Sanjay Kalra ( Dept. of Endocrinology, Bharti Hospital, Karnal, Haryana, India; University Center for Research & Development, Chandigarh University, Mohali, Punjab. )
Saptarshi Bhattacharya ( Dept. of Endocrinology, Apollo Indraprastha Hospital, New Delhi, India. )
Atul Dhingra ( Dept. of Endocrinology, Superspeciality Hospital, Sriganganagar, India. )
We conceptualize and define nanocrinology as the science that studies the nanometric and subnanometric precision that operates in diagnostic and therapeutic endocrinology. It includes advanced generation assays, which can detect low concentrations of hormones, and modern drug delivery systems that allow more efficient delivery of endocrinotropic agents. Nanocrinology is a rapidly growing field of endocrinology, and we call for greater research and adoption of this science.
Keywords: Diagnosis, endocrinology, hormone, radioimmunoassay, nanoformulation.
Endocrinology is a vast science which is expanding its ambit, as well as deepening its understanding, through rigorous research and clinical translation.
Endocrinology has been helped by advances in basic science. The development of radioimmunoassay fetched its inventor, Rosalyn Yalow the Nobel Prize. This was a seminal landmark in the history of the discipline.1 This allowed clinicians to measure and monitor, and thereby modify, hormone levels to their optimum. This discovery coincided with advances in physiology, pathology and pharmacology, which have helped shape the modern discipline of clinical endocrinology.
This evolution also owes credit to strengthening basic sciences, including mathematics and physics. Measurement too has become fine-tuned. For example, the prefixes ‘zepto’ and ‘yocto’ refer to measures of 10-21 and 10-24, respectively. One word which has entered routine usage is ‘nano’; as a prefix of a unit of measure ’nano’ means 10-9 while for other situations, it conveys a scale of nanometers.2
We use the word nanocrinology to refer to the precision that is now possible in diagnostic, and therapeutic endocrinology, and discuss how it has improved the quality of clinical care. We define it as the science that studies the nanometric and subnanometric precision that operates in diagnostic and therapeutic endocrinology.
Nanocrinology can be used to describe the development and usage of assays which are able to detect hormones and biomarkers in nano-or pico-molar concentration. Examples include N-terminal pro-B-type natriuretic peptide (NT-proBNP) which is used for risk stratification of asymptomatic persons living with diabetes, with regards to heart failure. The normal range of NT-proBNP, up to 125pg/ml, could not have been detected a few decades ago.3 Table 1 lists other hormones which have benefited from nanocrinology techniques
Nanocrinology operates in the therapeutic arena as well. Isolation of nano-sized drugs, as well as development nano-sized delivery methods, have improved our ability to treat disease. Usage of peptides, such as semaglutide, in oral formulation,4 hormones such as thyrotropin-releasing hormone (TRH) and adrenocorticotropic hormone (ACTH) in minute doses,5-7 and drugs like liquid Vitamin D, in nano particulate form,8 exemplify the importance of pharmaco-therapeutic nanocrinology.
In some ways, nanocrinology may be considered similar to precision medicine. However, we suggest that personalized medicine, are appropriate to clinical care, which utilize diagnostic and therapeutic nanocrinology for their success. In this manner, both are integral to each other, and feed each other’s growth
Science is an ever-changing subject, and so is endocrinology. As we discuss and debate the concept of nanocrinology, we look forward, with hope, to a healthier future, where zeptocrinology and yoctocrinology will be the norm.
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4. Knudsen LB, Lau J. The Discovery and Development of Liraglutide and Semaglutide. Front Endocrinol (Lausanne). 2019;10:155
5. Chambery A, Severino V, Di Maro A, D'Aniello A, Ruvo M, Parente A. Quantification of thyrotropin-releasing hormone by liquid chromatography-electrospray mass spectrometry. Amino Acids. 2010;38:1031-41
6. Hartoft-Nielsen ML, Lange M, Rasmussen AK, Scherer S, Zimmermann-Belsing T, Feldt-Rasmussen U. Thyrotropin-releasing hormone stimulation test in patients with pituitary pathology. Horm Res. 2004;61:53-7
7. Unluhizarci K, Kokoglu EO, Hacioglu A, Karaca Z, Kelestimur F. Comparison of a combination test (1 μg ACTH test plus glucagon test) versus 1 μg ACTH test and glucagon test in the evaluation of the hypothalamic-pituitary-adrenal axis in patients with pituitary disorders. Arch Endocrinol Metab. 2021;64:608-613.
8. Gupta R, Behera C, Paudwal G, Rawat N, Baldi A, Gupta PN. Recent Advances in Formulation Strategies for Efficient Delivery of Vitamin D. AAPS PharmSciTech. 2018;20:11.