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grooves.  The  reader  appraising  this  literature  should  be  warned  that  sometimes  these  surfaces  are  referred  to  as  “nano”  without  any  real
  justification (since the features are larger than nanoscale).
  The goal of investigations of the nano/bio interface could be to demonstrate that unique features of cell response arise as feature sizes fall below
  100 nm (taking the consensual definition of the upper limit of the nanoscale). Surprisingly, this has hitherto been done in only a very small number of
  cases. One of the few examples is the work by Teixeira et al. [160], who showed that when the ridges of a grooved pattern were shrunk to 70 nm,
  keratocyte alignment was significantly poorer than on ridges 10 times wider (whereas epithelial cell alignment was unchanged). Alternatively,
  following  the  spirit  of Chapter 2,  one  could  define  one  or  more  “biological  response  nanoscales”  by  presenting  cells  with  a  systematically
  diminishing set of structural features and observing at what scale the cells started to respond. Alignment is of course only one, perhaps the most
  trivial, of the huge variety of measurable responses. Table 4.1 summarizes some of the others.

  A rather diverse set of observations may be systematized by noting that the fundamental response of a cell to an environmental stimulus is an
  adaptive one. Following Sommerhoff [154], one can distinguish three temporal domains of adaptation: behavioral (short-term); ontogenic (medium-
  term); and phylogenetic (long-term). Although Sommerhoff was discussing organisms, these three domains have their cellular counterparts. At the
  cellular level, behavioral adaptation is largely represented by energetically driven phenomena [101], perhaps most notably the spreading transition
  characteristic of many cells adhering to substrata (Figure 4.3). Morphological changes have been shown [91] and the rate of spreading has been
  quantitatively shown, to depend on nanoscale features of the substratum [8].
















  Figure 4.3 Idealized cell (initial radius R) spreading on a substratum F in the presence of medium C. Upper panel: cross-sections, showing the transition from sphere to segment (h is the ultimate height of the cell). Lower panel: plans, as
  might for example be seen in a microscope (the dark region shows the actual contact area).
  The secretion of microexudates, growth factors, etc. would appear to involve the reception of chemical and/or morphological signals by the cell
  surface and their transmission to the nucleus in order to express hitherto silent genes. Indeed, this secretion appears to be part of an adaptive
  response to condition an uncongenial surface. Work in molecular biology has established that the amino acid triplet arginine–glycine–aspartic acid
  (RGD),  characteristically  present  in  extracellular  matrix  proteins  such  as  fibronectin,  is  a  ligand  for  integrins  (large  transmembrane  receptor
  molecules present in the cell membrane), binding to which triggers changes depending on cell type and circumstances. Such phenotypic changes
  fall into the category of ontogenic adaptation, also represented by stem cell differentiation. Recently reported work has shown that 30-nm diameter
  titania  nanotubes  promoted  human  mesenchymal  stem  cell  adhesion  without  noticeable  differentiation,  whereas  70–100-nm  diameter  tubes
  caused  a  ten-fold  cell  elongation,  which  in  turn  induced  cytoskeletal  stress  and  resulted  in  differentiation  into  osteoblast-like  cells [126].
  Phylogenetic adaptation involves a change of genetic constitution, and would correspond to, for example, the transformation of a normal cell to a
  cancerous one. There are well-established examples of such transformations induced by certain nanoparticles and zeolites. Two important criteria
  for deciding whether a nanoparticle might be carcinogenic seem to be:

    1. Whether the particle is insoluble (this does not, of course, apply to nanoparticles made from known soluble carcinogens active when dispersed
    molecularly).
    2. Whether the particle is acicular and significantly longer than macrophages (see Figure 4.3).
  If both these criteria are fulfilled the macrophages ceaselessly try to engulf the particles and they become permanent sites of inflation, which may be
  the  indirect  cause  of  tumorigenesis.  Nevertheless,  given  the  long  induction  periods  (typically  decades)  that  elapse  between  exposure  to  the
  particles and the development of a tumor, elucidation of the exact mechanism remains a challenge. Incidentally, there appear to be no known
  examples of nanostructured substrata that directly induce cancer through contact. However, it should be kept in mind that the mechanism for any
  influence may be indirect (as in [126]; note also that an extracellular matrix protein might bind to a certain nanotextured substratum, change its
  conformation—see Section 4.1.4—and expose RGD such that it becomes accessible to a cell approaching the substratum, triggering ontogenic
  changes  that  would  not  have  been  triggered  by  the  protein-free  substratum)  and  is  generally  unknown.  The  secretion  of  macromolecular,
  proteinaceous substances that adsorb on the substratum is an especially complicating aspect of the nano/bio interface, not least because any
  special nanostructured arrangement initially present is likely to be rapidly eliminated thereby.

  Prokaryotic Cells
  In contrast to eukaryotes, prokaryotes (archaea and bacteria) are typically spherical or spherocylindrical, smaller (diameters are usually a few
  hundred nm) and enveloped by a relatively rigid cell wall predominantly constituted from polysaccharides, which tends to maintain cell shape.
  Prokaryotes  have  received  rather  less  attention  than  eukaryotes,  although  the  interaction  of  bacteria  with  surfaces  is  also  a  topic  of  great
  importance for the biocompatibility of medical devices, which is normally viewed in terms of adhesion rather than adaptation. Nevertheless, if one
  considers bacterial communities, the formation of a biofilm, based on a complex mixture of exudates, and which usually has extremely deleterious
  consequences, should be considered as an adaptive response at least at the ontogenic level, since the expression pattern of the genome changes
  significantly. A worthy (and hitherto unreached) goal of investigation, therefore, is whether one can prevent biofilm formation by nanostructuring a
  substratum.

  4.1.4. Biomolecules
  A protein is comparable in size or smaller to the nanoscale features that can nowadays be fabricated artificially. The problem of proteins adsorbing
  to nonliving interfaces has been studied for almost 200 years and an immense body of literature has been accumulated, much of it belonging to the
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