Treatment FAQ

what microcap company is leading gold nanotechnology and cancer treatment

by Adrain Hickle III Published 2 years ago Updated 2 years ago

Is gold nanoparticle-based cancer therapy a viable option?

Taking advantage of their unique properties, most studies of gold nanoparticle-based cancer therapy have used photothermal therapy for the destruction of cancer cells or tumor tissue, which may be potentially useful in the clinical setting.

How does nano gold kill tumors?

Nanoparticles of gold can be injected into a tumor. The patient is then exposed to a specific wavelength of light that harmlessly passes through the skin and body tissue but gets absorbed by the nano-gold, which heats up and destroys the surrounding tumor cells.

Who are the leading companies in nanotechnology in medicine?

Nanotechnology in medicine: Who are the leading public companies? 1 Amgen Inc 2 Bausch Health Companies Inc 3 Biogen Inc 4 Celgene Corp 5 Eisai Co Ltd 6 Roche 7 Gilead Science Inc 8 Ipsen SA 9 Jazz Pharmaceuticals Plc 10 Lantheus Holdings More items...

Can gold nanorods be used for cell imaging?

Gold nanorods have been reported for cell imaging using techniques such as dark field light SPR scattering (Oyelere et al 2007) and photoacoustic imaging (Li et al 2007a).

How do nanoparticles help cancer?

A new method of cancer treatment using gold-coated silica nanoparticles could someday help patients say goodbye to the side effects of chemotherapy and radiation. By engineering the size of the nano-gold, scientists tune the particles to absorb light from infrared lasers and destroy a tumor. The challenge is that the light must pass safely through healthy tissue, but activate the nanoparticles in the tumor. In this activity, visitors tackle this problem, experimenting with LED flashlights and real nano-gold solutions to determine the optimal wavelength of light and particle size.

How is nano gold used?

Explain that nano-gold can be used to treat cancer. Show visitors the graphic of how cancer therapy using nano-gold works. Ask what visitors know about cancer to introduce tumors. Nanoparticles of gold can be injected into a tumor. The patient is then exposed to a specific wavelength of light that harmlessly passes through ...

What is the red theatrical gel?

Reinforce the idea by holding the red theatrical gel (representing body tissue) against the flask of blue nano-gold and show how red light passes through tissue but gets absorbed by the nano-gold in the tumor .

Why is nano gold blue?

Because the blue nano-gold is comprised of rod-shaped particles, whose scattering properties differ from spheres, the sizes of the samples do not correlate exactly with the size/color relationship of spherical nanoshells. You may want to simplify these details when talking to most visitors and assume spherical shape.

What is nanospectra biosciences?

They have established a private company called Nanospectra Biosciences ( http://www.nanospectra.com) to develop the technology for clinical applications. They have shown that nano-gold cancer therapy is effective in animal studies.

Can you open nano gold flasks?

In order to minimize evaporation and contamination, do not open flasks unless necessary. Keep the flasks containing stocks of real nano-gold suspensions wrapped in aluminum foil and in a refrigerator to minimize the gold falling out of solution.

Who produced the report Nanotechnology in Medicine?

This is an edited extract from Nanotechnology in Medicine report produced by GlolbalData Thematic Research.

Which nanomedicines are approved by the FDA?

Nanomedicines approved by the FDA include Adynovate.

What is Roche's specialty?

Roche offers its products and services to hospitals, commercial diagnostic laboratories, healthcare professionals, researchers, and pharmacists. Nanomedicines approved by the FDA include Pegasys and Mircera.

What is Biogen Inc?

Biogen Inc (Biogen) is a biopharmaceutical company that discovers, develops, and delivers drugs for the treatment of neurological and neurodegenerative diseases. The company’s marketed products include Avonex (interferon beta-1a), Tysabri (natalizumab), Tecfidera (dimethyl fumarate), Fampyra (prolonged-release fampridine tablets), and Plegridy (peginterferon beta-1a) for the treatment of multiple sclerosis (MS); Spinraza (nusinersen) for spinal muscular atrophy (SMA); and Fumaderm (fumaric acid esters) for severe plaque psoriasis.

What is Gilead Sciences?

Gilead Sciences Inc (Gilead) is a research-based biopharmaceutical company. It focuses medicines for the treatment of cardiovascular, haematological, and respiratory diseases, inflammation, liver diseases, cancer, and human immunodeficiency virus (HIV) infection.

What is eisai company?

Eisai Co Ltd (Eisai) is a pharmaceutical company that conducts research and development (R&D), manufacture, and sales of pharmaceuticals, including over-the-counter (OTC) drugs, prescription medicines, and generics. The company’s franchise areas in research include neurology and oncology.

What is Celgene Corp?

Celgene Corp (Celgene) is an integrated biopharmaceutical company that is focused on therapies for the treatment of cancer and immune-inflammatory diseases. Its product portfolio includes Vidaza (azacitidine) for the treatment of myelodysplastic syndromes (MDS); Revlimid (lenalidomide), Pomalyst (pomalidomide), and Thalomid (thalidomide) for the treatment of multiple myeloma; Otezla (apremilast) for psoriatic arthritis; and Istodax (romidepsin) for cutaneous T-cell lymphoma (CTCL) and peripheral T-cell lymphoma (PTCL).

How much will the oncology market grow in 2027?

For its part, Research and Markets projects that the oncology drug market will increase at a compound annual growth rate of 7.4 percent to reach US$222.38 billion in 2027.

What is the oncology market?

The oncology market covers every area of cancer care, from diagnosis to treatment, and is one of the biggest sectors in the life science space. Cancer is the second leading cause of death worldwide, after cardiovascular diseases. Biotechnology and pharmaceutical companies alike are working to develop best-in-class therapeutics for the treatment ...

How much is Angiodynamics sales in 2020?

In its 2020 financials, AngioDynamics reported oncology sector net sales of US$14.3 million, up 14.2 percent compared to the prior-year period. The company attributed the year-over-year growth to increased sales of its NanoKnife and Microwave disposables and sales of the BioSentry Tract Sealant System. In August 2021, it highlighted its US Food and Drug Administration (FDA) approval for a pivotal study of its NanoKnife System for ablation of prostate cancer in an intermediate-risk patient population.

What is ALX oncology?

First on this top oncology companies list is ALX Oncology Holdings, a clinical-stage immuno-oncology company that is developing a pipeline of therapies that block the CD47 pathway; many forms of cancers use this gene expression to evade a patient’s immune response. ALX Oncology is creating therapies for solid tumors (for example, head and neck squamous cell carcinoma, as well as breast cancer) and hematology (such as myelodysplastic syndromes and non-Hodgkin’s lymphoma).

Who owns Tokyo Smoke?

Tokyo Smoke, a cannabis retail operator in Canada owned by Canopy Growth (NASDAQ: CGC ,TSX:WEED), announced a collaboration agreement with Uber Canada (NYSE: UBER) whereby cannabis consumers will be able to use the Uber Eats app to order products before they visit stores.

Is AL101 an orphan drug?

AL101 has received fast-track designation and orphan drug designation from the FDA and is currently in a Phase 2 clinical trial for patients with adenoid cystic carcinoma bearing Notch-activating mutations; it is also in a Phase 2 clinical trial for patients with triple negative breast cancer bearing Notch-activating mutations and other gene rearrangements. AL102 is currently being advanced to Phase 2/3 clinical trials for patients with desmoid tumors.

Why are gold nanoparticles used as drug carriers?

Gold nanoparticles have caught the attention of scientists for their use as drug carriers because of their SPR, optical, and tunable properties. They can be prepared in a broad range of core sizes (1 to 150 nm), which makes it easier to control their dispersion. The presence of a negative charge on the surface of gold nanoparticles makes them easily modifiable. This means that they can be functionalized easily by the addition of various biomolecules such as drugs, targeting ligands, and genes. In addition, the biocompatibility and non-toxic nature of gold nanoparticles makes them an excellent candidate for their use as drug carriers [29,30]. For example, methotrexate (MTX), which has been used to treat cancer for decades, upon conjugation with gold nanoparticles displayed higher cytotoxicity towards numerous tumor cell lines as compared to that of free MTX. MTX was observed to accumulate in the tumor cells at a faster rate and to a higher level when conjugated with gold nanoparticles [31]. Another drug, doxorubicin (DOX), when bound to gold nanoparticles via an acid labile linker, showed enhanced toxicity against the multi drug resistant MCF-7/ADR breast cancer cell line, thus overcoming the multi drug resistance to some extent due to the enhanced uptake of the gold nanoparticle-tethered drug followed by its responsive release within the cell [32]. In the past, peptide-drug-conjugates (PDCs) have been investigated for their use as anticancer agents [33,34,35,36]. However, their stability in the blood, liver, and kidneys pose a significant challenge to their successful use as an anticancer molecule. Recently, it was shown that this difficulty can be by-passed by conjugating these PDCs to gold nanoparticles. The authors reported an increase in the half-life of PDCs from 10.6–15.4 min (administered alone), to 21.0–22.3 h (upon conjugation with gold nanoparticle), while retaining cytotoxicity [37]. Apart from synthetic drugs, phytochemicals have also shown the potential of being used as anticancer drugs but, similar to PDCs, they too have certain problems such as low specificity, short half-life, fast clearance rate, and inefficient cell penetration. These problems in using phytochemicals can be by-passed by conjugating them to gold nanoparticles. For example, kaempferol (a phytochemical) conjugated to gold nanoparticles displayed both significantly higher apoptosis and inhibition of angiogenesis in MCF-7 breast cancer cells as compared to kaempferol alone [38]. Table 1lists some of the studies performed to investigate the anti-tumor applications of gold nanoparticles in drug delivery.

How does nanotechnology help cancer?

The application of nanotechnology for the treatment of cancer is mostly based on early tumor detection and diagnosis by nanodevices capable of selective targeting and delivery of chemotherapeutic drugs to the specific tumor site. Due to the remarkable properties of gold nanoparticles, they have long been considered as a potential tool for diagnosis of various cancers and for drug delivery applications. These properties include high surface area to volume ratio, surface plasmon resonance, surface chemistry and multi-functionalization, facile synthesis, and stable nature. Moreover, the non-toxic and non-immunogenic nature of gold nanoparticles and the high permeability and retention effect provide additional benefits by enabling easy penetration and accumulation of drugs at the tumor sites. Various innovative approaches with gold nanoparticles are under development. In this review, we provide an overview of recent progress made in the application of gold nanoparticles in the treatment of cancer by tumor detection, drug delivery, imaging, photothermal and photodynamic therapy and their current limitations in terms of bioavailability and the fate of the nanoparticles.

How are gold nanoparticles synthesized?

Typically, gold nanoparticles of controlled size and shape have been synthesized by various physical (microwave and ultraviolet (UV) irradiation, laser ablation), chemical, and biological ways . Chemical synthesis generally utilizes chemicals and solvents, which are associated to environmental and human health impacts. In addition, it demands extreme conditions (e.g., pH, temperature) which are not optimal [7,8,9]. On the other hand, biological nanoparticle synthesis (plants and microorganisms mediated) is a relatively new, eco-friendly, and promising area of research with a considerable potential for expansion [10,11,12]. Numerous medicinal plants have shown potential to produce stable gold nanoparticles within a few seconds [11,13,14,15]. Microorganisms are also equally capable of adsorbing gold atoms and accumulating gold nanoparticles by secreting large amounts of enzymes, which are involved in the enzymatic reduction of gold ions [16,17]. These biologically synthesized gold nanoparticles have become an attractive and potential option to explore as a tool for biosensors, immunoassays, targeted drug delivery, photoimaging, photothermal therapy (PTT), and photodynamic therapy (PDT) (Figure 2). Interestingly, in human cancer and cell biology, various types of gold nanoparticles, such as gold nanorods, nanocages, nanostars, nanocubes, and nanospheres, have become effective tools. Their application in cancer diagnostics and therapeutic development is due to their favorable optical and physical properties that provide a potential platform for developing cancer theranostics. The optical properties of gold nanoparticles rely on SPR. In principal, SPR is a process whereby the electrons of gold resonate in response to an incoming radiation, causing them to both absorb and scatter light. In addition, some specifically shaped gold nanoparticles contribute to photon capture cross sections that are four to five-fold greater than those of photothermal dyes. These attributes are exploited to obtain localized heating either to destroy the cells or for drug release, underlying the therapeutic applications. In addition, gold nanoparticles possess tunable properties, which allow for the synthesis of nanoparticles of specific size and desired shape, resulting in a plasmonic resonance shift from 520 to 800–1200 nm (complex shapes) [18]. Susie et al. showed the change in optical properties and resonance of gold nanoparticles (ranging from 500 to 1200) by slightly changing the nanoparticles’ shape from nanospheres of 15–30 nm to nanorods of 2.5–7.5 Aspect ratio (AR.) [19] The range between 800 and 1200 is therapeutically useful because the body tissue is moderately transparent to Near Infra-Red (NIR) light, thereby providing an opportunity for therapeutic effects in deep tissues by photothermal and photoimaging approaches. Another important property is the available surface area. It is well known that the surface area of nanoparticles is inversely proportional to their size, which results in a large surface area to volume ratio. In other words, nanoparticle have a large surface area available for drug loading, conjugation, or binding of any gene or biological moiety of choice, thus increasing drug solubility, stability, and pharmacokinetic parameters [20]. The available surface area also plays a critical role for the application of gold nanoparticles in cancer diagnostics, specifically in photo-imaging and photothermal therapy. In photothermal therapy, smaller nanoparticles are preferred as light is mainly adsorbed by the nanoparticles and thus efficiently converted to heat for destruction of cell, whereas in photo-imaging, lager nanoparticles are preferred because of their higher scattering efficiency. In addition, biological responses to nanoparticles tend to scale with surface area. This means that when nanoparticles are exposed to a biological environment, such as serum or plasma, more proteins from the surroundings bind to small nanoparticles with a larger surface area-to-volume ratio than to those with a larger size and a smaller surface area-to-volume ratio. In parallel with the above-mentioned properties, the tailored surface functionalization of gold nanoparticles has also evinced considerable interest. The possibility to conjugate gold nanoparticles with a variety of biologically active moieties, especially with amine and thiol groups, provides possibilities for important biomedical applications ranging from diagnostics, targeting specific delivery of drugs/genes, imaging, and sensing for electron microscopy markers [21,22].

How does photoimaging help with cancer?

Photoimaging is an advanced technique that can help detect early stage tumors and guide the surgeons for precision treatment. One of the biggest challenges today for the surgeons is to have a clear picture of where the tumor ends and the healthy tissue begins. During an operation, the surgeons face a nearly impossible task of deciding to what extent the tumor has to be removed: being too conservative can leave some tumor cells behind, and being too liberal can result in removing healthy tissues that can be vital. Being too conservative is the reason that most of the tumors recur with time. Magnetic Resonance Imaging (MRIs) and Computed Tomography (CT) scans are limited and can only detect tumors above a size of several millimeters or approximately 10 million cells, meaning that the tumors are detected only when they reach a certain threshold. Photoimaging is a novel approach in cancer treatment where millions of functionalized gold nanoparticles are site specifically injected into the tumor, where they specifically bind to the cancer cells and scatter (shine), making it easier for the surgeons to identify the tumor and healthy cells. Gold nanoparticles (nanorods, nanocages, and nanoshells) are known to be the best available photo imaging nanoparticles for cancer therapeutics due to their bio inertness and their ability to provide increased spacial and temporal resolution for imaging [65].

What is PDT in cancer?

Photodynamic therapy (PDT) is another form of cancer treatment that utilizes light, photosensitizers and oxygen from the tissues. Unlike PTT, which is oxygen independent, PDT is completely dependent on the availability of tissue oxygen. In the case of PDT, a photosensitizing agent such as porphyrin is intravenously injected into the tissues and excited by specific wavelengths, leading to the energy transfer that generates reactive oxygen species (ROS) and causes cell death by apoptosis. PDT typically has a very low chance of causing mutations as the ROS do not accumulate in the cell nuclei. Recently, PTT and PDT were applied simultaneously in melanoma-xenografted mice. The lipid-coated gold nanocages were exposed to a 980 nm continuous wave (CW) laser, which raised the temperature (~10 °C) and generated the singlet oxygen, ultimately damaging the tumor growth [56]. The biggest drawback with PDT is that the photosensitizers are not generally soluble in the physiological environment, which inhibits their uptake by the diseased tissues. Nevertheless, some studies do show that these photosensitizers can be conjugated to the gold nanoparticles, thereby facilitating their uptake and delivery to the cancer tissues [57]. On the other hand, PDT has its own advantages in terms of minimal invasiveness, no cumulative toxicity, and reduced morbidity [58], which has proven effective for lung cancer [59], head and neck cancers [60], and skin cancer [61]. The important and interesting aspect is that PDT and PTT can also be combined to have an effective dual therapy where gold nanoparticles (nanorods and nanocages) were used in conjugation [61,62,63]. One good example is the work by Seo et al., where methylene blue loaded mesoporous silica coated gold nanorods were used for PTT/PDT dual therapy [64]. The photosensitizer was physically adsorbed on the pores of the silica shell. Upon irradiation with NIR (near infra-red) light at 780 nm, the viability of CT-26 cells (Murine colon carcinoma) was found to decrease by 31% for the cells transfected with gold nanorods, while the methylene blue (MB) loaded nanocomposites showed an 11% drop, which indicates a synergistic effect of dual therapy [64]. An important aspect that has to be noted here is the effect of PTT therapy on PDT or vice versa. Liu et al. presented a detailed analysis of this dual therapy where they clearly showed that the hypoxic environment induced by PDT does not affect PTT as PTT is an oxygen-independent therapy.

What does PEG mean in nanotechnology?

Distribution of nanoparticles with varying coatings and bound proteins. PEG = poly-ethyleneglycol.

Is gold nanoparticle approved for cancer?

Very few clinical trials are being actively carried out for the approval of gold nanoparticles for cancer diagnostics and therapy (Table 2) [66,67]. According to the literature, the FDA has approved few gold nanoparticle-based technologies for diagnostic and therapeutic purposes in medicine [55,68]. The cytotoxicity of gold nanoparticles is highly dependent on the size and morphology of the particles, environmental scenario, and the method of production [66,69,70]. One of the clinical trials being carried out by Astra Zeneca in partnership with Cytimmune mainly focuses on gold nanoparticle-based cancer treatment (http://cytimmune.com/#pipeline). Their first phase of trials was successfully completed. Aurimune (CYT-6091) was used as a vehicle to deliver the recombinant human tumor necrosis factor alpha (rhTNF) into tumors, which disrupted the blood vessels, enabling chemotherapeutic drugs to penetrate the tumor and damage the cancer cells. Safe delivery of highly effective doses of rhTNF to tumor cells was observed [71]. The authors also found that the dose of rhTNF administered after immobilization to gold nanoparticles could be three times higher than its usual dose without any toxic effect [71]. The PEG layer also decreased the uptake of nanoparticles by the mononuclear phagocytic system (MPS) and aided in their accumulation in the tumor masses via the EPR effect.

How much money has been invested in nanotechnology?

In the United States alone, more than six billion dollars have been invested in nanotechnology research and more than sixty centers, networks, and facilities, funded by various agencies, are in operation or soon to open (Thayer 2007).

How are gold nanorods made?

These seeds, serving as the nucleation sites for nanorods, are then added to a growth solution of gold salt with a weak reducing agent such as ascorbic acid and hexadecyltrimethylammonium bromide. The aspect ratios of the gold nanorods can be controlled by varying the amount of gold seeds with respect to the gold precursor. Moreover, gold nanorods can be produced in quantitative yield with the addition of AgNO3(Jana et al 2001a, 2002). Besides the methods mentioned above, several other approaches have also been investigated for the fabrication of gold nanorods, including bio-reduction (Canizal et al 2001), growth on mica surface (Mieszawska and Zamborini 2005), and photochemical synthesis (Kim et al 2002).

What are SERS nanoparticles made of?

Another type of SERS nanoparticle is composed of a gold core, a Raman-active molecular layer, and a silica coating (Keren et al 2008). The silica coating can ensure physical robustness, inertness to various environmental conditions, and simple surface modification via silica chemistry. The thiol groups that were subsequently introduced onto the silica shell can be conjugated with maleimide-activated PEG chains for improved biocompatibility.

How are gold nanorods synthesized?

The synthesis of gold nanorods has been reported using a wide variety of strategies. Gold nanorods are typically synthesized using the template method, based on the electrochemical deposition of gold within the pores of nanoporous polycarbonate or alumina template membranes (Martin 1994; van der Zande et al 1997). The diameter of the gold nanorod is determined by the pore diameter of the template membrane, while the length of the nanorod can be controlled through the amount of gold deposited within the pores of the membrane. A fundamental disadvantage of this method is the low yield since only one monolayer of nanorods is prepared. Formation of gold nanorods through electrochemical synthesis has also been reported (Reetz and Helbig 1994; Yu et al 1997; Chang et al 1999). In this approach, many experimental parameters can determine the length of the nanorod thus affecting its aspect ratio (defined as the length divided by the width).

What is the absorption range of gold?

Typically, gold nanospheres display a single absorption peak in the visible range between 510 nm and 550 nm. With increasing particle size, the absorption peak shifts to a longer wavelength and the width of the absorption spectra is related to the size distribution range. Many other types of gold nanoparticles with different size/shape, such as nanorods, nanoshells, and nanocages, have been explored to obtain optical properties suitable for biomedical applications.

What are the applications of nanotechnology?

One of the major applications of nanotechnology is in biomedicine. Nanoparticles can be engineered as nanoplatforms for effective and targeted delivery of drugs and imaging labels by overcoming the many biological, biophysical, and biomedical barriers. For in vitro and ex vivo applications, the advantages of state-of-the-art nanodevices (eg, nanochips and nanosensors) over traditional assay methods are obvious (Grodzinski et al 2006; Sahoo et al 2007). However, several barriers exist for in vivo applications in preclinical and potentially clinical use of nanotechnology, among which are the biocompatibility, in vivo kinetics, tumor targeting efficacy, acute and chronic toxicity, ability to escape the reticuloendothelial system (RES), and cost-effectiveness (Cai and Chen 2007, 2008). In this review, we will summarize the current state-of-the-art of gold nanoparticles in biomedical applications.

How to make gold nanospheres?

Gold nanospheres (also known as gold colloids) of 2 nm to over 100 nm in diameter can be synthesized by controlled reduction of an aqueous HAuCl4solution using different reducing agents under varying conditions. The most commonly used reducing agent is citrate, which can produce nearly monodisperse gold nanospheres (Turkevich et al 1951; Frens 1973). The size of the nanospheres can be controlled by varying the citrate/gold ratio. Generally, smaller amount of citrate will yield larger nanospheres. The major limitations of this method are the low yield and the restriction of using water as the solvent.

What is gold nanoparticle?

Gold nanoparticles are emerging as promising agents for cancer therapy and are being investigated as drug carriers, photothermal agents, contrast agents and radiosensitisers. This review introduces the field of nanotechnology with a focus on recent gold nanoparticle research which has led to early-phase clinical trials.

What size of GNPs are used for trastuzumab?

Jiang et al [31] synthesised citrate-coated GNPs of controlled sizes ranging from 2 to 100 nm bound with multiple trastuzumab antibodies to enable targeting and cross-linking of human epidermal growth factor receptor (HER)-2 in human SK-BR-3 breast cancer cells. Larger nanoparticles had a greater protein-to-nanoparticle ratio than smaller, more curved particles, with more avid trastuzumab binding. In this study, the optimal size for nanoparticle cellular entry was 40–50 nm. Smaller particles dissociated from the cell membrane and larger particles appeared to reduce the membrane wrapping necessary for RME to occur. Furthermore, with 40 nm GNP–HER particles, the HER-2 receptor complex was noted to internalise to the cytoplasm, leading to a 40% reduction in surface HER-2, a process that does not occur with trastuzumab binding alone. This led to a reduced expression of downstream kinases including protein kinase B (Akt) and mitogen-activated protein kinase (MAPK) and a twofold increase in trastuzumab cytotoxicity. The concentration of GNPs used in this study was extremely low (fM concentrations), yet GNP–HER was clearly visualised in cytoplasmic lysosomes. This important work demonstrated that GNPs may not simply act as passive drug carriers, but may also influence drug–cell interactions and enhance therapeutic effects [31].

Is there a paucity of studies of in vivoradiosensitisation with G?

Despite the rapid increase of GNP publications in recent years and an increasing number of in vivostudies investigating the uptake and distribution of GNPs, there remains a paucity of studies of in vivoradiosensitisation with GNPs. These studies will be critical for successful translation of this approach to the clinic.

Is GNP oxidized or nonoxidized?

GNPs, however, exist in a non-oxidised state (Au [0]). GNPs are not new; in the 19th century, Michael Faraday [7] published the first scientific paper on GNP synthesis, describing the production of colloidal gold by the reduction of aurochloric acid by phosphorous.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9