Carbon nanotubes have distinctive and remarkable material properties,
different from bulk materials with the same chemical composition, and potential
technological applications, including those in biology and medicine (He et al., 2013; Prylutska et al., 2013; Guo et al., 2017;
Harvey et al., 2017). These nanotubes have recently emerged as a new
option for cancer treatment, bioengineering, as well as gene therapy, but
inconsistent data on cytotoxicity and limited control over functionalized
carbon nanotubes behavior currently restrict predictability of such applications
(Firme and Bandaru, 2010). Carbon nanotubes have a
highly hydrophobic surface and a non-biodegradable nature that contributes to
their reduced biocompatibility, limiting their biomedical applications, with
growing concerns about their chronic toxicity (Prylutska et al., 2008; Tejral et
al., 2009; Yang et al., 2009; Minchenko et al., 2016; Kobayashi et al., 2017). It was
reported that different variants of these nanotubes exhibit different toxicity both in vitro and in vivo and
that intratracheal administration of single-walled carbon nanotubes (SWCNTs)
resulted in inflammation (Uo et al., 2011). The toxicity of carbon nanotubes is attributed to
their physicochemical properties, including structure, length and aspect ratio,
surface area, degree of aggregation, extent of oxidation, surface topology,
bound functional groups, concentration, and dose offered to cells or organisms (Tejral et al., 2009; Uo et al., 2011). It is
interesting to note that carbon
nanotubes can elicit toxicity through numerous mechanisms: membrane damage, DNA
damage, oxidative stress, changes in mitochondrial activities, altered
intracellular metabolic routes, and protein synthesis Yuan et al., 2011, 2012; Shvedova
et al., 2012; Ahmadi et al., 2017; Guo et al., 2017). Recently, it was
shown that functionalized SWCNTs induce oxidative stress in human circulating leukocytes (Kermanizadeh et al., 2018). However,
their cytotoxicity is significantly controversial, with a large number of
studies reporting altered toxic responses to SWCNTs both in vitro and in vivo (Uo et al., 2011).

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