The present disclosure relates to devices that employ an electrical current for therapeutic applications.
There are a number of therapeutic applications that employ an electrical current. Examples include electrical stimulation and iontophoresis. However, the existing bioelectronic systems have not fully resolved mismatches between engineered circuits and biological systems. Consequently, electrical current-based therapies often result in pain and/or damage to biological tissues.
In order to avoid irreversible damage to biological tissues, some electrical current-based therapies can only be applied at low current intensity and may be limited in this regard. For instance, iontophoresis applied at low current intensity is inefficient at transporting macromolecule drugs and nanoparticles due to their larger sizes.
To address limitations of existing bioelectronic systems, there is a need for improved devices that can employ high current intensity while maintaining acceptable levels of pH and thermal energy at the device-to-biological tissue interface to prevent pain and/or damage to biological tissues.
A hydrogel ionic circuit (HIC) electrode configured for electrical stimulation and/or drug therapy (e.g., iontophoresis) is disclosed. In embodiments, the HIC electrode includes a chamber containing a salt solution. The chamber is at least partially bound by a hydrogel membrane that defines a barrier for the salt solution. The HIC electrode further includes an electrode configured to apply an electrical current to the chamber to induce an ion current in the salt solution, wherein the hydrogel membrane is ionically conductive and configured to transmit the ion current.
In a sense, the HIC electrode is a buffered electrode that mitigates thermal and/or pH changes at a device-to-biological tissue interface for therapeutic applications that employ an electrical current. The HIC electrode converts the electrical current to ion current that can be transmitted through the hydrogel membrane. This may allow for the use of electrical current at higher current intensity than would otherwise be possible for electrical stimulation, iontophoresis, and other therapeutic applications that employ an electrical current.
An iontophoresis device that incorporates at least one HIC electrode is also disclosed. In embodiments, the iontophoresis device includes a first chamber containing a salt solution and a second chamber containing a therapeutic solution, wherein the second chamber is configured to interface with a portion of a surface overlaying a target region. The iontophoresis device further includes a hydrogel membrane separating the first chamber from the second chamber. An electrode is configured to apply an electrical current to the first chamber to induce an ion current in the salt solution, wherein the ion current acts on the second chamber to iontophoretically transport molecules (e.g., drug molecules) from the therapeutic solution across the surface to the target region.
An electrical stimulation device for wound healing that incorporates at least one HIC electrode is also disclosed. In embodiments, the electrical stimulation device includes a substrate configured to overlay a cutaneous wound. The substrate may have a plurality of channels embedded within or attached to the substrate, with each of the channels containing a salt solution and being at least partially bound by a hydrogel membrane that defines a barrier between the salt solution and the cutaneous wound. An electrode is configured to apply an electrical current to a channel of the plurality of channels to induce an ion current in the salt solution, wherein the ion current acts on the cutaneous wound to stimulate healing.
This Summary is provided solely as an introduction to subject matter that is fully described in the Detailed Description and Drawings. The Summary should not be considered to describe essential features nor be used to determine the scope of the Claims. Moreover, it is to be understood that both the foregoing Summary and the following Detailed Description are example and explanatory only and are not necessarily restrictive of the subject matter claimed.
The detailed description is described with reference to the accompanying figures. The use of the same reference numbers in different instances in the description and the figures may indicate similar or identical items. Various embodiments or examples (“examples”) of the present disclosure are disclosed in the following detailed description and the accompanying drawings. The drawings are not necessarily to scale. In general, operations of disclosed processes may be performed in an arbitrary order, unless otherwise provided in the claims.
Electrical stimulation is a non-invasive and non-pharmacological physical stimulus. Electrical stimulation has a broad range of biomedical effects. At the molecular level, it can facilitate the transport of both charged and uncharged biomolecules through biological membranes via electrophoresis and electroosmosis. These two processes collectively are called iontophoresis. At the cellular level, electrical stimulation can interact with a variety of cellular components, such as ion channels, membrane-bound proteins, cytoskeleton, and intracellular organelles. These interactions alter cellular activities and functions, such as contraction, migration, orientation, and proliferation. Electrical stimulation shows strong clinical potential for drug delivery, tissue regeneration, and wound healing. However, the existing bioelectronic systems have not fully resolved mismatches between engineered circuits and biological systems, resulting in pain and/or damage to biological tissues.
In this disclosure, aqueous two-phase systems are utilized to generate programmable hydrogel ionic circuits (HICs). High-conductivity salt-solution patterns are stably encapsulated within hydrogel matrices using salt phase separation, which route ionic current with high resolution and enable localized delivery of electrical stimulation. This strategy allows designer electronics that match biological systems, including transparency, complete aqueous-based connective interface, distribution of ionic electrical signals between engineered and biological systems, and avoidance of tissue damage from electrical stimulation.
The library of conductive materials used in currently available bioelectronic devices typically includes metals, carbon-based materials, and conductive polymers. Such requirements significantly increase both design complexity and footprint, and fundamentally affect the conductivity of the device. Moreover, most existing conductive materials exhibit a mechanical mismatch with human tissues, making them unsuitable for long-term wear and implantable applications. Critically, the conductive materials used in the devices carry electron (or, in some cases, hole) current, which has to be converted to ion current at the electrode/electrolyte interfaces through electrochemical reactions in order to stimulate the biological systems. This is particularly important for voltage drops across the interfaces higher than a certain threshold (typically 1 V for water), which induces local heat (through Joule heating), pH changes, electrode degradation, and the generation of highly reactive chemical species. These reactions can cause pain and damage to the biological tissues, an issue especially relevant for the long-term or high current electrostimulation, such as iontophoresis. Thus, new options for materials and device designs are needed to facilitate a new generation of biocompatible electronic systems that can interface with living systems.
Ionically conductive hydrogel materials have been developed that offer intrinsic biocompatibility, a mechanical match to tissues, and can potentially be engineered to possess degradability. These hydrogel conductors utilize ionic charge transport, thus eliminating electron-to-ionic current conversion at biological interfaces (and the associated adverse effects) and enable seamless and safe interfaces with the biological tissues. Specifically, the ionic hydrogel conductors allow the electron-conducting materials (e.g., metal electrodes) to be separated from the biological tissues; chemical changes at electron-conductor/hydrogel interfaces induced by the electrochemical reactions can be sufficiently buffered before reaching biological tissues. Moreover, due to the high water content of hydrogels, the heat generated by current injection dissipates rather than accumulating on the tissue surface, reducing local burns and pain typically caused by traditional conductors.
The ionic hydrogel conductors (e.g., polyethylene glycol, dextran, dipotassium phosphate, ethanol, etc.) have been utilized as electrodes in electromechanical systems and as interconnects for constructing hydrogel circuits on insulating silicone substrates. However, the existing ionic hydrogel conductors either cannot form stable interconnect patterns in aqueous environments due to ion diffusion or possess low conductivity, which hinder the expansion of their applicability to the integrated electronic systems in biologically relevant environments. This disclosure presents complex, aqueous-stable, HICs enabled by the salt aqueous two-phase systems and compatible for direct interfaces with the living systems. Furthermore, the hydrogel ionic design of ionically conductive patterns can be mechanically reprogrammed and modulated after fabrication. Additional utility of these HICs is demonstrated by delivering localized electrical stimulation in the biological environments with reduced adverse effects when compared to the conventional metal- and carbon-based electrodes.
Various embodiments of this disclosure are directed to a HIC-based device for ocular drug delivery and electrical stimulation iontophoresis. The disclosed device serves as an alternative to intraocular injections for posterior segment drug delivery which causes changes in ocular pressure capable of causing adverse effects including retinal detachment, endophthalmitis, hemorrhages, and rise in intraocular pressure.
Macromolecular and nanoparticle (NP) ophthalmic drugs have seen increasing utility in ocular disease treatment. Macromolecules, primarily monoclonal antibodies against human vascular endothelial growth factor (anti-VEGF), have been successfully used in treating a wide range of eye conditions, including neovascular age-related macular degeneration (AMD), diabetic macular edema, proliferative diabetic retinopathy, corneal neovascularization, and neovascular glaucoma. NP formula provides better solubility for hydrophobic drugs, sustained release over a prolonged period of time, and the ability to target specific tissues through surface modification. Several NP ophthalmic drugs have been FDA-approved to treat dry eye syndrome (cyclosporine nanoemulsion) and for photodynamic therapy (verteporfin liposome). More clinical trials are underway to test NP ophthalmic drugs in the treatment of macular degeneration, cataracts, glaucoma, ocular infection, and hypertension.
Despite the promising therapeutic efficacy of macromolecular and NP ophthalmic drugs, their intraocular delivery presents a significant challenge. The large size of macromolecular and NP drugs leads to a slower permeation rate through ocular tissue barriers compared to small molecule drugs. When eye drops are used, only a small fraction (typically less than 1%) of the applied macromolecule and NP drugs is delivered into the eye even with multiple doses per day. Although drug-eluting contact lenses effectively increase the residence time of drugs and are capable of sustained drug release, they do not enhance the drug permeation rate in ocular tissues. As a result, drug-eluting contact lenses typically need to be worn for an extended period of time (several days to weeks) to provide sustained therapeutically effective drug concentration. Extended wear of contact lens can cause irritation to ocular tissues and discomfort due to friction, which have shown to adversely affect the public acceptance of contact lenses. An anti-VEGF (ranibizumab)-eluting contact lens has been developed, but it failed to deliver a therapeutically efficacious concentration of ranibizumab into posterior segment tissue despite extended wear for several days. Systemically administered macromolecules and NPs need to overcome the blood-aqueous and blood-retinal barriers, and are subject to liver modification and kidney clearance. These lead to a very low bioavailability of typically less than 0.1%. Due to the challenges of topical and systemic routes, intraocular injection remains the most effective method for delivering macromolecular and NP ophthalmic drugs. However, the invasive injection procedure carries a risk of potentially blinding complications, including retinal pigment epithelium tear, retinal detachment, and endophthalmitis. Needle phobia can cause anxiety in patients, which negatively affects patient adherence to the treatment. Moreover, intraocular injection needs to be performed by a specialist. The uneven distribution of specialists between rural and urban areas and between developing and developed countries leads to a disparate treatment provision. There is a critical need for a next generation intraocular macromolecular and NP drug delivery technology that is safe, non-invasive, highly efficacious, and allows easy operation by patients or their caregivers without special trainings.
Iontophoresis is a constant (DC) electrical current-based, non-invasive drug delivery technology. It can be used to deliver both charged and neutral drug molecules and can be easily applied using portable or wearable devices. The potential of iontophoresis in ocular drug delivery has been explored, and a variety of different drugs from small molecules (e.g., steroids, oligonucleotides, antibiotics, and riboflavin) to macromolecules (e.g., anti-VEGF and nanoparticles have been tested. Although effective in delivering small-molecule drugs, current ocular iontophoresis has low efficiency when delivering macromolecule drugs and nanoparticles due to their larger sizes. Transscleral iontophoresis of Avastin (bevacizumab, M.W. 148 kDa) has been previously studied using isolated human sclera in vitro. When 3.8 mA/cm2 anodal iontophoresis was applied for up to 2 h, the permeation was only enhanced by 7.5 compared to passive diffusion. Anodal iontophoretic (1.8 mA/cm2 for 20 min) delivery of Avastin has been previously studied in vivo using the Visulex iontophoresis system. The total amount of Avastin delivered into the eye was 353±42 μg. Only 5±3 μg was observed in the retina/choroid tissues, without data reported in vitreous humor, which is not effective since at least 600 μg was delivered in the vitreous humor to treat wet AMD by intravitreal injection. Previous studies have performed 6 mA/cm2 iontophoresis of charged nanoparticles (20-45 nm) for 5 min on rabbit cornea and sclera in vivo, while the improvement of nanoparticle permeation in ocular tissues is still limited. In order to enhance the delivery efficiency of macromolecules and nanoparticles, higher current intensity is required, since iontophoretic efficiency is proportional to the current intensity applied. However, applying higher current intensities presents significant challenge for current ocular iontophoresis devices. All current devices employ electrodes that conduct electron currents. These electron currents have to be converted to ion currents at the electrode/tissue interface, because biological tissues conduct ion currents. For DC current, this conversion requires electrochemical (EC) reactions. These EC reactions can induce significant pH change (due to water electrolysis) and local heating (due to electrode overpotential) that can damage tissues when the current intensity is high. Previous studies have reported that ocular iontophoresis is considered safe when current intensity does not exceed 5.5 mA/cm2, and the duration does not exceed 40 minutes. Studies have reported that significant ocular damage can be induced at 15 mA/cm2.
A potential solution to this issue is the newly developed ionically conductive materials. They conduct ion currents, so when they are used as electrodes, EC reaction-based current conversion does not happen at the electrode/tissue interface. These materials include hydrogels containing high-concentration NaCl/LiCl, ionic liquid hydrogels, natural and synthesized polyelectrolyte hydrogels. However, NaCl/LiCl-containing hydrogels are not stable in aqueous tissue environments due to ion diffusion. Polyelectrolytes and ionic liquids have low conductivity (in general less than 2 S/m), which dissipates/attenuates electrical energy and increases Joule heating. Ionic liquids also have yet to address the issue of cyto- and tissue-toxicity. Therefore, these materials are not suitable for ocular iontophoresis at high current intensities.
To address the issues of current ionic conductors, a novel ion current-conducting circuit device has been developed, referred to herein as the “hydrogel ionic circuit (HIC)”.
Based on the principles of the HIC 100, it was contemplated that a HIC-based iontophoresis system can safely apply higher current intensities than a conventional iontophoresis device to significantly enhance iontophoretic drug delivery efficiency without causing ocular tissue damage.
As shown in
It is noted that, although the present disclosure focuses on transmission across ocular surfaces, the HIC-based iontophoresis systems/devices described herein may be used to deliver therapeutic solutions across a variety of biological surfaces to underlying target regions. Accordingly, the specific embodiments provided herein should be considered as non-limiting examples unless otherwise claimed.
Referring now to
Example Embodiment of the HIC-Based Iontophoresis Device
Chamber 310 may be configured to interface with a portion of an ocular surface 314 (e.g., sclera, corneal epithelium, etc.) overlaying a target region (e.g., vitreous, posterior segment, or any other intraocular region). For example, the chamber 310 may have an opening or permeable/semi-permeable membrane configured to be placed into contact with the ocular surface 314. In some embodiments, chambers 304 and 310 may be cylindrical to provide a cylindrically stacked ocular iontophoresis device that can interface with a front portion of an eyeball much like a contact lens; however, other geometries may also be appropriate depending on the application.
When the HIC-based iontophoresis device 300 is in use, the electrode 302 is configured to apply electrical current from a power source to chamber 304, wherein the electrical current induces an ion current in the salt solution 306. This ion current is transmitted to (or induces a second ion current within) chamber 310 by via the hydrogel membrane 308 while salt ions are stably contained in chamber 304 due to ATPS. The ion current acts on (e.g., is transmitted to/through) chamber 310 to iontophoretically transport molecules (e.g., drug molecules, such as Anti-VEGF molecules 318, PLGA nanoparticles 320, etc., or any combination thereof) from the therapeutic solution 310 across the ocular surface 314.
A method of delivering a therapeutic agent (e.g., drug molecules) across the ocular surface 314 with the HIC-based iontophoresis device 300 may include, but is not limited to, the following steps: (1) disposing the salt solution 306 within chamber 304; (2) disposing the therapeutic solution 312 containing the therapeutic agent within chamber 310, wherein chamber 304 and chamber 310 are separated by the hydrogel membrane 308; (3) interfacing chamber 310 with the ocular surface 314; and (4) applying an electrical current to chamber 304 to induce an ion current in the salt solution 306, wherein the ion current acts on chamber 310 to iontophoretically transport the therapeutic agent from the therapeutic solution 312 across the ocular surface 314.
More generally, a method of delivering a current across an ocular surface 314 with the HIC-based iontophoresis device 300 (or a HIC electrode lacking chamber 310) may include, but is not limited to, the following steps: (1) disposing the salt solution 306 within chamber 304, wherein the chamber 304 is at least partially bound by the hydrogel membrane 308 that defines a barrier between the salt solution 306 and the ocular surface 314; and (2) applying an electrical current to the chamber 304 to induce an ion current in the salt solution 306, wherein the hydrogel membrane 308 is ionically conductive and configured to transmit the ion current across the ocular surface 314.
In an in vivo/clinical implementation of the HIC-based iontophoresis device 300, the therapeutic solution chamber 310 may be placed into contact with a front/side portion of an eyeball and a counter electrode device may be placed into contact with a different front/side portion of the eyeball and/or into contact with surrounding tissue (e.g., a nearby portion of skin) to define a path for the ion current. For example, some ocular iontophoresis systems utilize a counter electrode applied to a patient's forehead.
During iontophoresis, the electron current from a DC current source is converted to ion current at the current source/HIC interface through EC reactions. In accordance with certain embodiments, the high-concentration salt solutions (e.g., phosphate, sulfate, citrate, carbonate, or polyacrylate salt solutions) in the HIC-based iontophoresis device 300 have high efficiency in buffering the pH changes, compared to physiological phosphate-buffered saline (PBS). They can also absorb the heat generated by the EC reactions. As a result, the pH and temperature changes do not affect the ocular tissues. The high-concentration salt solutions then route the ion current to the eye with higher conductivities compared to physiological saline, effectively reducing Joule heating. Furthermore, a unique aqueous two-phase separation (ATPS) between the PEG hydrogel and the salt solution is formed when their concentrations exceed specific thresholds. As a result of this phase separation, high-concentration salt ions (e.g., phosphate, sulfate, citrate, carbonate, or polyacrylate salt ions) are stably contained in chamber 304 with minimal diffusion into the PEG hydrogel, so the salt ions do not affect the drug solution or the ocular tissues.
Minimization of the Impact of pH Changes on the Eye
The Faradaic charge transfer between electron current-conducting electrodes and ion current-conducting media inevitably decomposes water molecules and generates pH changes when polarizable electrodes (e.g., platinum, carbon, etc.) are involved. Non-polarizable electrodes, such as silver/silver chloride, transfer charges through reactions between electrode material and soluble ions, so they do not decompose water molecules or generate pH changes. However, during high-intensity DC current application, the electrode material (e.g., AgCl) may be quickly depleted, after which water decomposition can happen. For this section, pH changes were estimated during high-intensity iontophoresis application and the amount of salt solution 306 (e.g., phosphate salt solution) to buffer these changes to maintain an ocular pH of 6.5 to 8.5, which is considered safe for ocular tissues. A worst-case scenario was used for estimation purposes, which assumed all electron transferred at the current source/HIC interface were used to decompose water molecule. Based on this assumption, the amount of salt (e.g., phosphate salt) required to maintain a safe ocular surface pH can be calculated using the Henderson-Hasselbalch equation, pH=pKa+log (Cs/Cas), where pKa is the negative logarithm of the acid dissociation constant for the salt (e.g., phosphate salt), and Cs and Cas are molarities of the weak acid and its conjugate base. Using an 100 mA, 15-minute long iontophoresis as an example, a total of 5.62×1020 hydrogen ions and hydroxide ions will be generated at the anode and cathode interfaces, respectively. According to the Henderson-Hasselbalch equation, 0.9 mmol of disodium phosphate and sodium dihydrogen phosphate are required to react with these hydrogen/hydroxide ions to maintain an ocular surface pH between 6.5 and 8.5. This method was used to calculate the volume of anode and cathode salt solution in ex vivo drug delivery experiments.
Minimization of the Impact of Temperature Increase on the Eye
Two sources of heat are involved in the HIC-based iontophoresis device 300: (1) electrode overpotential-induced heat at the current source/HIC interface and (2) Joule heating. The electrode overpotential is the potential different between the actual voltage drop across the electrode/electrolyte interface and the thermodynamically required potential for EC reactions and charge transfer. For water electrolysis, the thermodynamically required potential is 1.48 V. Any additional potential above 1.48 V, i.e., overpotential, contributes to heat generation. The Joule heating is the resistive heating produced when current flows through a resistive media. For this section, heat generated during the iontophoresis procedure was estimated, as well as the volume of the liquid in the HIC-based iontophoresis device 300 that is required to maintain an eye temperature of less than 43° C., which is considered safe for ocular tissues.
Due to the complexity of the heat generation and transfer process, computer-aided finite-element analysis (FEA) was used to predict the heat generation and temperature distribution during the high-intensity iontophoresis procedure. The carbon electrode overpotential was measured using a voltage meter. The electrical conductivity of the salt solution 306 (e.g., phosphate salt solution) was measured using a LCR meter/conductivity meter. The electrical conductivity of ocular tissues, the heat transfer coefficients and the specific heat capacities were extracted from literature. The carbon electrode (3.8 cm2 contact area) overpotential at 100 mA was measured to be 4 V. In experiments, the highest temperature increase happened at the drug solution chamber 310, the ocular surface 314 that is in direct contact with drug solution 312, and the hydrogel membrane 308. The high-concentration salt solution 306 had lower temperature increase due to its high electrical conductivity. The inside of the eye also had lower temperature increase due to the lower current density inside of the eye when compared to the ocular surface 314 at the contact point with chamber 310.
Aqueous Two-Phase Separation (ATPS) Between PEG Hydrogel and High-Concentration Phosphate Salt Solution
As a critical feature in the HIC-based iontophoresis device 300, the function of phosphate-PEG ATPS is to contain the high-concentration salt solutions (e.g., salt solution 306) in the HIC-based iontophoresis device 300, so they can buffer pH changes, absorb heat, and conduct ion current with high conductivity, while having little impact on the surrounding ocular tissue environment. Therefore, the stability of the phosphate-PEG ATPS is of high importance to the correct functioning of the HIC-based iontophoresis device 300. Long-term stability of the phosphate-PEG ATPS and its long-term impact on surrounding tissue environment was examined. In embodiments, the PEG hydrogel (hydrogel membrane 308) was prepared by photo-crosslinking of a precursor solution containing 10% w/w PEG dimethacrylate (8 kDa) and 5% w/w PEG diacrylate (700 Da). This PEG formula exceeds the minimal PEG concentration required for the formation of phosphate-PEG ATPS and provides sufficient mechanical strength to support the weight of high-concentration salt solution in the HIC-based iontophoresis device 300. Saturated Na2HPO4 solution (0.6 M, pH=9.0±0.01) was used in the anode device to buffer the hydrogen ions generated by the anode reaction. Saturated Na2HPO4 solution was used here to achieve maximal hydrogen ion buffering capability and maximal electrical conductivity to minimize Joule heating. To buffer the hydroxide ions generated by cathode reaction, a NaH2PO4 solution is required. However, high-concentration NaH2PO4 solution typically has a pH that is much lower than 6.5 (e.g., 3 M NaH2PO4 solution has a pH of 3.9±0.01), which may cause ocular tissue damage. Therefore, a mixture solution containing 0.6 M NaH2PO4 and 0.48 M Na2HPO4 was used in the cathode device. This mixture had a pH of 6.42±0.01.
To evaluate ATPS stability, PEG hydrogel was immersed in anode and cathode phosphate salt solutions and measured its conductivity changes over a 2-week period. As can be seen in
Once the ATPS was formed, the high-concentration phosphate salt solution in the HIC-based iontophoresis device 300 had minimal impact on the surrounding environment. The HIC-based anode and cathode devices were then immersed in PBS and monitored the conductivity and pH changes of the phosphate salt solutions in the HIC-based iontophoresis device 300 and the PBS over a one-hour period. As a comparison, HIC anode and cathode devices filled with 3 M NaCl were also immersed in PBS. As shown in
It was demonstrated that ATPS helped minimize the cytotoxic effects of the high-concentration phosphate salt solution in the HIC-based iontophoresis device 300. PEG hydrogel of HIC-based iontophoresis device 300 was immersed in in vitro cultures of corneal epithelium and endothelium cells, retinal pigmented epithelium cells, and choroid/retina endothelium cells for 1 h and measured the cell viability using LIVE/DEAD stain. As shown in
Safety of High-Intensity Ion Current Application Using the HIC-Based Iontophoresis Device
The safety of the HIC-based iontophoresis device 300 when applying high-intensity ion currents has been demonstrated using the system 600 illustrated in
As shown in
The pH was measured at the drug solution chamber (chamber 310), the sclera surface, and the vitreous fluid after the current application. As shown in
Enhancement of Drug Permeation Rate by High-Intensity Iontophoresis
There are two main mechanisms of iontophoresis: electrophoresis and electroosmosis. Both electrophoretically induced drug flux and electroosmotically induced drug flux are proportional to the applied current intensity:
where ε is the combined porosity and tortuosity factor of the membrane. ψ is the electrical potential, uj is the effective elecromobility. veff is the average effective velocity due to convection results from electroosmosis. zj is the charge number of the ion. C and x are the concentration and position of the permeant in the membrane, respectively. Δψ is the electrical potential applied across membrane. σ is the pore surface charge density. η is the velocity of the bulk solution. 1/k is the thickness of the electrical double layer. h is the membrane thickness. I is the current density and R is the electrical resistance normalized by the surface area of the membrane.
Therefore, it was contemplated that the high-intensity current enabled by the HIC-based iontophoresis device 300 can significantly enhance the iontophoretic drug delivery efficiency with a linear relationship. This hypothesis was tested by performing transscleral (porcine) drug delivery studies using a Franz cell setup and dextran (fluorescein isothiocyanate (FITC)-labeled, molecular weight=40 kDa) as a model drug.
Different current intensities were tested (e.g., 0 mA (i.e., passive diffusion), 40 mA, 60 mA, 80 mA, and 100 mA), and the amount of dextran-40 kDa was sampled in the receipt chamber 704 at different time points (3 min, 6 min, 9 min, 12 min, and 15 min) using a fluorescent plate reader. As shown in
The total amount of drug that permeate through tissue is directly proportional to the total amount of electrical charge applied. This was demonstrated by varying the current intensity and iontophoretic duration, while keeping the total charge applied the same. As can be seen in
The dependence of iontophoretic drug delivery efficiency on the molecular weight of drug has also been studied. The transscleral delivery of fluorescently labeled dextran with molecule weight of 70 k (FD-70) was tested and compared to the results of FD-40. The amount of FD-70 permeated across sclera was in general lower than that of FD-40 during the 15-min iontophoresis at the same current intensity (
Lastly, the dependence of macromolecular drug delivery efficiency on the drug concentration loaded in the HIC-based iontophoresis device 300 was analyzed. Three different FD-40 concentrations were tested, including 5 mg/mL, 10 mg/mL, and 25 mg/mL. As shown in
Macromolecule Delivery to the Posterior Segment Using the HIC-Based Iontophoresis Device
In the Franz cell study described above, it was demonstrated that the significant enhancement effect of the HIC-enabled high-intensity iontophoresis on transscleral macromolecular drug delivery efficiency. A step further was taken to determine the efficacy of the HIC-based iontophoresis technology in enhancing the macromolecular drug delivery to posterior segment using excised rabbit whole eyes. Rabbit eyes were used because they have similar size as human eyes. For this ex vivo study, the anode (i.e., HIC-based iontophoretic device 300) was attached to the front of the eye. The cornea was covered by a plastic film, so the drug molecule could only enter the eye at pars plana. The cathode (i.e., counter electrode device) was attached to the back of the eye.
Iontophoretic delivery of FD-40 was first tested. 100 mA current was applied for 5 min, 10 min, 15 min, and 20 min. The total amount of FD-40 delivered into the eye and its distribution in different tissue layers were measured at different time points.
In light of promising results from the FD-40 posterior segment delivery study, the inventors sought to determine whether the HIC-based iontophoresis device 300 could deliver a therapeutically effective concentrations of bevacizumab, the most commonly used ophthalmic anti-VEGF agent, into the posterior segment. 100 mA iontophoresis was applied with 25 mg/mL bevacizumab loaded in the HIC-based iontophoresis device 300 for 20 min. It was found that 692.02±119.24 μg bevacizumab was delivered into the vitreous (
As previously mentioned, the primary concern of using high-intensity iontophoresis is its potential damage to ocular tissues. It was demonstrated above that the HIC-based iontophoresis device 300 induced minimal temperature and pH changes that were within the safe range for ocular tissues. Here, the impact of high-intensity ion current application on the integrity of ocular tissues was determined using freshly excised rabbit eyes and the viability of in vitro cultured ocular cells. The results demonstrated that after treated by high-intensity ion current (157 mA/cm2 for 20 minutes) applied by the HIC-based iontophoresis device 300, ocular tissue structure remained intact (
Intracorneal Delivery of Macromolecules Using the HIC-Based Iontophoresis Device
In light of promising ex vivo posterior segment macromolecule delivery results, the inventors sought to determine the utility of the HIC-based iontophoresis device 300 in delivering macromolecules to the anterior segment, particularly the cornea. Corneal neovascularization is one of the major ocular diseases occurred in the anterior eye segment, particularly in the stromal layer of cornea. It is commonly treated by subconjunctival or intrastromal injection of anti-VEGF, which can lead to various complications. The tight junctions of the corneal epithelium presents a major barrier to macromolecular drugs, so their diffusion to deeper corneal layers (the stromal and endothelial layers) is limited. It has been reported that the passive diffusion was not effective in delivering dextran to the mouse corneal epithelium, and the penetration improvement was also limited by using conventional iontophoresis devices. High-intensity iontophoresis of FD-40 (157 mA/cm2) was applied on cornea using the HIC-based iontophoresis device 300 for different durations from 2 to 10 minutes. The drug solution chamber (chamber 310) was filled with 25 mg/mL FD-40. High-intensity iontophoresis using the HIC-based iontophoresis device 300 was compared to passive diffusion and low-intensity iontophoresis at 7.5 mA/cm2 applied by the HIC-based iontophoresis device 300. At the end of the iontophoresis, the corneal tissues were examined under fluorescent microscope to visualize the distribution of FD-40. The total amount of FD-40 in cornea was also measured. As shown in
The accumulated amount of FD-40 in cornea as a function of iontophoresis duration was shown in
Next, the impact of high-intensity ion current application by the HIC-based iontophoresis device 300 on corneal tissue integrity was examined using freshly excised rabbit eyes and the viability of in vitro cultured corneal cells. As shown in
Intraocular Delivery of Nanoparticles Using the HIC-Based Iontophoresis Device
The nanoparticle ophthalmic drug formula has several advantages over free-form drugs, including the capability of sustained release, improved drug stability, and the capability of incorporating both hydrophilic and hydrophobic drugs. However, nanoparticles have low permeation rate in ocular tissues due to their large sizes. As a result, nanoparticle ophthalmic drugs are most commonly administered through injection, which can cause potentially blinding ocular tissue damage and adverse impact on patient compliance. The inventors sought to determine the efficacy of HIC-based iontophoresis device 300 operated with high current intensity to enhance the intraocular delivery of nanoparticle ophthalmic drugs. Dexamethasone-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticle was used as a model drug.
In this study, PLGA nanoparticles were fabricated and coated with positively charged chitosan. FTIC was loaded in the nanoparticles as a small molecular drug model. As shown in
Example Embodiment of an Ocular Lens Embedded HIC-Based Iontophoresis Device
As shown in
In embodiments, chamber 304, hydrogel membrane 308, and chamber 310 are stacked within the ocular lens 1100, wherein chamber 304 defines a channel containing the salt solution 306 and chamber 310 defines another channel containing the therapeutic solution 312. As shown in
In some embodiments, the ocular lens 1100 is formed from a hydrogel. For example, the ocular lens 1100 may be formed from the same hydrogel as the hydrogel membrane 308. In this regard, the hydrogel membrane 308 may simply be a portion of the ocular lens 1100 disposed between chambers 304 and 310. Alternatively, the ocular lens 1100 may be formed from a different hydrogel or different biocompatible material. In embodiments, the channels/chambers may be defined by the ocular lens 1100 structure. For example, the ocular lens 1100 may include the channels/chambers etched or molded within the material (e.g., hydrogel) making up the ocular lens 1100. Alternatively, the channels/chambers can be separately manufactured and then embedded within the ocular lens 1100, or built into the ocular lens 1100 (e.g., by 3D printing or another material deposition technique).
The lens embedded HIC-based iontophoresis device 300 may further include a counter electrode channel embedded within the ocular lens 1100 to complete the circuit. The counter electrode channel may also include a chamber 322 containing a salt solution 324 (e.g., phosphate, sulfate, citrate, carbonate, or polyacrylate salt solution) that is at least partially bound by a hydrogel membrane 326 (e.g., PEG hydrogel matrix), wherein a counter electrode 328 (e.g., carbon/metal electrode) is coupled to chamber 322 to complete the circuit so that ion current flows from the electrode channel defined by chamber 304 through a portion of the eyeball 1102 to the counter electrode channel defined by chamber 322. In some embodiments, the counter electrode channel also includes another chamber that is separated from chamber 322 by the hydrogel membrane 326. The chamber adjacent to chamber 322 may be configured to interface with a portion of the eyeball 1102 and may contain a PBS solution or any other inert solution/buffer to further mitigate pH and/or thermal changes at the surface of the eyeball 1102.
The HIC channels defined by chambers 304 and 322 may be coupled to a power source 1104, respectively, by electrodes 302 and 328 (e.g., carbon/metal electrodes). In some embodiments, the HIC channels may be used to perfuse therapeutic agents (e.g., drug molecules) in either direction depending on whether the therapeutic solution 312 is loaded next to chamber 304 or chamber 322. In further embodiments, chamber 310 is a fluid-defined chamber that is defined by a gel loaded with drug solution 312, such that the drug loaded gel (chamber 310) can be disposed next to either HIC channel (i.e., next to chamber 304 or chamber 322). By engineering this biocompatible circuit design into a contact lens, drug (e.g., anti-VEGF, antibiotics, antifungals) loaded gel (chamber 310) can be positioned by either HIC channel (i.e., adjacent to chamber 304 or chamber 322) and perfused across the inducible ion gradient in order to perfuse drug into the posterior segment of the eyeball 1102. This device may facilitate high efficiency drug delivery despite static barriers (e.g., cornea, lens, and choroid) and dynamic barriers (e.g., blood and lymph flow).
Example Embodiment of a HIC-Based Electrical Stimulation Device for Wound Healing
At a cellular level, electrical stimulation can alter cellular activities, which further changes cellular functions, such as contraction, migration, and proliferation. The ability of electrical stimulation to provide a non-pharmacological way to facilitate cell migration has been studied with regard to its effects on wound healing. Many cell types migrate directionally in direct current (DC) electrical field, a phenomenon called electrotaxis. It has been demonstrated that electrotaxis increased the speed of closure of in vitro scratch wounds, suggesting strong therapeutic potentials of electrical stimulation. However, in vivo studies that tested the efficacy of electrical stimulation for wound healing showed inconsistent outcomes. For example, out of eleven randomized controlled clinical trials (RCTs) conducted from 1985 to 2010, five showed that pulsed or continuous DC electrical stimulation significantly increased the wound healing rate compared to controls (p<0.05) (14-18). One RCT showed significantly increased wound healing rate by pulsed DC electrical stimulation (p<0.05), but the number of wounds healed was fewer than control at the end of the study (p>0.05). Five other RCTs showed insignificant (p>0.05) or no improvement on wound healing by pulsed DC electrical stimulation compared to controls (20-24). A careful review of these studies revealed one common problem that is likely to be responsible for such inconsistent outcomes: the time when electrical stimulation was applied was too short due to the use of pulsed voltage. For most studies, the voltage was applied for less than 4 minutes per day. This was not sufficient for electrotaxis-induced scratch wound healing, which requires at least 2 hours of electrical stimulation.
In order to apply electrical stimulation safely for a sufficient amount of time and a high enough current intensity to improve the rate of wound healing, there is a need for improved circuit design that will not damage biological tissue or cause intolerable pain/burning sensation. To address this need, a HIC-based electrical stimulation device is disclosed.
The substrate 1201 may have a plurality of channels (e.g., channels 1206, 1212, 1218) embedded within or attached to the substrate 1201, with each of the channels containing a salt solution (e.g., salt solution 1208, 1214, 1220) and being at least partially bound by a hydrogel membrane (e.g., hydrogel membrane 1222, 1224, 1226) that defines a barrier between the salt solution and the cutaneous wound. As shown in
In an embodiment, the substrate 1201 includes channel 1206 coupled to electrode 1204 and channel 1212 coupled to electrode 1210. Electrode 1204 is configured to apply an electrical current to channel 1206 to induce an ion current in salt solution 1208, wherein the ion current acts on the cutaneous wound to stimulate healing. For example, the ion current may flow through a portion of the cutaneous wound from the channel 1206 to channel 1212, wherein channel 1212 is coupled to electrode 1210 (a counter electrode) to complete the circuit between channels 1206 and 1212.
In some embodiments, the substrate 1201 may only include two HIC channels (e.g., only channels 1206 and 1212). In other embodiments, such as the embodiments illustrated in
As shown in
The HIC-based electrical stimulation device 1200 is configured to convert electron current to ion current at the current source/HIC interface through EC reactions. In embodiments, the high-concentration salt solutions (e.g., phosphate, sulfate, citrate, carbonate, or polyacrylate salt solution) in the HIC-based electrical stimulation device 1200 have high efficiency in buffering the pH changes. They can also absorb the heat generated by the EC reactions. As a result, the pH and temperature changes do not affect biological tissue at the site of the cutaneous wound. This allows for prolonged electrical stimulation at sufficiently high current intensity to improve the rate of wound healing.
Although the technology has been described with reference to the embodiments illustrated in the attached drawing figures, equivalents may be employed, and substitutions may be made herein without departing from the scope of the technology as recited in the claims. Components illustrated and described herein are examples of devices and components that may be used to implement the embodiments of the present invention and may be replaced with other devices and components without departing from the scope of the invention. Furthermore, any dimensions, degrees, and/or numerical ranges provided herein are to be understood as non-limiting examples unless otherwise specified in the claims.
The present application claims priority to U.S. Provisional Application No. 63/059,490, filed Jul. 31, 2020 and titled “Hydrogel Ionic Circuit for Electrical Stimulation and Drug Therapy,” which is incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2021/043718 | 7/29/2021 | WO |
Number | Date | Country | |
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63059490 | Jul 2020 | US |