590