Historically, partitioning of biomarkers from blood to sweat has been demonstrated in great detail. As more of these biomarkers emerge, sweat appears to be a convincing media for continuous and spontaneous health monitoring. However, ‘clinical’ techniques of sample collection, purification and analysis have restricted growth in the sweat-sensing area because of the cost and time associated with these techniques. With the advent of miniaturized sensors, however, many of these issues can be alleviated. Still, a large task has largely been left unexplored for compact sweat sensing technologies: sample extraction and collection.
Common techniques for sweat stimulation and analysis involve sweat stimulation in a region from a sweat generating unit 10, followed by removal of this unit 10 from the skin 12, cleaning of the skin 12 and reapplication of a sensing unit 14 or collection device 16, as shown in
Further, contamination from the stimulation reservoir and sensor region is unavoidable as they share the same area. In reference to
Attempts to reduce contamination have previously been made. For example, a technique includes utilizing an isolating membrane between sweat stimulation mechanisms and the sensors and sensing sites. However, such techniques utilizing isolating membranes (or similar techniques) may only partially or temporarily separate sweat stimulation mechanisms, such as an electric field and/or chemicals, from the sensors and sensing sites. In the instance of isolating membranes, these also have the drawback of increasing the dead volume between a sensor and the skin 12, which reduces temporal resolution. Furthermore, horizontal iontophoretic driving of an iontophoretic chemical, such as pilocarpine, may be used. However, this will again subject the sensor, sweat, and skin to an electric field and/or contamination. For many biomarkers and sensors, such interference could reduce performance of a sweat sensing device, in some cases making sensing impossible. There is an increasing need to provide improved sweat sensing techniques and devices that address one or more of the above drawbacks.
Embodiments of the present invention rely in part on the premise that sudomotor axon reflex (SAR) sweating can be utilized by a sweat inducing and sensing device for sweat analysis. SAR sweating can potentially be initiated by a variety of mechanisms: thermal, direct-electrical, chemical, occlusion, and others. In this setting, direct-electrical refers to a biophysical phenomenon where sweating is initiated by the flow of electron and ion current without the aid of a chemical active compound. Additionally, embodiments of the present invention can greatly reduce contamination and improve chronological sampling of sweat. Furthermore, the embodiments of the present invention described below have the ability to use a variety of sensing techniques which greatly improves the impact and variety of applications for such a device.
The objects and advantages of the present invention will be further appreciated in light of the following detailed descriptions and drawings in which:
The embodiments of the present invention described herein improve greatly on prior simultaneous stimulation and collection of sweat sample methods, such as that presented in
Embodiments of the present invention take advantage of a biological response referred to as the sudomotor axon reflex (“SAR”). This mechanism acts on the premise that innervation of sweat glands occurs as a result of peripheral functionality of sudomotor units (i.e., the body will stimulate a series of sweat glands directly underneath the stimulation region, “direct stimulation”, but will also generate sweat from sweat glands outside of this region, “indirect stimulation”). For example, in the case of chemical sweat stimulation, the sweat stimulant acts on the neural receptors surrounding the sweat glands to elicit a sweating response. The chemical stimulant can act on two primary receptors at the base of the sweat gland: muscarinic or nicotinic receptors. SAR response is typically observed with chemicals that interact strongly with nicotinic receptors at the base of the sweat gland. For example, pilocarpine acts weakly on nicotinic receptors and is therefore a poor chemical stimulant for SAR response. However, nicotine acts strongly on nicotinic receptors and is therefore an attractive stimulant for SAR response. Furthermore, there are chemical stimulants, such as acetylcholine, that act strongly on both muscarinic and nicotinic receptors, which can be leveraged to produce a SAR response. It should be recognized that, although not named, multiple other chemical stimulants are capable of causing a SAR response and are useful in embodiments of the present invention. Although there has largely been limited research in this area of sweat stimulation, it is also hypothesized that thermal, direct-electrical, occlusion, and other sweat stimulant techniques will produce a similar antidromic responses as chemical stimulants. Consequently, one can stimulate sweat glands in a region within close proximity of a sensor array to generate sweat directly underneath the stimulation region (“direct stimulation”) and directly underneath the sensors (“indirect stimulation”). Typically, the “spreading” of SAR induced sweating, the distance from the edge of direct stimulation to the decay of indirect stimulation, is limited on the order of several tens of millimeters (e.g., up to about 30 mm). The degree of a SAR response, in the case of chemical stimulation, depends largely on the amount and type of sweat stimulant which is delivered to a given location.
In reference to
Optionally, each of these regions (sweat generation, sweat sensing, and sweat collecting) may be separated by an isolation layer 28 as shown in
The term “sweat generation unit”, including other denotative or connotative phrases, as used herein, captures a plurality of sweat stimulation methods that are capable of initiating SAR sweating. For example, a sweat generation unit may involve one or more of chemical, thermal, direct-electrical, or other suitable mechanisms which stimulates the generation of sweat and are not specifically described. The most common technique for sweat stimulation is a chemical technique referred to as iontophoresis. This involves electric-field driven movement of a sweat stimulant drug into the skin surface, ultimately reaching the secretory coil of the sweat gland, to initiate sweating. It should be recognized that, although iontophoresis is the most common chemical technique, electroporation, injection or microneedles delivery, passive diffusion of a sweat stimulant from a drug reservoir, which may be improved by a diffusion enhancer (e.g., propylene glycol) applied to the skin prior to device application or incorporated directly into the stimulation unit itself, or other techniques are also possible routes of chemical delivery of a sweat stimulant in embodiments of the present invention. Utilizing such a design according to the present invention will greatly reduce contamination between a stimulation reservoir (e.g., in the sweat generation unit 22) and collection and/or the sensor region (e.g., relating to the collection unit 24 and the sensing unit 26).
Additionally, the terms “sensing unit” and “sensing mechanism,” including other denotative or connotative phrases, as used herein could include one or more of a plurality of mechanisms for sensing sweat and/or its components or properties including potentiometric, amperometric, conductometric, impedance spectroscopy, skin impedance, galvanic skin response (GSR), or other suitable mechanisms. Similarly, the term “collection unit”, including other denotative or connotative phrases, as used herein, describes a collection method, material, or structure.
The terms “collection and/or sensing unit” and “analysis unit”, including other denotative or connotative phrases, as used herein, describe a unit that is capable of sensing sweat, collecting sweat, or a combination of the two. A sensing unit (e.g., sensing unit 26) and/or a collection unit (e.g., collection unit 24) may have integrated electronics or controls which monitor physiological parameters, provide feedback to a user or similar function. In an embodiment with both a sensing unit(s) and a collection unit(s) (e.g., device 20), the units may function independently of each other or may operate together.
Sweat generation units, collection units, sensing units, and combinations of such units may include a variety of functional aspects such as wired or wireless communications, rigid or flexible structure or other method, material, function, or particular structure not specifically described here. These units may also have intelligent communication between or within each unit via optical, electrical, or similar communication method (not shown).
In another embodiment,
The construction of device 30 could simplify device construction and assembly compared to other configurations. For example, in one embodiment, units 34, 36 could be fabricated using standard flexible electronics techniques (such as on PET or Kapton film), and pressed against skin 12. The sweat generation unit 32 could be a gel including a sweat stimulant and a driving electrode (not shown) that is pressed down against units 34, 36 and skin 12. Some of the iontophoretic chemical stimulant in sweat generation unit 32 may find itself between units 34 and 36 and skin (similar to as diagramed in
A benefit of the vertical alignment between the analysis units (e.g. collection unit 34 and sensing unit 36) and a sweat generation unit (e.g., sweat generation unit 32) is an increase in the density of the units. This benefit could be realized in other configurations of the sweat generation and analysis units, such as in the honeycomb formation described below. Depending on the sweat generation mechanism, SAR-initiated sweat may only be able to be collected or sensed up to several millimeters away from the direct stimulation region. Therefore, embodiments of the present invention achieve a greater benefit with a high density of sweat generation and analysis units.
Regarding
Furthermore, in a device according to the present invention where the sweat generation method is via direct-electrical methods or iontophoresis, a return electrode can be placed on the periphery of the device so as to maximize the amount of current or drug delivered in the desired location. For example, in
In
With reference to
Peripheral (indirect) sweating after 5 minutes of iontophoresis is significant (e.g., sweat rates of about 1-3 nL/min/gl) on average to at least 8 mm from the boundary of the direct stimulation region. A sweat stimulant could be delivered iontophoretically or by another method and could constitute a wide range of various sweat stimulants (e.g., pilocarpine, acetylcholine, etc.). Considering that sensors can be fabricated utilizing previously demonstrated technology well below 8 mm in diameter (e.g., 500 μm in diameter), an array of biomarker sensors may be easily placed within the indirect sweating region. Although indirect sweating results in a reduction in sweat rate (e.g., about 60% reduction as compared to the sweat rate in the area being directly stimulated), the reduction of the risk of contamination and potential to reduce drug dosage (as described below) outweigh this downfall.
The spacing between the stimulation regions and the collection and/or sensor units may vary depending on the configuration. In one embodiment, an array of stimulation units and analysis units may have a minimum half-pitch (smallest repeating unit) less than one millimeter at an accuracy within tens of micrometers or better.
A sampling effectiveness metric (“SE”) for comparing sweat stimulation devices can be defined by Equation 1:
where Q is the sweat rate per minute, and F is the dose of drug stimulant delivered in the case of iontophoretic delivery. A base metric, e.g., SE0, for the case of the stimulation region being the same as the collection region (e.g., as shown in
In alternative embodiments, the stimulation region could be much smaller than the collection/sensor region. This is because only a small area would be required to initiate the SAR response of many nearby sweat glands. Furthermore, in the case of iontophoresis, this reduction in the stimulation area would improve the SE, which would allow for less drug delivery (dosage) to achieve the same previously attained SE.
A metric for comparing the dead volume (“DV”) of such devices can be defined by Equation 2:
where Vdead is the dead volume between the sensor and skin, and Asensor is the area of the sensor. Comparing to an instance where the stimulation and collection regions are in the same area and the device includes an element to reduce contamination (not shown), such as a membrane, the gap between the sensor and skin could be on the order of 200 μm (e.g., due to roughness of skin, thickness of paper wicking layer, thickness of a drug reservoir, etc.). However, with indirect stimulation, one can greatly improve the contact between the skin and sensor while reducing the contamination from the stimulation. In this regard, the device may be so intimate with the skin that the only source of dead volume would be from the topology of the skin (e.g., about 30 μm). Thus, the reduction in dead volume between the device where the stimulation and collection regions are in the same area and this embodiment would be a reduction of at least 6×(200 μm/30 μm). This holds great significance when one estimates the time to “refresh” the sweat underneath the sensor. If there is 6× less volume to refill underneath the sensor, then for a given flow rate, the time required to refresh the sweat underneath the sensor would also be reduced 6×. This has profound impact on time-resolution capabilities.
Utilizing the two calculations above for SE and DV and assuming the addition of an isolating membrane between sensor and skin, the effective improvement may be the multiplication of these two values. Therefore, the total improvement between an exemplary previous device described above and an embodiment of the present invention would be an improvement of at least 7.2× with potentially an improvement approaching 13.2×—when sweat rate per unit area, dose per unit area and dead volume per unit area are considered.
While all of the invention has been illustrated by a description of various embodiments and while these embodiments have been described in considerable detail, it is not the intention of the Applicants to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. The invention in its broader aspects is therefore not limited to the specific details, representative apparatus and method, and illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the Applicants' general inventive concept.
This application claims priority to U.S. Provisional Application No. 62/115,851, the disclosure of which is hereby incorporated by reference herein in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US16/17726 | 2/12/2016 | WO | 00 |
Number | Date | Country | |
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62115851 | Feb 2015 | US |