• Micelles in nanomedicine:Innovations in drug delivery, diagnostics, and Non-ionizing therapies for cancer
  • Bahareh Khalili Najafabad,1 Amirhossein Rashnoodi,2 Zeynab Seraj,3 Niyoosha Zamani,4,*
    4. Shahid Beheshti University of Medical Sciences


  • Introduction: 1. Introduction  Micelles are colloidal aggregates formed by amphiphilic molecules, which contain both hydrophilic (water-absorbing) and hydrophobic (water-repelling) components. Usually, these molecules arrange themselves in a spherical shape in aqueous solutions, with the hydrophilic heads that face outward and the hydrophobic tails inward. This unique structure is critical for micelle formation, as it minimizes the energetic cost of exposing hydrophobic parts to water (1). The critical moment in formation of micelles is when the concentration of amphiphilic molecules exceeds a certain limit, known as the critical micelle concentration (CMC). Below this concentration, the molecules exist as individual molecules, while above it, they self-assemble into micelles (2). This organization results in a hydrophilic outer layer, which mostly interacts with the aqueous environment, and a hydrophobic core that can encapsulate non-polar materials (3). Micelles have some unique properties that make them valuable in many applications. Their ability to solubilize hydrophobic drugs in an aqueous environment enhances drug bioavailability and stability (4). This characteristic is relevant in fields such as gene therapy, where they can facilitate the delivery of nucleic acids, and in imaging techniques and enhance the contrast of diagnostic agents (5, 6) but most importantly in drug delivery systems, where micelles can deliver therapeutic agents directly to target regions, improving efficacy while minimizing side effects of the therapeutic method (7).
  • Methods: Micelles are very useful tools in medicine, but they pose many challenges and limitations that reduce their widespread clinical application in nanomedicine. One of the prevalent challenges is the scalability and reproducibility of micelle production. Changing methods from laboratory level into industrial-scale manufacturing has considerable difficulties. Producing micelles with the same size, composition, and drug-loading capacity is critical for making sure that therapeutic outcomes are uniform. Variations during production can lead to unpredictable pharmacokinetics and pharmacodynamics and underminethe reliability of micelle-based treatments. Plus, many techniques that are effective at a small scale face some barriers when scaled up, which often results in reduced stability and efficacy of the micelle in clinical settings , which makes the way for their applications as standard tools in nanomedicine (108). Another significant obstacle is expanding the regulatory perspective for micelle-based therapies. Regulatory agencies require extensive data to approve such nanocarriers for clinical use, such as comprehensive information on their safety, efficacy, and quality. The process is more complicated by the lack of standardized evaluation criteria specific to nanomedicine. Unlike traditional smallmolecule drugs, micelle formulations must be done with precise characterization to address their unique physicochemical and biological properties. The long-term safety of micelle-based systems is still a concern, as there is limited data on their chronic effects in biological systems. Potential issues include bioaccumulation, unforeseen toxicities, and interactions with complex biological environments (109). BBB Figure 4. Nanocarries crossing BBB The intrinsic properties of micelles also present several limitations that reduce their effectiveness. The nanoscale size of micelles, while suitable for tumor penetration, can also lead to challenges such as rapid renal clearance or unintended uptake by the reticuloendothelial system. These phenomena can reduce the availability of therapeutic agents at the target site and so compromises treatment efficacy. Premature drug release is another important issue because it can result in subtherapeutic concentrations of the drug reaching the target that destroys the overall therapeutic benefit (110). Delivery efficiency is also a significant challenge for micelle-based systems. Making sure that micelles will be stable during circulation and release their payload specifically at the target site is still a difficulty. Micelles can prematurely disintegrate or lose their encapsulated drug due to dilution in the bloodstream or interactions with serum proteins, which further reduces their effectiveness. Identifying these challenges requires an inclusive approach that includes the development of advanced materials for micelle construction, optimization of drug-loading strategies, and integration of targeting mechanisms to improve site-specific delivery (111). To overcome these barriers, interdisciplinary collaboration is essential. Advances in materials science, engineering, and pharmacology are required to establish strong and scalable production processes. At the same time, regulatory frameworks must evolve to provide clear guidelines for the evaluation of nanomedicine-based therapeutics. Comprehensive studies to examine the pharmacokinetics, biodistribution, and long-term safety of micelle-based treatments are crucial to reduce concerns about their chronic use. By addressing these challenges systematically, the full potential of micelles in clinical settings can be realized, paving the way for their adoption as standard tools in nanomedicine.
  • Results: Difficulties of Crossing the BBB and Micelles’ Potential Brain tumors include a wide range of neoplasms with different pathological and clinical characteristics. Their classification is based on the cell of origin and molecular profiles, which influence tumor behavior and treatment response (1). Gliomas, the most common primary brain tumors in adults, include subtypes like glioblastoma (GBM), noted for its aggressive nature, rapid growth, and poor prognosis due to intra-tumoral heterogeneity (87). Meningiomas, arising from the meninges, are the second most common brain tumors, with most being benign (WHO grade I), but some can be atypical (grade II) or malignant (grade III), leading to higher recurrence rates (88). Other types include primitive neuroectodermal tumors (PNETs), such as medulloblastoma, and brain metastases from other cancers (89). Treatment strategies are tailored to the tumor's type, size, location, and the patient's health. Surgical resection is the primary approach, often complemented by radiotherapy and chemotherapy, particularly for high-grade tumors (90). Temozolomide, in combination with radiotherapy, has improved survival rates in GBM patients (91). However, challenges remain, notably the blood-brain barrier (BBB) and tumor heterogeneity, which complicate effective treatment and contribute to recurrence. The blood-brain barrier (BBB) is a highly selective barrier that protects the brain from harmful substances while allowing essential nutrients to pass through. This barrier poses a significant challenge for drug delivery, especially for treating neurological disorders and brain cancers. The BBB's tight junctions and specific transport mechanisms restrict the entry of most drugs, making it difficult to achieve therapeutic concentrations in the brain (92, 93). The emergence of nanotechnology in the treatment of brain tumors signifies a crucial change in overcoming the significant challenges presented by the brain's protective barriers and the intricate tumor microenvironment (94). The design of nanoparticles (NPs) is crucial for enhancing their ability to penetrate the blood-brain barrier (BBB) and improve therapeutic effectiveness. Key factors influencing this design include size, charge, and surface modifications. Size is a critical parameter, with NPs in the range of 20– 100 nm being optimal for BBB penetration. Research shows that this size range benefits from the enhanced permeability and retention (EPR) effect, allowing for accumulation in tumor tissues characterized by leaky blood vessels. NPs smaller than 20 nm are rapidly cleared from circulation, while those larger than 100 nm face challenges in crossing the BBB. Therefore, targeting NPs within this size range is essential for effective delivery to brain tumors (95). The surface charge of NPs also plays a significant role in their interactions with the BBB. Neutral or slightly negative charges are preferred because they reduce non-specific interactions with the endothelial cells of the BBB. This minimizes opsonization and immune clearance, thereby enhancing NP penetration through the barrier by decreasing electrostatic repulsion, -specific interactions with the endothelial cells of the BBB. This minimizes opsonization and immune clearance, thereby enhancing NP penetration through the barrier by decreasing electrostatic repulsion with cell membranes (96). Moreover, the functionalization of NPs with specific ligands that target receptors on the BBB or tumor cells can greatly improve their capacity to cross the BBB and reach tumor sites. Ligands such as transferrin or specific peptides can facilitate receptor-mediated transcytosis. Additionally, PEGylation, which involves adding polyethylene glycol chains to the NP surface, extends circulation time and reduces recognition by the immune system. This modification enhances the specificity and efficacy of NPbased therapies, making it a vital aspect of NP design for brain tumor treatment (97, 98). Micelles, which are nanoscale carriers formed by the self-assembly of amphiphilic molecules, offer a promising solution to this challenge. Their small size and ability to encapsulate hydrophobic drugs make them suitable for crossing the BBB. Micelles can be engineered to exploit various transport mechanisms, such as receptor-mediated transcytosis, to enhance drug delivery to the brain (92, 93). Table 1. A brief review of case studies in the usage of nanomicelles for crossing blood-brain barrier . barrier Disease/Condition Description Key Findings Alzheimer’s Disease (AD) Development of lactoferrincoated multifunctional copolymer micelles for drug delivery across the BBB. High stability, biocompatibility, and effective BBB penetration in mice, indicating potential for CNS disorder treatment (99). Brain Cancer Star-polymer unimolecular micelle nanoparticles designed to deliver doxorubicin across the BBB. Prolonged circulation, efficient BBB penetration, and reduced cardiotoxicity in mice, highlighting potential for brain-specific cancer therapy (100). Gene Therapy Polymeric micelles are used for delivering nucleic acids in neurological disorders. Protect nucleic acids from degradation and enhance cellular uptake, showing promise in preclinical models for various brain diseases (101). Glioma (Micelle-Based) Micelle-based nanocarrier designed to cross the BBB for glioma treatment, loaded with doxorubicin (DOX). Effective BBB penetration, accumulation in the brain, and significant anti-tumor effects in animal models (102). Glioma (ApoE-Coated) Novel brain-targeted nanomicelles coated with ApoE for glioma treatment, loaded with paclitaxel (PTX) and decorated with Aβ-CN peptide. Improved cellular uptake, better inhibition of glioma cell proliferation, increased apoptosis, and prolonged survival of glioma-bearing mice in animal models (103). Glioma (TransferrinModified) Hybrid micelle system modified with transferrin for delivering paclitaxel (PTX) to glioma. Enhanced targeting capabilities, improved delivery to glioma cells, better anti-tumor efficacy, and reduced systemic toxicity in both in vitro and in vivo studies (104). 6.2. Future Prospects The future of micelle-based drug delivery systems in treating brain-related diseases is highly promising. Advances in nanotechnology and a deeper understanding of blood-brain barrier (BBB) transport mechanisms are expected to significantly enhance the design and efficacy of micelles for brain-targeted therapies (105, 106). Researchers are developing stimuli-responsive micelles that release their therapeutic payloads in response to specific triggers within the brain environment, such as pH changes or enzymatic activity. Additionally, combining micelles with other delivery methods, like transnasal pathways, could further improve drug delivery to the brain by bypassing the BBB (105). Emerging strategies also include the use of micelles for delivering a combination of drugs and genetic material, which could provide more comprehensive treatment options for complex neurological disorders. For example, micelles loaded with both chemotherapy drugs and gene therapy agents are being explored for their potential to treat brain tumors more effectively (107). Overall, micelles hold significant potential for revolutionizing the treatment of brain-related diseases, offering hope for more effective therapies for conditions like Alzheimer's disease, brain cancer, and other neurological disorder
  • Conclusion: 8. Future Directions and Conclusion Micelles are poised to revolutionize nanomedicine through enhanced drug delivery and imaging applications (112, 113). Future research will likely focus on improving targeting capabilities by incorporating specific ligands that bind to cancer cell receptors, thereby minimizing off-target effects (111, 114). Additionally, the integration of micelles with other treatment modalities, such as radiotherapy and immunotherapy, could provide synergistic effects (115, 116). Advances in the design of nanoparticles, particularly regarding size and surface modifications, will enhance their ability to cross biological barriers like the blood-brain barrier, which is crucial for effective brain tumor treatment (117, 118). In conclusion, micelles offer a versatile platform for advancing cancer therapies and diagnostics. Their ability to encapsulate hydrophobic drugs and improve bioavailability makes them invaluable in modern medicine (72, 119). As research continues to address challenges related to stability, biocompatibility, and targeted delivery, micelles are expected to play an increasingly significant role in the diagnosis and treatment of various diseases, ultimately leading to improved patient outcomes.
  • Keywords: Nanomicelles, Non-ionizing radiation, Cancer treatment, medical imaging