1. Field of the Invention
Embodiments of the present invention relate to a delivery apparatus, and more particularly, to an apparatus for facilitating delivery of various cargos to target sites and an apparatus associated therewith, wherein the apparatus provides an electric field to drive cargo through tissue as in iontophoretic approaches or where the apparatus induces the electrochemical degradation of a delivery component to release the various cargos, and combinations thereof.
2. Description of Related Art
Many techniques exist for the delivery of drugs and therapeutic agents to the body. Traditional delivery methods include, for example, oral administration, topical administration, intravenous administration, and intramuscular, intradermal, and subcutaneous injections. With the exception of topical administration which permits more localized delivery of therapeutic agents to particular area of the body, the aforementioned drug delivery methods generally result in systemic delivery of the therapeutic agent throughout the body. Accordingly, these delivery methods are not appropriate for localized targeting of drugs and therapeutic agents to specific internal body tissues.
As a result, other methods, such as endovascular medical devices, Natural Orifice Translumenal Endoscopic Surgery (NOTES)-based devices, and iontophoresis, have been developed to provide localized targeting of therapeutic agents to a particular internal body tissue. Iontophoresis is a form of drug delivery that uses electrical current to enhance the movement of charged molecules across or through tissue. Iontophoresis is usually defined as a non-invasive method of propelling high concentrations of a charged substance, normally therapeutic or bioactive-agents, transdermally by repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle. In some instances, one or two chambers are filled with a solution containing an active ingredient and its solvent, termed the vehicle. The positively charged chamber (anode) repels a positively charged chemical, while the negatively charged chamber (cathode) repels a negatively charged chemical into the skin or other tissue. Unlike traditional transdermal administration methods that involve passive absorption of a therapeutic agent, iontophoresis relies on active transportation within an electric field. In the presence of an electric field, electromigration and electroosmosis are the dominant forces in mass transport. As an example, iontophoresis has been used to treat the dilated vessel in percutaneous transluminal coronary angioplasty (PTCA), and thus limit or prevent restenosis. In PTCA, catheters are inserted into the cardiovascular system under local anesthesia and an expandable balloon portion is then inflated to compress the atherosclerosis and dilate the lumen of the artery.
The delivery of drugs or therapeutic agents by iontophoresis avoids first-pass drug metabolism, a significant disadvantage associated with oral administration of therapeutic agents. When a drug is taken orally and absorbed from the digestive tract into the blood stream, the blood containing the drug first passes through the liver before entering the vasculature where it will be delivered to the tissue to be treated. A large portion of an orally ingested drug, however, may be metabolically inactivated before it has a chance to exert its pharmacological effect on the body. Furthermore it may be desirable to avoid systematic delivery all together in order to allow high doses locally while avoiding potential side effects elsewhere, wherein local delivery is desirable for localized conditions. Existing medical device technologies that enable localized placement of therapeutics fail to provide the opportunity to embed/secure therapeutics in the tissue(s) of interest.
Accordingly, it would be desirable to provide an improved apparatus and method for selectively and locally targeting delivery of various drugs and therapeutic agents to an internal body tissue, and fixing such cargos in the tissue(s) of interest. Further, it would be desirable to provide an apparatus and method for delivering various drugs and therapeutic agents to a bodily segment removed from a patient for external treatment thereof.
The present invention relates to a delivery apparatus and method, and in particular, a delivery apparatus adapted for delivering a cargo to a target site of body tissue. The delivery apparatus comprises a flexible tubular member having a distal end adapted for insertion proximate to a target site of internal body tissue. A first electrode is configured to extend within the flexible tubular member so as to be disposed proximate to the target site. A second electrode is in electrical communication with the first electrode and is opposably positionable with respect thereto. The second electrode is configured to cooperate with the first electrode to form an electric field. A delivery component has a cargo carried thereby and is coupled with the first electrode such that the delivery component is capable of being positioned proximate to the target site. The delivery component is configured to degrade when exposed to the electric field formed between the first electrode and the second electrode so as to release the cargo to the target site.
Other aspects of the present invention relate to methods for delivering a cargo intraluminally to a target site of internal body tissue. The method includes disposing a first electrode proximate to a target site of internal body tissue, wherein the first electrode has a delivery component coupled thereto, and the delivery component is configured to carry a cargo therewith. The method further comprises opposably positioning a second electrode with respect to the first electrode such that the target site is disposed between the first and second electrodes. A voltage potential is applied across the first and second electrodes to form an electric field. In one aspect, the delivery component is configured to degrade when exposed to the electric field formed between the first electrode and the second electrode, thereby releasing the cargo. In another aspect, the electric field iontophoretically drives the cargo into the target site. In one aspect, the delivery component is configured to degrade when exposed to the electric field formed between the first electrode and the second electrode, and the delivery component is further configured to carry the charged cargo such that the charged cargo is iontophoretically delivered to the target site upon degradation thereof. In another aspect, the target site is removed from a first body location so as to externally receive the cargo in an ex vivo manner and transplanted to a second body location after receiving the cargo.
As such, embodiments of the present invention are provided to enable a highly targeted and efficient delivery of various cargos to predetermined target sites.
In order to assist the understanding of embodiments of the invention, reference will now be made to the appended drawings, which are not necessarily drawn to scale. The drawing is exemplary only, and should not be construed as limiting the invention.
Embodiments of the present inventions now will be described more fully hereinafter with reference to the accompanying drawings. The invention may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like numbers refer to like elements throughout.
The delivery apparatus of the present invention has applicability for treating tissue and organ systems and, further, has applicability with any body passageway including, among others, blood vessels, tubular structures of the urinary, genitourinary, and intestinal tracts, the trachea and the like, and may be used to treat, for example, renal disease, uterine fibroids, urinary incontinence, erectile dysfunction, colorectal disease and inner and outer ear infections. Furthermore, other applications may include delivery of cargo for treating, for example, Parkinsons disease, stroke, and pain management. In other instances, the delivery apparatus may be implemented for delivery of therapeutic agents to the brain.
One particular application of the delivery apparatus may include the delivery of therapeutic agents to the cardiovascular system. Cardiovascular disease is the primary cause of death in the United States. The major underlying pathology of cardiovascular disease is atherosclerosis, which has manifestations ranging from narrowing of the coronary arteries due to plaque formation, to acute plaque rupture causing myocardial infarction. Coronary bypass surgery is a common treatment option wherein a vein, typically from the leg or chest cavity, is used to route blood around a blockage in the heart. Unfortunately this procedure has a high long-term failure rate due intimal hyperplasia and restenosis caused by vascular smooth muscle cell proliferation into the bypass. Restenosis is considered to be the “Achilles' heel” of percutaneous transluminal coronary angioplasty. Restenosis is a complex process of injury-induced events triggered by vessel wall damage.
Accordingly, embodiments of the present invention allow high concentrations of therapeutic agents to be delivered directly to the site of angioplasty without exposing the entire circulation to the medication and with the ability to protect delicate therapeutics such as, for example, siRNA from degradation while in circulation. Furthermore, embodiments of the present invention facilitate the delivery of therapeutics to the site of the vulnerable plaque prior to rupture.
The catheter may include a delivery component 102 disposed near its distal end 10. In some embodiments, the delivery component 102, carrying an ionically charged cargo, may traverse the interior of the catheter to reach the target site so as to maintain the integrity of the delivery component 102. An electrical lead 24 may be provided so as to electrically connect the electrodes 70 to a power supply 72 (See
The delivery component 102 may, in some instances, be constructed of a degradable structure capable of being electrochemically degraded. In some instances, the delivery component 102 may be a polymer network/matrix, such as, for example, a hydrogel, which oxidatively breaks down due to the voltage at the electrode. As the polymer becomes soluble, the polymer and the cargo are released from the anode. The degradative network/matrix may facilitate quick and improved release of all cargo from the electrode. In other embodiments, the polymer may be a hydrogel which swells and releases the cargo so as to be delivered to the target site. Still, in other embodiments, the delivery component may include a polymer or sponge-type material capable of being saturated with a charged cargo. In some cases the degradable polymer may also be entrained within a semipermeable membrane to facilitate keeping the degradable polymer within close proximity of the electrode and lending mechanical stability to the materials.
In one exemplary embodiment of the present invention, as illustrated in
As an example, a hydrogel of acrylic acid and the sodium salt form of acrylic acid (0-50 wt %) may be crosslinked with a divinyl vincinal diol, wherein breakdown of the crosslinked network occurs when using a Pt anode when treated under conditions of 10V (3 mA) for 20 minutes, as represented by the following:
The cargo 104 may include small molecule ionic molecules, nucleic acids, proteins, therapeutic agents, diagnostic agents, and imaging agents as well as organic nanoparticles which may encapsulate a wide range of therapeutic, diagnostic, and imaging agents. The cargo may be configured to traffic preferentially based on size, shape, charge and surface functionality; and/or controllably release a therapeutic. Such cargos may include but are not limited to small molecule pharmaceuticals, therapeutic and diagnostic proteins, antibodies, DNA and RNA sequences, imaging agents, and other active pharmaceutical ingredients. Further, such cargo may include active agents wich may include, without limitation, analgesics, anti-inflammatory agents (including NSAIDs), anticancer agents, antimetabolites, anthelmintics, anti-arrhythmic agents, antibiotics, anticoagulants, antidepressants, antidiabetic agents, antiepileptics, antihistamines, antihypertensive agents, antimuscarinic agents, antimycobacterial agents, antineoplastic agents, immunosuppressants, antithyroid agents, antiviral agents, anxiolytic sedatives (hypnotics and neuroleptics), astringents, beta-adrenoceptor blocking agents, blood products and substitutes, cardiac inotropic agents, contrast media, corticosteroids, cough suppressants (expectorants and mucolytics), diagnostic agents, diagnostic imaging agents, diuretics, dopaminergics (antiparkinsonian agents), haemostatics, immunological agents, therapeutic proteins, enzymes, lipid regulating agents, muscle relaxants, parasympathomimetics, parathyroid calcitonin and biphosphonates, prostaglandins, radio-pharmaceuticals, sex hormones (including steroids), anti-allergic agents, stimulants and anoretics, sympathomimetics, thyroid agents, vasodilators, xanthines, and antiviral agents. In addition, the cargo 104 may include a polynucleotide. The polynucleotide may be provided as an antisense agent or interfering RNA molecule such as an RNAi or siRNA molecule to disrupt or inhibit expression of an encoded protein.
Other cargo 104 may include, without limitation, MR imaging agents, contrast agents, gadolinium chelates, gadolinium-based contrast agents, radiosensitizers, such as, for example, 1,2,4-benzotriazin-3-amine 1,4-dioxide (SR 4889) and 1,2,4-benzotriazine-7-amine 1,4-dioxide (WIN 59075); platinum coordination complexes such as cisplatin and carboplatin; anthracenediones, such as mitoxantrone; substituted ureas, such as hydroxyurea; and adrenocortical suppressants, such as mitotane and aminoglutethimide.
In other embodiments, the cargo 104 may comprise Particle Replication In Non-wetting Templates (PRINT) nanoparticles (sometimes referred to as devices) such as disclosed, for example, in PCT WO 2005/101466 to DeSimone et al.; PCT WO 2007/024323 to DeSimone et al.; WO 2007/030698 to DeSimone et al.; and WO 2007/094829 to DeSimone et al., each of which is incorporated herein by reference. PRINT is a technology which produces monodisperse, shape specific particles which can encapsulate a wide variety of cargos including small molecules, biologics, nucleic acids, proteins, imaging agents. Cationically charged PRINT nanoparticles smaller than 1 micron are readily taken up by cells over a relatively short time frame, but penetration of the particles throughout the tissue is a longer process. For the delivery of PRINT nanoparticles throughout the tissue to be effective, the penetration needs to occur within a reasonable operational time frame. As such, the delivery apparatus 100 may be used to achieve such penetration by employing iontophoresis, in which charged PRINT nanoparticles are driven into body tissue using repulsive electromotive forces. The PRINT particles may or may not contain a therapeutic. In some instances, the cargo may be a therapeutic agent such as PLGA. In addition, the PRINT nanoparticles may be engineered to achieve a certain mission, and design-in handles that permit remote control for externally turning the cargo “on” or switching it “off”. As such, the cargo may be manipulated using ultrasound, low-dose radiation, magnetics, and other suitable means.
In other instances, the delivery apparatus 100 may be used to provide therapeutic treatment, for example, to heart tissue, as shown in
The functional circulation of the heart 20 pumps blood to the body in general, i.e., the systematic circulation, and to the lungs for oxygenation, i.e., the pulmonic and pulmonary circulation. The left side of the heart supplies the systemic circulation throughout the rest of the body. The right side 23 of the heart supplies the lungs with blood for oxygenation. Deoxygenated blood from the systematic circulation is returned to the heart 20 and is supplied to the right atrium 28 by the superior and inferior venae cavae 48, 50. The heart 20 pumps the deoxygenated blood into the lungs for oxygenation by way of the main pulmonary artery 40. The main pulmonary artery 40 separates into the right and left pulmonary arteries, 52, 54 which circulate to the right and left lungs, respectively, oxygenated blood returns to the heart 20 at the left atrium 27 via four pulmonary veins 56 (of which two are shown). The blood then flows to the left ventricle 30 where it is pumped into the aorta 44, which supplies the body with oxygenated blood. The functional circulation, however, does not supply blood to the heart muscle or structures. Therefore, functional circulation does not supply oxygen or nutrients to the heart 20 itself. The actual blood supply to the heart structure, i.e., the oxygen and nutrient supply, is provided by the coronary circulation of the heart, consisting of coronary arteries, indicated generally at 58, and cardiac veins. Coronary artery 58 resides closely proximate the endocardial wall of heart 24.
With continuing reference to
In the illustrative embodiment, the cargo carried by delivery component 102 is energized to contain, for example, negative ions. When power supply 72 is energized, the delivery component 102 degrades and the electrodes 70 achieve a voltage potential with respect to the negatively charged ions of the cargo. The voltage potential created across the electrodes 70 and the electrode 22 sets up a field which interacts with the ionic cargo which acts to drive the charged cargo, such as a particle or therapeutic agent, into the heart tissue in the heart wall between the electrodes 70 and the electrode 22. That is, when the voltage potential is set up across electrodes 70 and 22, the ions of the cargo tend to migrate toward electrode 22. This drives the ions into the heart tissue between the electrodes 70 and 22. This driving force is the result of the iontophoretic technique. In some instances, electrode 22 may be inserted as a patch through a small hole in the chest and unfolded and then applied to the heart muscle. In any manner, the drug to be transferred to the heart muscle is provided on one side of the heart tissue. The electrode on the other side of the heart tissue is then energized to create the necessary field for transfer of the cargo into the heart tissue.
In one particular embodiment, as illustrated in
The embodiment of
In some embodiments, the balloon component 12 may be constructed of a various inflatable/expandable substrates that may be permeable, microporous or semi-permeable materials, which may include, for example, ePTFE, VTEC, nitinol, cellulose, cellulose acetate, polyvinyl chloride, polysulfone, polyacrylonitrile, silicon, polyurethanes, natural and synthetic elastomers, polyester, polyolefin, a fluorpolymer, or any other suitable material.
In other instances, the delivery apparatus 100 may be applied in an ex vivo manner, in which, for example, the delivery apparatus 100 is used for therapeutic delivery to vein segments which are removed from one location in the patient and transplanted to another location. That is, a bodily portion, such as a vein segment, may be removed from the body for treatment and then transplanted to a different location within the body thereafter. For example, the delivery apparatus 100 may be utilized for pre-treatment of arteries/veins harvested from the legs/arms (of the patient or of a cadaver or other model), for transplant into other regions of the body. As shown in
In other embodiments of the present invention, placement of the cargo, such as the PRINT nanoparticles, may be achieved by using a needle having an iontophoretic tip to facilitate distribution of the particles into the surrounding target site (tissue). In such embodiments, the needle tip may represent a first electrode, while a second electrode is positioned external to the body so as to create a voltage potential when a power supply is energized, as described previously with respect to iontophoretic techniques. Such a technique may be used for disease states including cancer (brain, prostate, colon, others), inflammation, damaged tissue ‘rescue’ situations (e.g. cardio/neuro/peripheral vascular), ocular diseases, rhinitis, and other applications. Still, in other embodiments, placement of the cargo, such as PRINT nanoparticles, may be achieved using endovascular or NOTES-based devices, for the minimally invasive treatment of accessible cancers. Such treatment may include colon, pancreatic, brain, esophageal, liver, cervical, and ovarian. These devices may be passive in nature (elution or simple placement), or may be more active in placement method (iontophoretic, ultrasound, radio/micro waves).
Many modifications and other embodiments of the invention will come to mind to one skilled in the art to which this invention pertains having the benefit of the teachings presented in the foregoing description; and it will be apparent to those skilled in the art that variations and modifications of the present invention can be made without departing from the scope or spirit of the invention. Therefore, it is to be understood that the invention is not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
The following examples are presented by way of illustration, not by way of limitation.
A tube of agarose gel measuring 2.5 cm in length with an outer diameter of 1.5 cm and an inner diameter of 0.5 cm was used as a mock vessel. Covered copper electrical wiring was used and the electrode consisted of a stripped end of the wire. A piece of sponge approximately 2 cm in length and 0.5 cm in diameter was placed over the stripped end of one piece of copper electrical wire which was to be the anode.
The sponge was thoroughly soaked in a solution of Rhodamine B, a cationic dye, in water. The sponge was then placed inside the agarose vessel and the other end of the wire was hooked to the anode of a DC power source with an alligator clip. The agarose vessel was submersed in a polypropylene dish containing PBS. The cathode, a second piece of copper wire, was placed in the PBS beside the agarose vessel. In the negative control, this soaked without voltage for 10 minutes. In the experimental condition, the voltage applied was 10V and the current was 22 mA. This also ran for 10 minutes. To characterize, a cross-section of the agarose vessel was taken and fluorescence microscopy was used, as shown in
A tube of agarose gel measuring 2.5 cm in length with an outer diameter of 1.5 cm and an inner diameter of 0.5 cm was used as a mock vessel. Covered copper electrical wiring was used and the electrode consisted of a stripped end of the wire. A piece of sponge approximately 2 cm in length and 0.5 cm in diameter was placed over the stripped end of one piece of copper electrical wire which was to be the anode.
The sponge was soaked in a solution of 1 micron cationically charged particles tagged with FITC. The same procedure used in Example 1 was followed. The difference, as shown in
The splenic artery of a pig was excised and cut into sections approximately 1 cm long. Particles were made using the PRINT® technology. A monomer solution consisting of 88% poly(ethylene glycol) triacrylate, 10% [2-(acryloyloxy)ethyl]trimethylammonium chloride, 1% fluorescein-o-acrylate, and 1% diethoxyacetophenone was used to fill a 2 micron cubic mold and photocured. These particles were then collected. The solution of cationic particles was injected into the luminal space of the artery. A silver wire measuring 0.125 mm in diameter acted as the anode and was inserted into the luminal space and attached to a DC power source. The artery was placed in a water bath. The cathode, a second piece of silver wire, was placed beside the artery. In the control no voltage was applied. In the experimental condition 3V was applied for 5 minutes. The vessels were fixed and histology slices were prepared. Fluorescent microscopy was used to image the histology sections. As shown in
The carotid artery of a dog was excised and cut into sections approximately 1 cm long. Particles were made using the PRINT® technology. A monomer solution consisting of 65% poly(ethylene glycol) triacrylate, 20% poly(ethylene glycol) monomethacrylate, 10% amino-ethylmethacrylate, 3% fluorescein-o-acrylate, and 2% diethoxyacetophenone was used to fill a 200 nanometer cylindrical mold and photocured. These particles were then collected. The solution of cationic particles was injected into the luminal space of the artery. A silver wire measuring 0.125 mm in diameter acted as the anode and was inserted into the luminal space and attached to a DC power source. The vessel was placed in a water bath. The cathode, a second piece of silver wire, was placed beside the artery. In the control, no voltage was applied. In the experimental condition, 90V pulses approximately 1 second in duration every 5 seconds were applied for 1 minute. The vessels were fixed and histology slices were prepared. As shown in
This disclosure was partially made with U.S. Government support under contract number CHE-9876674 awarded by the United States National Science Foundation (NSF). The U.S. Government may have certain rights in the disclosure.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US09/35070 | 2/25/2009 | WO | 00 | 11/23/2010 |
Number | Date | Country | |
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61031083 | Feb 2008 | US |