The present invention relates to a microsyringe. More particularly, the present invention discloses a microsyringe pre-filled with a pharmaceutical and designed to provide controlled delivery of small amounts of the pharmaceutical at slow delivery rates.
Today, therapies exist that involve the administration at precisely defined locations of very small amounts of a pharmaceutical over the course of minutes or even hours. These therapies include, for example, viral vectors for gene therapy, or protein suppression therapies. As some of these pharmaceuticals can be extremely expensive, waste of the pharmaceutical is to be minimized. Waste of the pharmaceutical may occur, for example, from dead space within the delivery system, such as the volumes inherent in catheters, needles, syringes and the like. For practical reasons, such as when delivering the pharmaceutical to brain tissue, the pharmaceutical cannot be diluted up to higher volumes. Hence, precisely controlled delivery of small amounts of a pharmaceutical with minimal waste is greatly desired for such therapies.
One aspect of the invention discloses a microsyringe adapted to provide controlled delivery of small amounts of a pharmaceutical. The microsyringe includes a body, a barrier movably disposed within the body, and a flow regulator. The body includes a pressurizable chamber, an inlet fluidly connected to the pressurizable chamber, an outlet fluidly connected to the pressurizable chamber, and a cannula fluidly connected to the outlet. The flow regulator is fluidly connected to the cannula to limit the flow of a pharmaceutical through the cannula to a maximum rate. The cannula may be a catheter, hypodermic needle or the like. The movable barrier fluidly separates the inlet from the outlet. A pharmaceutical is disposed in a space between the movable barrier and the outlet. The inlet is designed to mechanically and fluidly couple to a hydraulic fluid delivery system. Hydraulic fluid from the inlet pressurizes the chamber, causing the barrier to move and displace the pharmaceutical out of the chamber and into the cannula. The flow regulator ensures that the flow rate of the pharmaceutical through the cannula is not excessive.
In one embodiment, during manufacture of the microsyringe, the microsyringe may be pre-loaded with the pharmaceutical. The body may be formed of a material capable of withstanding temperatures of at least −80° C. so as to conform to the storage protocols of the pharmaceutical.
In certain embodiments, the movable barrier may be a piston slidably disposed within the pressurizable chamber. In other embodiments, the movable barrier may be a collapsible membrane disposed within the pressurizable chamber.
A first embodiment microsyringe 10 is depicted in
Because the microsyringe 10 is designed for the administration of the pharmaceutical 50, and as it is further envisioned that the microsyringe 10 will be provided to a physician pre-packaged with the pharmaceutical 50, the body 20 is preferably made from a material that can both withstand the temperatures commonly employed to store and preserve the pharmaceutical 50, and which is compatible with the pharmaceutical 50. Compatibility indicates that the materials used to form the microsyringe 10, and in particular the body 20, do not adversely affect the therapeutic efficacy of the pharmaceutical 50 over the expected shelf-life of the microsyringe 10. Because temperatures as low as −80° C. may be used to store and preserve the pharmaceutical 50, it may be desirable that the material used to form the body 20 be able to withstand temperatures of at least −80° C.; that is, when removed from cold storage, the material should not subsequently fail when the microsyringe 10 is used, or cause leakage, waste or contamination of the pharmaceutical 50. Exemplary materials suitable for the body 20 include, but are not limited to, polyethylene or polypropylene. Exemplary methods for manufacturing of the body 20 include molding of the body in two halves that are later connected together by a threaded connection, where each half is formed by extrusion blow molding, injection blow molding, or stretch blow molding.
In certain embodiments, the body 20 defines a pressurizable chamber 25 having an inlet 26 and an outlet 22. The pressurizable chamber 25 may, for example, have an internal volume of 0.050-0.500 cm3. Both the inlet 26 and the outlet 22 are fluidly connected to the pressurizable chamber 25. Inlet 26 may include a quick connect/disconnect fitting 28 designed to mechanically and fluidly connect to a corresponding quick connect/disconnect mating 62 of a hydraulic fluid delivery system 60. Such hydraulic mating fixtures are known, and may include, for example and without limitation, the hydraulic coupler set part number 9A2 AZ025 001 manufactured by Kent Systems, LLC, Loveland, Colo., USA. The corresponding mating connections 28, 62 should provide a fluid-tight seal that enables the hydraulic fluid delivery system 60 to provide hydraulic fluid 64 to the pressurizable chamber 25 without loss of pressure. Additionally, the body 20 defines a cannula 24 that is fluidly connected to the outlet 22. The cannula 24 is preferably a catheter, but may also be a hypodermic needle or the like. The cannula 24 may have a length of about 5 cm to about 20 cm. The cannula 24 may have an external diameter of 0.20 mm to 1.30 mm, and an internal diameter of about 0.10 mm to about 0.90 mm. These dimensions are comparable to a syringe needle of gauge 33 to gauge 18. A person of the ordinary skill in the art will appreciate that the fluid pressure needed to move the pharmaceutical 50 through the cannula at the desired flow rates (ranging from 0.10 to 5.0 microliters per minute) is so small that pressure rating of the material thickness of cannula 24 is not an engineering constraint. For purposes of the following disclosure, it is assumed that cannula 24 is a catheter, but it should be understood that microsyringes of the instant invention are not so limited.
In a preferred embodiment, the flow regulator 40 is disposed within the pressurizable chamber 25 and fluidly connected to the catheter 24 via the outlet 22. Hence, any pharmaceutical 50 that would pass through the outlet 22 into the catheter 24 must first pass through the flow regulator 40. As known to those skilled in the art, the flow regulator may be comprised of a tortuous fluid path, such as disclosed, for example, in U.S. Pat. No. 5,993,414, or it may comprise a deflectable membrane as disclosed, for example, in U.S. Pat. No. 6,203,523 and U.S. Pat. No. 6,878,135. In the preferred embodiment of the subject invention, the flow regulator is a separate device inserted into the body 20 and connected to the catheter 24 via outlet 22 at the time the body is assembled, prior to the filling of pharmaceutical reservoir chamber 32 with the deliverable pharmaceutical. The flow regulator 40 prevents the flow rate of the pharmaceutical 50 in the catheter 24 from exceeding a predetermined maximum rate. Thus, the flow regulator 40 thereby prevents the delivery rate of the pharmaceutical 50 to a patient from exceeding the maximum rate. The maximum flow rate will, of course, depend upon the type of pharmaceutical 50 that is being delivered to the patient, and the treatment regimen. Exemplary maximum rates may range from about 0.10 to about 5.0 microliters per minute. For example, if the pharmaceutical 50 is a solution of adeno-associated viral vector particles in saline, the maximum flow rate for a given therapy delivery to a given patient may be 1.0 microliters per minute. Suitable flow regulators 40 are described, without limitation in U.S. Pat. Nos. 5,993,414, 6,203,523 and 6,878,135, incorporated herein by reference in their entireties. For example, the flow regulator 40 may comprise a flow restrictor in between two pressure sensors, that form a flow sensor system in total. The flow sensor is connected to safety valve which restricts the flow of the pharmaceutical 50 when the flow sensor system detects an overflow of the pharmaceutical 50. In another example, disclosed in details in U.S. Pat. No. 6,203,523, the flow regulator features a membrane having a hole, the membrane itself positioned above a bottom layer of the reservoir chamber 32 such that sufficient deflection of the membrane causes the membrane to engage against the bottom layer. As liquid flows through the hole a force is applied to the membrane, resulting in a deflection of the membrane which, in turn, impedes the flow path. In a further embodiment the bottom layer features a variable flow channel such that upon membrane deflection flow may only proceed through the hole and through the flow channel. By tailoring the shape and length of the variable flow channel the flow characteristics of the regulator versus pressure may be adjusted. The flow regulator exemplified in this embodiment permits the flow rate to be independent of reservoir pressure within a given pressure range. Other embodiments of the flow regulator 40 suitable for the instant invention are also possible. In certain embodiments, the barrier 30 is a plunger movably installed inside the pressurizable chamber 25. The plunger 30 may be made from a suitably rigid or elastomeric material that preferably is compatible with both the pharmaceutical 50 and the hydraulic fluid 64. That is, the material used to form the plunger 30 is preferably chemically inert with respect to the pharmaceutical 50 and hydraulic fluid 64 so that the material remains structurally sound and does not contaminate the pharmaceutical 50 over the expected shelf-life of the microsyringe 10. Additionally, the plunger 30 should also be able to withstand the temperatures associated with storage of the pharmaceutical 50, such as temperatures of at least −80° C. The plunger 30 may be made, for example, from polypropylene or polyurethane. The shape of the plunger 30 is conformal with the inner surface of the pressurizable chamber 25 to provide a sliding, fluid-tight seal against the inner surface of the pressurizable chamber 25. The inner surface of the pressurizable chamber 25 is preferably smooth and geometrically invariant along the axis along which the plunger 30 is capable of sliding; as shown in
A distal face 36 of the plunger 30 is preferably conformal with a proximal face 42 of the flow regulator 40 so that when the plunger 30 abuts the flow regulator 40 a bare minimum of dead space is present so as to minimize waste of the pharmaceutical 50. More generally, when the plunger 30 reaches its most distal stop position, which is as close to the outlet 22 as the plunger 30 can reach, the distal face 36 preferably geometrically conforms to the corresponding shape of the stop position so as to minimize dead space between the distal face 36 and outlet 22. For example, if the flow regulator 40 were instead to be positioned elsewhere along the catheter 24, the distal face 36 of the plunger 30 may have a shape that is conformal to the shape of the distal end (the end containing the outlet 22) of the pressurizable chamber 25.
The catheter 24 is a fluid delivery device, the distal end 29 of which may be positioned into a desired target location within a patient. For example, a pre-positioned guide tube, as known in the art, may be used to position the distal end 29 of the catheter 24 within a patient. Such guide tubes are frequently used, for example, in neurosurgery, and are themselves positioned using stereotactic microdrives. Stereotactic microdrives frequently employ an extremely precise hydraulic system to position the guide tube. Hence, the hydraulic fluid delivery system 60 may be the same hydraulic system that is used by the stereotactic microdrive to position the guide tube. Examples of such a hydraulic systems are the SM-25C Stereotaxic Micromanipulator (Thin-type, Single Axis, Oil Hydraulic System), manufactured by Narishige Co., Ltd., Japan, and the SomaPatch™ MW Series Hydraulic Micromanipulators provided by Soma Scientific Instruments, Irvine, Calif., USA
In other embodiments, when the precise location of the targeted area is crucial, e.g., when the pharmaceutical is delivered into the brain of the patient, other mapping means may be used instead of or in addition to the stereotactic positioning. Such mapping means include, without limitation, Positron Emission Tomography and Single Photon Emission Computed Tomography (PET and SPECT, respectively), pharmacological Magnetic Resonance Imaging (phMRI), functional MRI (fMRI), and contrast-enhanced computerized tomography (CT) scan. Further, computer-aided atlas-based functional neurosurgery methodology can be used to accurately and precisely inject the pharmaceutical. Such methodologies permit three-dimensional display and real-time manipulation of cerebral structures. Neurosurgical planning with mutually preregistered multiple brain atlases in all three orthogonal orientations is therefore possible and permits increased accuracy of target definition for neurotoxin injection or implantation, reduced time of the surgical procedure by decreasing the number of tracts, and facilitates planning of more sophisticated trajectories. See e.g. Nowinski W. L. et al., Computer-Aided Stereotactic Functional Neurosurgery Enhanced by the Use of the Multiple Brain Atlas Database, IEEE Trans Med Imaging 19(1); 62-69:2000.
Once the guide tube is positioned, the catheter 24 may be fed down the guide tube until the distal end 29 is positioned at the desired location within the patient. To assist in fluoroscopic or x-ray imaging, which may be employed to aid in the positioning of the catheter 24, the catheter 24 may also be provided one or more radiopaque markers, such as at the distal end 29 and at regular intervals between the distal end 29 and the outlet 22. Methods for manufacturing catheters incorporating radiopaque markers are well known in the art, and are disclosed in such issued patents as U.S. Pat. No. 5,846,220 and U.S. Pat. No. 6,179,811, the contents of which are incorporated herein by reference. For example, the radiopaque marker band may be incorporated into the catheter 24 by inserting a mandrel containing the bands of the radiopaque marker into the catheter 24, and then heating the catheter 24 to about 300-350° F. thus melting the bands into the catheter 24. Once distal end 29 is properly positioned, the quick connect/disconnect 62 may be disconnected from the stereotactic microdrive and connected to the corresponding fitting 28 of the inlet 26. In one embodiment, the chamber 34 is pre-packaged with the hydraulic fluid. Similarly, in a preferred embodiment, the chamber 32 is pre-packaged with drug 50. Thus, in such embodiment inlet 26 will also further comprise a seal. In one embodiment, the seal is a foil seal, held onto the end of the device that connects to the hydraulic fluid delivery system by the threaded connection of two portions of the body of the device such that the foil seal is sandwiched between the body of the device and an end-ring. Fluidly connected to the inlet 26, the hydraulic fluid delivery system 60 is then ready to provide hydraulic fluid 64 under finely controlled pressure to the pressurizable hydraulic fluid chamber 34.
For purposes of the instant disclosure, it should be understood that the term “fluid” is broadly meant to include any substance that is capable of flowing and being used as a medium for transferring pressure from one point to another. A fluid may therefore include both gasses and liquids. For example, the hydraulic fluid 64 could, in fact, be nitrogen, filtered air, mineral oil, distilled water, or saline. The pressure provided by the hydraulic fluid delivery system 60 via the hydraulic fluid 64 creates an increase of pressure within the pressurizable hydraulic fluid chamber 34. This increased pressure exerts a force upon the plunger 30, causing the plunger 30 to slide distally towards the outlet 22. The distal movement of the plunger 30 causes a corresponding volumetric displacement of the pharmaceutical 50, which flows past the flow regulator 40, through the catheter 24 and into the patient at the predetermined position set by the distal end 29 of catheter 24. By utilizing the hydraulic fluid delivery system 60 to finely control the pressure developed in the pressurizable hydraulic fluid chamber 34, precise control of the delivery rate of the pharmaceutical 50 is made possible over extended periods of time; however, in no event will the delivery rate exceed the maximum rate set by the flow regulator 40, thus ensuring patient safety. In the preferred embodiment, regulator 40 will allow a single maximum flow rate that is equal to the desired flow rate, and any minimal externally applied pressure by hydraulic fluid system 60 is sufficient to deliver the pharmaceutical 50 (e.g., viral particles) from body 20 through the flow regulator 40 and to the patient at that desired flow rate. Because the entire body 20 will experience the delivery pressure exerted by the hydraulic fluid delivery system 60, it is desirable that the body 20 be fashioned to withstand at least the maximum pressures expected from the hydraulic delivery system 60. Assuming that the maximum pressure will be about 80 mm Hg, the body 20 is preferably made of polypropylene of having a minimum thickness of about 1 mm. Since the cannula is preferably made of a metal, such as, for example, stainless steel, no special considerations are needed for the metal to be able to withstand the pressure ranging up to 80 mm Hg.
Exemplary manufacturing steps for microsyringe 10 are: 1) the body 20 is molded in two threaded halves, 2) the cannula 24 is attached to the end of body 20 by, for example, a threaded connection, 3) the distal end of body 20 and the entire cannula 24 are filled with the viral vector and frozen, 4) the plunger 30 is placed on top of the frozen vector and the second half of the body 20 is attached by a threaded connection, 5) the second half of the body 20 is filled with mineral oil, 6) a cap with a foil seal is placed at the open end of the second half of body 20 and attached by a ring with a threaded connection, 7) the entire unit is placed in a sterile outer packaging, and sterilized by exposure to ethylene oxide gas. Once completed, the pre-packaged microsyringe 10 may be transported and stored under temperatures that are suitable to ensure preservation of the pharmaceutical 50. When pharmaceutical 50 is needed, the microsyringe 10 may be taken from storage and provided to the physician, who removes the microsyringe 10 from its sterile packaging and uses the microsyringe 10 in conjunction with the hydraulic fluid delivery system 60 to administer the pharmaceutical 50, as described above. After the pharmaceutical 50 has been administered, the microsyringe 10 may be discarded. The microsyringe 10 thus provides a single-use cartridge that may be conveniently delivered into the operating room when needed.
The microsyringe of the instant invention can be used to deliver different pharmaceuticals. Suitable examples include small molecules, such as, for example, ibuprofen, and proteins or fragments thereof, including, for example, glial cell derived neurotrophic factor, or GDNF. In addition, the microsyringe can be used to deliver gene therapy systems, whether administered as naked nucleic acid sequences or within vectors, including both viral and non-viral vectors, providing suitable dosages of these pharmaceuticals into the operating room as needed with minimal waste.
A second embodiment of microsyringe 200 is shown in
The collapsible membrane 230 may be made from any suitably flexible or easily deformable material, either by design through shape, inherently by material properties or both, and is preferably compatible with the pharmaceutical 250 and the hydraulic fluid 64. Additionally, the collapsible membrane is preferably able to withstand the storage temperatures associated with the pharmaceutical 250, such as such as temperatures of −80° C. or lower. The collapsible membrane 230 may be made, for example, from a thermoplastic hydrocarbon elastomer, such as thermoplastic polyolefin elastomer. Methods for manufacturing a pharmaceutical delivery device comprising an internal, collapsible membrane, are well known in the art and exemplified by U.S. Pat. No. 4,203,440, incorporated herein by reference in its entirety. The device disclosed in U.S. Pat. No. 4,203,440 differs from the microsyringe of the instant invention in that the expulsion of the pharmaceutical 50 from within microsyringe 200 occurs due to the increase in hydraulic pressure in chamber 225, rather than due to influx of fluid into an outer chamber due to osmosis as disclosed in U.S. Pat. No. 4,203,440. The collapsible membrane 230 fluidly divides the pressurizable chamber 225 into two logically distinct regions: a pharmaceutical reservoir chamber 232 that holds the pharmaceutical 250, and a pressurizable hydraulic fluid chamber 234, which accepts the hydraulic fluid 64 under pressure from the hydraulic fluid delivery system 60. The collapsible membrane 230 is ideally impermeable to both the pharmaceutical 250 and the hydraulic fluid 64. The pharmaceutical reservoir chamber 232 and the pressurizable hydraulic fluid chamber 234 are therefore fluidly isolated from each other, although fluidly connected to outlet 222 and inlet 226, respectively.
Once connected to fitting 228, the hydraulic fluid delivery system 60 creates an increase of pressure within the pressurizable hydraulic fluid chamber 234. This pressure exerts a force upon the collapsible membrane 230, in effect squeezing the pharmaceutical 250 out of the pharmaceutical reservoir chamber 232. The pharmaceutical 250 flows past the flow regulator 240 and outlet 222, through the cannula 224 and into the patient at the predetermined position set by the distal end 229 of cannula 224. The fine pressure control provided by the hydraulic fluid delivery system 60 enables precise control of the delivery rate of the pharmaceutical 250 over extended periods of time. Flow regulator 240 ensures that the flow rate of pharmaceutical 250 through cannula 224 never exceeds the pre-set maximum rate. The body 220 is preferably fashioned to withstand at least the maximum pressures expected from the hydraulic delivery system 60 to avoid unexpected structural failures of any portion of the body 220. It will be appreciated that hydraulic fitting 228 may comprise a one-way valve to prevent backflow of the hydraulic fluid 64 from the pressurizable hydraulic fluid chamber 234.
Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the following claims.
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