Embodiments of the present disclosure relate to implantable medical devices. In some embodiments, implantable encapsulation devices are provided that are operable to house cells, tissue, and/or therapeutic agents and deliver therapeutic effects to a host or recipient of the device.
The number of patients suffering from Type I and Type II diabetes is estimated to affect about 4.6% of the world's population. Pancreas transplantation and islet transplantation are known methods for treating diabetes. However, pancreas and islet transplantation into diabetic patients is limited to a small percent of patients who might benefit from either procedure due to the lack of available human pancreata or pancreatic islets. With the recent development of insulin secreting cells derived from human stem cells, there is a possibility of treating patients with insulin dependent diabetes through transplantation. However, such cells would be subject to rejection by the immune system of the recipient patient unless immunosuppressive drugs were administered to the patient for the rest of their life. Alternatively, insulin secreting cells could be provided with an immuno-isolating implantable device and placed in the diabetic patient to act as an insulin delivery source.
Since the islet transplantation protocol was established, clinical islet transplantation has been regarded as a treatment method for treating type 1 diabetics. However, the low engraftment success of transplanted islet cells remains a major cause of failure of long-term blood sugar regulation. Upon implantation, it is necessary for islet cells to be successfully engrafted through revascularization and blood flow regulation within a few days after transplantation. However, transplanted islet cells are exposed to a state with low vascular density and insufficient oxygen conditions, making it difficult to achieve normal engraftment of islet cells and the ability to achieve regulated insulin secretion in the patient.
Currently, there are limited means and materials to effectively implement live cell containing immuno-isolation devices in vivo. Limitations associated with supply of adequate oxygen levels to encapsulated cells, sufficient nutrient levels to the encapsulated cells, insufficient vascularization of the implanted device and immune response to the implant, remain barriers to use of cell-containing implantable devices.
Embodiments of the present disclosure provide encapsulation devices having a matrix or scaffold for supporting cells. In some embodiments, methods of preparing and forming an encapsulation device with a matrix are provided. Donor islet cells (e.g. from a cadaver) have been observed to “clump” together and function normally when implanted into an encapsulation device, while cells derived from differentiation of stem cells (for example) do not function as well as cadaver cells. Accordingly, embodiments of the present disclosure contemplate and provide one or more matrix structures within a void or cell-receiving area of the device. Matrices of the present disclosure provide a structural means of stabilizing and aggregating cells.
International Application Nos. PCT/US2017/060036 to Papas, PCT/US2017/060034 to Papas, PCT/US2017/060041 to Papas, and PCT/US2017/060043 to Papas relate to encapsulation devices and are each incorporated by reference in their entireties herein for all purposes.
Devices of the present disclosure include various materials, including those deemed appropriate by a person skilled in the art for an implantable medical device. For example, membranes of the present disclosure are contemplated as being prepared from a polymeric material. In such embodiments, the single layer gradient membrane is prepared from such polymeric materials as: polysulfone, polyarylethersulfone (PAES), polyethersulfone (PES), cellulose ester (cellulose acetate, cellulose triacetate, cellulose nitrate), nanocellulose, regenerated cellulose (RC), silicone, polyamide (nylon), polyimide, polyamide imide, polyamide urea, polycarbonate, ceramic, titanium oxide, aluminum oxide, silicon, zeolite (alumosilicate), polyarylonitrile (PAN), polyethylene (PE), low density polyethylene (LDPE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), polyvinylchloride (PVC), polypiperazine amide, polyethylene terephthalate (PET), polycarbonate (PC), polyurethane, and any complex or mixtures thereof. In particular embodiments, a single layer gradient membrane includes a polymeric material including polytetrafluoroethylene (PTFE). In certain preferred embodiments, PTFE is provided for at least a vascularizing layer of devices of the present disclosure. Additional materials are contemplated as being provided in membranes and implants of the present disclosure in addition to or in lieu of PTFE.
The advantages of the presently disclosed immune-isolation implantable devices include a maximization of surface area presented by the device available for vascularization by a host. In particular, implantable devices or portions thereof that include an immuno-isolation device present a surface area that may be vascularized by the host when implanted. This structure maximizes vascularization of the device as a whole in the animal.
In one embodiment, a method for filling an implantable encapsulation device including an internal void for encapsulation of cells, a channel adjacent a first side of the void and separated from the void by a fluid permeable membrane, and a vascularization membrane on a second side of the void is provided. The method includes introducing a composition including cells and a matrix-forming material into the void; introducing a cross-linking agent into the channel, whereby the cross-linking agent passes the fluid permeable membrane to cross-link the matrix-forming material near the fluid permeable membrane; introducing a quenching agent into the channel, whereby the quenching agent passes the fluid permeable membrane to reduce cross-linking of the matrix-forming material, whereby the void includes a matrix gradient having higher cross-linking near the fluid permeable membrane and lower cross-linking density near the vascularization membrane.
In one embodiment, an implantable encapsulation device is provided that includes a first void for receiving and encapsulating cells, wherein the first void has a first side; a channel adjacent the first side of the first void and separated from the first void by a gas permeable membrane; wherein the channel occupies a portion of the first side of the first void that is less than all of the first side of the first void; and wherein the portion of the first side of the first void not occupied by the channel includes a vascularization membrane.
In various embodiments, methods of preparing, preserving, freezing and/or thawing encapsulation devices are provided. In some embodiments, methods are provided that include introducing a cryopreservation solution to freeze cells within a matrix or encapsulation device. It is contemplated that cryopreservation solution is provided to an encapsulation device to affect a transfer of thermal energy and reduce the temperature of the device and associated cells. In preferred embodiments, a cryopreservation solution is delivered through one or more channels that extend in or through a volume of an encapsulation device. It is contemplated that cryopreservation solution(s) are applied to the device in a flow-through manner in which solution is continuously applied through the device and/or solution is delivered through an opening and allowed to remain static while cooling occurs. Additionally, methods and systems of the present disclosure further contemplate the provision of applying cryopreservation solution(s) to an exterior of an encapsulation device in lieu of or in addition to the application of solution(s) to the gas chamber.
In some embodiments, the cryopreservation solution includes dimethyl sulfoxide. The solution(s) are contemplated as including various different concentrations of dimethyl sulfoxide and, in various embodiments, include dimethyl sulfoxide provided with or diluted in additional fluid.
Embodiments of the present disclosure further contemplate delivering a fluid (gas or liquid) to increase thermal energy within the device and/or cells. For example, it is contemplated that gas (e.g. ambient air) or liquid is provided in or through a gas chamber of an encapsulation device to thaw or otherwise increase a temperature of the device and housed cells. Accordingly, the present disclosure is not limited to methods of freezing or cooling devices and cells.
In various embodiments of the present disclosure, encapsulation devices are provided with a cell matrix for housing, supporting, and promoting proper functioning of cells. In various embodiments, a matrix-forming material, such as alginate, is provided through a flow channel or internal conduit to form a matrix with a greater density proximal to the gas chamber and a decreasing density (at least in terms of cross-linking) at distances farther away from the channel and membrane between the channel and the matrix. Methods of forming a matrix and preparing an encapsulation device are provided that initiate matrix creation at or near an interior of the device and proximal to the channel, and wherein the matrix density is less at points distal from the channel. Such embodiments allow for solution(s) to be provided to the device through the flow channel or chamber while reducing risk that the solution(s) will block or clog the membranes and prevent gas delivery (for example) into the matrix. Various embodiments of the present disclosure contemplate the provision of a flow channel and the use of that channel for multiple purposes. For example, systems and methods of the present disclosure contemplate applying and conveying a cryopreservation solution to or through the channel to freeze the device and housed cells. The channel(s) of such devices must later be available for receiving fluid (e.g. oxygen-carrying gas) to deliver necessary materials to the cells as shown and described herein in various embodiments. Accordingly, processes related to cryopreservation and the application of cryopreservation solution(s) preferably avoid clogging or obstructing the channel, the membrane, and the matrix. In various embodiments, methods of the present disclosure include treating or washing encapsulation subsequent to cryopreservation or thawing steps. In some embodiments, sodium chloride is applied to the exterior surfaces and/or inner channel of a device to wash or treat the device and remove any dimethyl sulfoxide (or other materials) that may be present on the device and which may have undesirable impacts on the cells if not removed or remedied.
In some embodiments, matrix formation is provided wherein calcium chloride is provided within a flow channel of an encapsulation device and sodium chloride is provided or injected into the cell chamber of the device to form a matrix with a desired gradient or density distribution. A gradient is formed by the interaction between calcium chloride and sodium chloride, and wherein the matrix includes a greater density proximal to the channel.
In one embodiment, a method is provided for filling an implantable encapsulation device including an internal void for encapsulation of cells, a channel adjacent a first side of the void and separated from the void by fluid permeable membrane, and a vascularization membrane on a second side of the void. The method includes introducing a composition including cells and a matrix-forming material into the void and introducing a cross-linking agent into the channel, whereby the cross-linking agent passes the fluid permeable membrane to cross-link the matrix-forming material near the fluid permeable membrane. A quenching agent is introduced at least one of into the channel or to surround the chamber, whereby the quenching agent passes the fluid permeable membrane to reduce cross-linking of the matrix-forming material, whereby the void includes a matrix gradient having higher cross-linking near the fluid permeable membrane and lower cross-linking density near the vascularization membrane.
In one embodiment, an implantable encapsulation device is provided that includes a first void for receiving and encapsulating cells. The first void has a first side and a channel adjacent the first side of the first void and separated from the first void by a gas permeable membrane. The channel occupies a portion of the first side of the first void that is less than all of the first side of the first void. The portion of the first side of the first void not occupied by the channel includes a vascularization membrane.
In one embodiment, a method is provided for preparing an implantable encapsulation device is provided wherein the device includes first and second chambers for encapsulation of cells; a channel adjacent first exterior surfaces of the first and second chambers and separated from interiors of the chambers by at least one fluid permeable membrane; and wherein the first and second chambers have second exterior surfaces. The method includes introducing a composition including cells into the interiors of the chambers, delivering a fluid into the channel to increase or decrease a temperature of the cells, and delivering a fluid across the second exterior surfaces of the first and second chambers to increase or decrease a temperature of the cells.
Various concepts disclosed herein may be provided in combination with one another even if such combination is not specifically depicted or described. For example, and without limitation, cryopreservation and fluid delivery concepts may be provided with the device of
Unless otherwise defined, all technical and/or scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the invention pertains. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the invention, exemplary methods and/or materials are described below. In addition, the materials, methods, and examples are illustrative only and are not intended to be necessarily limiting.
Reference to an element by the indefinite article “a” or “an” does not exclude the possibility that more than one element is present, unless the context clearly requires that there be one and only one element. The indefinite article “a” or “an” thus usually means “at least one.”
As used herein, “about” means within a statistically meaningful range of a value or values such as a stated concentration, length, molecular weight, pH, sequence identity, time frame, temperature or volume. Such a value or range can be within an order of magnitude, typically within 20%, more typically within 10%, and even more typically within 5% of a given value or range. The allowable variation encompassed by “about” will depend upon the particular system under study, and can be readily appreciated by one of skill in the art.
In various embodiments, including those shown in
Devices of the present disclosure are contemplated as including various shapes and sizes and as having internal voids with various different internal volumes. For example, in some embodiments, the void has a volume of between about 4.5 μL and about 400 μL, or any intermediate range between those endpoints. In some embodiments, encapsulation devices of the present disclosure include a length of between about 2 and about 10 cm, or any intermediate range, such as between about 4 and about 5 cm. In addition, encapsulation devices of the present disclosure include a width of between about 1 and about 5 cm, or any intermediate range, such as between about 2 and about 3 cm. Thus, the encapsulation devices may be generally rectangular (or other geometric shape, e.g., polygonal) with a thickness sufficient to accommodate the layers of membranes and voids.
In various embodiments, cells 6 provided within an encapsulation device are contemplated as including islet cells or stem cell derived beta cells or the like, e.g., for regulating blood glucose, or other cells or spheroids that may produce and release a therapeutic agent that is useful in the body. The cells in the different encapsulation devices may be the same, similar, or various different combinations of cells may be included within the encapsulation devices or throughout the device(s). For example, in embodiments including a plurality of encapsulation devices, the cells in the first encapsulation device may be the same as the cells in the second encapsulation device. Or, in some embodiments, the cells in the first encapsulation device may be the different from the cells in the second encapsulation device.
In addition to loading cells 52 into the void 54, the embodiments further include introducing a solution including a matrix-forming material so that the void, including the area immediately surrounding the cells, is provided with a matrix-forming material that may form a hydrogel or other similar matrix. For example, the matrix-forming material may be a monomeric or polymeric material that upon introduction of a binder or crosslinker forms a hydrogel or other matrix. In some embodiments, the matrix-forming material may be alginic acid or other polysaccharide or fibrinogen that may form alginate or fibrin gels. U.S. Pat. No. 9,642,814 to Ramachandran et al., which is hereby incorporated by reference in its entirety, discloses various processes and materials for matrix formation.
The void is bounded by at least one membrane 56. The membrane 56 preferably surrounds and encapsulates the void 54 but is shown as an upper and lower-layer in the cross-section of
The channel 58 is provided adjacent to the void 54 and is separated by the membrane 56. Oxygen is provided and allowed to flow through the channel. Oxygen is allowed to diffuse through the membrane and infiltrate at least a portion of the void 54.
In various embodiments according to the present disclosure, and as shown in
The present disclosure contemplates various materials for forming a matrix or scaffold. For example, in some embodiments glutaraldehyde (GA) is used as a crosslinking agent for improving biocompatibility and durability. In various embodiments, other crosslinking agents are contemplated. An ideal biomaterial crosslinking agent includes no cytotoxicity and includes a low-cost material. Preferably, the agent improves the mechanical performance of the materials. Various chemical crosslinking agents and natural crosslinking agents are contemplated. For example, contemplated chemical crosslinking agents include, but are not limited to, glutaraldehyde (GA), carbodiimide (1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide (EDC)), epoxy compounds, six methylene diisocyanate, glycerin and alginate, or the like. In addition, contemplated natural crosslinking agents include, but are not limited to, genipin (GP), nordihydroguaiaretic acid (NDGA), tannic acid and procyanidins (PC). Various concentrations of crosslinking agents are contemplated herewith and no limitation with respect to an amount, proportion, or concentration of any particular crosslinking agent is provided. Additionally, no limitation with respect to agents is provided herewith. It is contemplated that various agents and materials are provided to form a matrix or scaffold as shown and described herein. For example, various plasma gels are contemplated for use. Commercially available products such as SURGIFLO® Hemostatic Matrix and Grifols VISTASEAL® are contemplated as clotting or cross-linking agents for use with systems and methods of the present disclosure. Matrices and devices of the present disclosure are contemplated as being biodegradable in various embodiments. In other embodiments, the matrices and devices are contemplated as being substantially non-biodegradable, permanent features.
When sufficient cross-linking and matrix formation has occurred such that the cells are embedded or bound in the matrix and the distal portions of the cells 52 are not provided in the matrix, or the matrix is of an appropriate density to allow passage of and proper kinetics of glucose and insulin, provision of the cross-linking agent is stopped. In addition, matrices formed by practice of the invention may have a thickness of between about 10 μm and about 600 μm, or any intermediate range thereof. As shown in
In one example embodiment, the cells 52 may be loaded via an opening 64 of the void 54 via a loader 66. In addition, the fluid or quenching agent may be introduced into the channel 58 via an opening 68 in the channel 58 by tubing 70 (e.g., removable tubing). Further, the fluid or quenching agent may surround the chamber 56 and/or the channel 58 within a bath or containment device 74.
Methods, systems and devices as shown in
Additional embodiments according to the present disclosure includes an implantable encapsulation device including an internal chamber for encapsulation of cells, a channel adjacent a first side of the chamber and separated from the chamber by fluid permeable membrane, and a vascularization membrane on a second side of the chamber, wherein the chamber includes a matrix gradient having higher cross-linking near the fluid permeable membrane and lower cross-linking density near the vascularization membrane. Still further additional embodiments according to the disclosure is the implantation of such an encapsulation device into a patient in need thereof to provide a therapeutic benefit to the patient.
Although the embodiments of
Another embodiment of the present invention includes implantation of an encapsulation device having a reduced fluid channel footprint as described herein into a patient in need thereof to provide a therapeutic benefit to the patient. In this embodiment, vascularization on the device between cell chamber layers is achieved.
Additionally, it is contemplated that at least one of the fluid flows 108, 110 is provided as a warming or thawing process that includes a fluid with a temperature above 0° Celsius for warming or thawing the device 100 and housed cells prior to implantation. The channel 102 is further operable to be provided as and function as a conduit for delivering gas (e.g. oxygen) or nutrients to cells prior to or subsequent to implantation.
The systems and methods of
A stacked arrangement is provided where an encapsulation device 120 includes a plurality of cell chambers 122 with voids 123 operable to receive and house cells 124 within a formed matrix. The cells 124 may be provided in the form of spheroids including multiple cells within each spheroid. Alternatively, individual cells or “clumps” of cells may be loaded into the cell chambers 122 of the device 120. In some embodiments, the chambers 122 or other membranes of the encapsulation device 120 may be constructed from materials such as polytetraflouroethylene (PTFE) or other similar material (e.g., as described throughout the present disclosure). It is noted embodiments related to the formation of a matrix within a void for embedding or aggregating cells in a graduated matrix by use of a fluid channel and a void for housing of cells as described with respect to
The encapsulation device 120 includes one or more channels 126. The channels 126 extend through or at least partially through an interior volume of the encapsulation device 120. In one example embodiment, a channel 126 may be provided adjacent to and extends between two cell chambers 122a, 122b. The channels 126 are fabricated from a rubber or plastic. For example, the channels 126 may be fabricated from a fluid-permeable silicone rubber tube, or may be fabricated from another material as described throughout the present disclosure. The channels 126 include one or more ports 128 which operate as inlets/outlets for a fluid. For example, the encapsulation device 120 may include an inlet 128a and an outlet 128b for oxygen.
The encapsulation device 120 may include one or more immunoisolation membranes 130 and/or one or more vascularization membranes 132.
In one example embodiment as shown in
In another example embodiment as shown in
The encapsulation device 120 is secured with space provided to permit vascularization. For example, the encapsulation device 120 may be secured by sutures, a kinetic glue, or welded together (e.g., spot welded, or the like). In some embodiments, including those shown in
As shown in a cross-sectional top plan view in
In this regard, the encapsulation device 120 embodied in at least
A stacked arrangement is provided where an encapsulation device 140 includes a plurality of cell chambers 142 with voids 143 operable to receive and house cells 144 within a formed matrix. The cells 144 may be provided in the form of spheroids including multiple cells within each spheroid. Alternatively, individual cells or “clumps” of cells may be loaded into the cell chambers 142 of the device 140.s In some embodiments, the chambers 142 or membranes are constructed from materials such as polytetraflouroethylene (PTFE) or other similar material (e.g., as described throughout the present disclosure). It is noted embodiments related to the formation of a matrix within a void for embedding or aggregating cells in a graduated matrix by use of a fluid channel and a void for housing of cells as described with respect to
The encapsulation device 140 includes one or more channels 146. The channels 146 extend through or at least partially through an interior volume of the encapsulation device 140. In one example embodiment, a channel 146a is provided adjacent to and extends between two cell chambers 142a, 142b, and a channel 146b is provided adjacent to and extends between two cell chambers 142b, 142c. The channels 146 are fabricated from a rubber or plastic. For example, the channels 146 may be fabricated from a fluid-permeable silicone rubber tube, or may be fabricated from another material as described throughout the present disclosure.
It is noted the encapsulation device 140 is not limited to the three chambers 142 and two channels 146 as illustrated in
The channels 146 include one or more ports 148 which operate as inlets/outlets for a fluid. For example, the encapsulation device 140 may include an inlet 148a and an outlet 148b for oxygen. For instance, the inlet 148a and the outlet 148b may be separate.
As shown in an example embodiment in
Although embodiments of the present disclosure are directed to the channels 146 being used for gas delivery, it is noted herein the channels 146 may in addition or alternatively be used as a heat exchanger.
The encapsulation device 140 may include one or more vascularization membranes 150. In one example embodiment as shown in
The encapsulation device 140 is secured with space provided to permit vascularization. For example, the encapsulation device 140 may be secured by sutures, a kinetic glue, or welded together (e.g., spot welded, or the like). In some embodiments, including those shown in
As shown in the views in
As shown in
It is noted the entire encapsulation device 140 may be secured via spot welds, gluing or the like. In addition, it is noted the tubing 146 may be secured on the bottom or top chamber 142 (e.g., of the stack) vascularization membrane 150 (e.g., that is not isolating) or immunoisolation membrane 154.
In this regard, the encapsulation device 140 embodied in at least
It is noted that for purposes of the present disclosure, “oxygen” may refer to a pure or substantially pure O2 gas, a mixture of pure O2 gas and air, or air. In addition, it is noted any embodiment directed to a particular encapsulation device as shown in
Although various methods and systems of the present disclosure contemplate the provision of cells within a matrix provided within an encapsulation device, methods and systems are contemplated that do not include a matrix as shown and described herein. For example, in some embodiments, spheroid cells are provided in a cell chamber and a matrix is not formed in the encapsulation device. Methods of the present disclosure, including but not limited to those related to cryopreservation are contemplated for such devices including spheroids. Examples of spheroid cells are provided in International Application PCT/NL2017/050098 to Van Beurden which is hereby incorporated by reference in its entirety.
The examples set forth above are provided to give those of ordinary skill in the art a complete disclosure and description of how to make and use the embodiments of the methods for prediction of the selected modifications that may be made to a biomolecule of interest, and are not intended to limit the scope of what the inventors regard as the scope of the disclosure. Modifications of the above-described modes for carrying out the disclosure may be used by persons of skill in the art, and are intended to be within the scope of the following claims.
It is to be understood that the disclosure is not limited to particular methods or systems, which can, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting.
A number of embodiments of the disclosure have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the present disclosure. Accordingly, other embodiments are within the scope of the following claims.
This U.S. Non-Provisional Application claims the benefit of priority from U.S. Provisional Patent Application Ser. No. 63/108,017 filed Oct. 30, 2020, the entire disclosure of which is hereby incorporated by reference.
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Number | Date | Country | |
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20220134074 A1 | May 2022 | US |
Number | Date | Country | |
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63108017 | Oct 2020 | US |