Towards 2020 – Photonics driving economic growth in Europe

44 Towards 2020 – Photonics driving economic growth in Europe
The eye can provide a
‘diagnostic window’ to
the body, offering easy
and minimally-invasive
access to key parameters
identified with cardiovascular
diseases, diabetes
or Alzheimer‘s disease.
even when a cancer has been detected correctly,
determining its physical extent for subsequent
removal frequently presents a major challenge.
A two-step procedure is envisaged for screening
citizens for a range of different cancers. In the first
step, photonic (or a combination of photonic and
non-photonic modalities, such as ultrasound and
magnetic resonance) point-of-care technology
would be applied to provide a low cost, rapid and
reliable risk assessment for a particular cancer or
combination of cancers. If the result of this screening
indicates risks, advanced and improved analytic
(multi-band photonic/spectroscopic) methods,
developed for locating and analysing the cancer
in a sufficiently reliable and precise way, will be
applied. It is likely that these techniques will make
use of label-free methods, since the time needed
for development of a tool such as an endoscope is
usually much shorter than the period necessary to
get safety approval of labels for in vivo applications.
The techniques could, if advantageous, also employ
a combination of photonic and non-photonic
technologies, such as ultrasound, magnetic resonance
or nuclear scanners. The same techniques
or combinations thereof, employed for localising
and identifying a tumor, might also be applied
in an surgical microscope or in an endoscope for
determining the physical extent of degenerated
tissue with unprecedented precision, and thus allow
the complete removal of this tissue. In cases
where removal is not possible, for example, in
the case of large area distributed lesions, as can
occur for skin cancer, highly targeted treatments
based on light, possibly in combination with other
effective self-targeting therapeutic approaches,
may provide the means for selectively eliminating
cancerous tissue.
Infectious diseases: Often the outcome in the
case of infectious diseases can be highly dependent
on the time interval between onset of infection
and administration of therapeutic agents. This is
particularly true for sepsis, which is still one of the
most underestimated but life-threatening diseases
occurring in the clinical practice. Ideally, a suitable
therapeutic agent should be administered within
one hour after the occurrence of a septic shock.
Sepsis can be caused by a wide range of bacteria,
as well as by fungi and viruses, so it is of vital importance
to identify the specific pathogen responsible.
Conventional techniques like cultivation and even
new techniques based on polymerase chain reactions
(PCR) are often too slow or not sufficiently
reliable. These techniques need to be replaced
by methods that are really capable of making a
difference. Similar techniques, as envisioned for
use in screening, will also have the potential to
reliably identify pathogens, determine potential
antibacterial resistances, and evaluate the host’s
immune response. This will enable the administration
of targeted agents, avoiding the use of
broad-spectrum antibiotics that could facilitate
anti bacterial resistance. If resistant bacteria are encountered,
targeted photodynamic therapies offer
a potential solution, especially since their mode of
action does not promote resistances. Photonic
technologies can also be employed for treatment
monitoring (for example, for infectious diseases
or cancer therapy) to measure progress and identify
necessary treatment modifications, as well as
monitoring of the local environment and food to
prevent the outbreak of infections (for example,
food poisoning from Staphylococcus aureus, described
below). Ultimately, very cheap photonic
monitoring devices could even be incorporated
directly into bandages, infusion sets, etc..
Ophthalmology: Although the eye itself is a
tissue affected by age-related diseases, such as
retinopathy or geriatric macular degeneration, it
can also provide a so-called ‘diagnostic window’
to the body, offering easy and minimally-invasive
access to the key parameters identified with cardiovascular
diseases, diabetes or neurodegenerative
diseases such as Alzheimer’s disease. In addition to
the currently available morphological information,
functional information could help diagnose eye
diseases earlier and in a more personalised manner.