The present disclosure relates to a photodynamic therapy device including a cooling water circulation unit for blood.
In photodynamic therapy (PDT), blood having absorbed a photoreactive agent having a characteristic light absorption band is once taken out of a patient's body and irradiated with a light beam corresponding to the characteristic light absorption band, thereby destroying or affecting undesirable components in the blood. For example, an LED is used as a light source of a light beam which is irradiation light.
By the way, when the blood taken out of the patient's body is irradiated with the light beam by the LED at the time of the PDT treatment described above, the blood generates heat and the temperature rises. An increase in the temperature of the blood may place a burden on the patient's body to which the blood is returned. Furthermore, an increase in temperature adversely affects the blood itself.
Patent Document 1: WO 2017/164202 A
The present disclosure provides a photodynamic therapy device that suppresses an increase in blood temperature in PDT.
The photodynamic therapy device of the present disclosure is a photodynamic therapy device that irradiates light from a light source onto blood that has been taken out of a patient's body and is flowing in a blood tube, the blood having absorbed a photoreactive agent, to destroy an undesirable component in the blood or to affect the component. Such a photodynamic therapy device includes:
The circuit cooling block is connected to a pump that circulates cooling water in the circuit cooling block, a reservoir tank, and a cooling unit that cools water, by a water flow path that flows the cooling water.
In the photodynamic therapy device of the present disclosure, a temperature rise caused by the heat generation of the blood due to the absorption of the irradiation light is suppressed.
In the following, an embodiment will be described in detail with reference to the drawings as appropriate. However, unnecessarily detailed descriptions will be omitted in some cases. For example, detailed descriptions of already well-known matters and repetition of descriptions of substantially the same configuration will be omitted in some cases. This is to prevent the following description from being unnecessary redundant and to facilitate those skilled in the art to understand the present disclosure.
Note that the inventors provide the accompanying drawings and the following description in order for those skilled in the art to fully understand the present disclosure, and does not intend to limit the subject matter described in the claims by the accompanying drawings and the following description.
Photodynamic therapy (PDT) is a treatment method in which a photosensitizer or a precursor thereof is administered, the photosensitizer or the precursor thereof is accumulated in an affected area such as a tumor tissue, a new blood vessel, or a skin surface, a light beam corresponding to an absorption band wavelength of the photosensitizer is irradiated as excitation light, and a cytocidal effect of active oxygen species including singlet oxygen generated by the excitation is utilized.
Taking an example in which a patient is a hematologic cancer patient and has tumor cells, in photodynamic therapy, first 5-aminolevulinic acid (5-ALA) having oral absorbability is administered to the patient. Then, in the process of biosynthesis of heme in intracellular mitochondria, aminolevulinic acid is metabolized to protoporphyrin IX (PpIX) which is a photosensitizer. Since protoporphyrin IX has a property of accumulating in mitochondria in a tumor cell specific manner, protoporphyrin IX accumulates in tumor cells of a patient.
Subsequently, in the photodynamic therapy, a patient's circulatory organ is connected to an irradiation device for the photodynamic therapy via a blood circuit for flowing blood. The blood of the patient contains tumor cells in which the protoporphyrin IX is accumulated, and the blood flows into the irradiation device through the blood circuit by the action of a circulation pump connected to the blood circuit for flowing blood. In the irradiation device, when light in a wavelength range (for example, in the vicinity of 410 nm and in the vicinity of 500 to 650 nm) where protoporphyrin IX can absorb is irradiated, the protoporphyrin IX contained in the blood becomes in an excited singlet state. The protoporphyrin IX returns from the excited singlet state to the ground state through an excited triplet state. Oxygen that has absorbed the energy at that time becomes singlet oxygen, and can destroy or affect tumor cells in the blood. The blood that has been irradiated with light is returned to the patient's circulatory organ by the action of the circulation pump via the blood circuit for flowing blood.
The blood circuit is connected to a translucent blood tube formed of a predetermined resin in the irradiation device. The blood tube through which blood flows inside is irradiated with a light beam corresponding to an absorption band wavelength of protoporphyrin IX, which is a photosensitive substance, by an LED, which is a light source, for example. At this time, the inventors have noticed that the blood may generate heat due to absorption of the irradiation light, and a temperature of the blood may rise. In particular, the illuminance of the light source must be correspondingly increased in order to obtain a sufficient effect for the photodynamic therapy at a treatment time (for example, 3 hours) that does not significantly affect the patient's physical strength. In that case, according to trial calculation and trial by the inventors, the temperature of the blood may reach 60° C. An increase in the temperature of the blood imposes a burden of a high temperature on the patient's body to which the blood is returned. Moreover, the increase in temperature adversely affects the blood itself.
Note that the inventors have found that it is desirable that the temperature of the blood that can be increased by the irradiation device is 40° C. or lower at most by a large number of trials and trial calculations.
The present disclosure overcomes these problems, and provides a photodynamic therapy device that suppresses a temperature rise of blood due to irradiation light in the photodynamic therapy.
Hereinafter, preferred embodiments of the present disclosure will be described with reference to the accompanying drawings.
First, a configuration of a photodynamic therapy device according to an embodiment will be described.
As illustrated in
The circuit cooling block 6 is formed of a predetermined material, and as will be described later, is inserted into a circuit holder 22 (See
The photodynamic therapy device 2 illustrated in
Furthermore, in the photodynamic therapy device 2 illustrated in
Note that in the exploded view of the circuit holder 22 illustrated in
Each of the two circuit holder side surface portions 26 is formed of a transparent resin thin plate, for example, a polycarbonate thin plate in order to cause the irradiation light from the light source of the irradiation unit 4 to reach the blood tube 34 and the blood flowing therein. As illustrated by the circuit holder side surface portion 26 in
Furthermore, a large number of thin ribs 27 in a longitudinal direction are also provided inside the circuit holder side surface portion 26. The large number of ribs 27 in the longitudinal direction improve the adhesion of the blood tube 34 to the aluminum sheet metal 24.
Most of the blood tube 34 wound around the winding core portion 33 of the circuit holder 22 is sandwiched between the circuit holder side surface portion 26 that transmits the irradiation light from the light source of the irradiation unit 4 and the aluminum sheet metal 24 cooled by being in direct contact with the circuit cooling block 6.
Note that a transparent thin film cover may be provided between the circuit holder side surface portion 26 and the blood tube 34, or the circuit holder side surface portion 26 and the blood tube 34 may be in direct contact with each other without sandwiching anything therebetween. A cover made of a transparent thin film may also be provided between the aluminum sheet metal 24 and the blood tube 34, or the aluminum sheet metal 24 and the blood tube 34 may be in direct contact with each other without sandwiching anything therebetween.
A shaft 11 passes through the elastic body 10. This shaft 11 is configured to be fixed relative to the sliding circuit cooling sub-block 6s and slidable relative to the fixed circuit cooling sub-block 6f. This allows the sliding circuit cooling sub-block 6s to slide with respect to the fixed circuit cooling sub-block 6f while accurately maintaining a parallel positional relationship between the fixed circuit cooling sub-block 6f and the sliding circuit cooling sub-block 6s. The shaft 11 may be configured to be fixed relative to the fixed circuit cooling sub-block 6f and slidable relative to the sliding circuit cooling sub-block 6s.
In the pair of fixed circuit cooling sub-blocks 6f and sliding circuit cooling sub-blocks 6s facing each other, a plurality of the elastic bodies 10, for example, four elastic bodies are provided.
As described above, by setting the plurality of elastic bodies 10 to be sandwiched, the sliding circuit cooling sub-block 6s is biased in a direction of an arrow A illustrated in
That is, in the two circuit cooling sub-blocks (6s, 6f) facing each other, one is fixed, and the other is held in a state where a reaction force is applied in a facing direction by the elastic body mechanism. This is to improve the adhesion of the circuit cooling sub-blocks (6s, 6f) to the aluminum sheet metal 24 of the circuit holder 22. This enhances the cooling action of the circuit cooling block 6 on the aluminum sheet metal 24 of the circuit holder 22, the blood tube 34, and thus the blood in the blood tube 34.
That is, the temperature of the blood is transferred and heat-exchanged with the blood tube 34→the aluminum sheet metal 24→the circuit cooling block 6, so that the increase in the blood temperature is suppressed.
Note that the circuit cooling block 6 may be configured such that, in the two circuit cooling sub-blocks facing each other, both are the sliding circuit cooling sub-blocks 6s, and the sliding circuit cooling sub-blocks 6s are biased outward by the elastic mechanism.
As illustrated in
(In
As illustrated in
The cooling unit 16 is configured to cool the water circulating to the circuit cooling block 6. The cooling unit 16 includes, for example, a Peltier element. The cooling unit 16 may include a heat exchanger that cools water, and may include, for example, a radiator. Furthermore, the cooling unit 16 may be a refrigerator such as a circulating constant-temperature water tank by a compressor using a chlorofluorocarbon gas as a refrigerant. In this case, the cooling unit 16, the reservoir tank 18, and the pump 20 may be provided in a casing different from the photodynamic therapy device 2 including the circuit cooling block 6 and the irradiation unit 4. Note that in order to suppress freezing, an antifreeze liquid may be used as the cooling water.
In the present embodiment, the cooling unit 16, the first valve 14a and the second valve 14b, the reservoir tank 18, and the pump 20 constituting the cooling water circulation unit are accommodated in the lower casing 8 of the photodynamic therapy device 2 illustrated in
Next, an operation of the cooling water circulation unit connected to the photodynamic therapy device according to the embodiment will be described.
Referring again to
As described above, during the preparation for treatment, the cooling water is not circulated into the circuit cooling block 6, and is short-circuited in the cooling unit 16, the reservoir tank 18, and the pump 20, whereby the cooling water is cooled to a target temperature.
This has mainly two purposes. One is to avoid sending the cooled saline solution into the patient's body immediately after the start of treatment. That is, before starting the treatment, the blood circuit is initially filled with physiological saline. At this time, when the circuit holder 22 including the blood circuit is installed on the circuit cooling block 6 that has been sufficiently cooled, the temperature of the physiological saline in the blood circuit is further lowered by the circuit cooling block 6 without being raised by the irradiation light. It is required that this lowered temperature saline should be prevented from being fed into the body of the patient.
Another purpose is to efficiently cool the water at the time of preparation for treatment by short-circuiting.
Subsequently, referring to
The photodynamic therapy device 2 according to the present embodiment is a photodynamic therapy device that irradiates light from a light source onto blood that has been taken out of a patient's body and is flowing in the blood tube 34, the blood having absorbed a photoreactive agent, to destroy an undesirable component in the blood or affect the component. The photodynamic therapy device 2 includes the irradiation unit 4 that includes a light source and irradiates the blood in the blood tube 34 with light, and the circuit cooling block 6 that cools the blood in the blood tube 34. The circuit cooling block 6 is connected to the pump 20 that circulates cooling water in the circuit cooling block 6, the reservoir tank 18, and the cooling unit 16 that cools water by the water flow path 12 for flowing the cooling water.
By configuring the photodynamic therapy device 2 in this manner, in the photodynamic therapy, the temperature rise caused by the heat generation of the blood due to the absorption of the irradiation light is suppressed.
As described above, the embodiment has been described as an example of the technique disclosed in the present application. However, the technique in the present disclosure is not limited thereto, and can also be applied to embodiments in which changes, replacements, additions, omissions, and the like are made as appropriate.
As described above, the temperature of the blood that can be increased by the irradiation unit 4 is required to be suppressed to 40° C. or lower. Therefore, for example, in the blood circuit, a temperature sensor that detects the temperature of the blood inside the blood tube 34 immediately before returning to the circulatory organ of the patient in real time may be provided, and a controller that controls the cooling capacity of the cooling unit 16 based on a detection value of the temperature sensor may be further provided. That is, when the temperature sensor detects a temperature close to 40° C. (for example, 39° C.), the controller that has received the detection value may increase a current and/or voltage flowing through the Peltier element of the cooling unit 16 to further increase the cooling capacity. Furthermore, when the temperature sensor detects a temperature lower than a normal body temperature (for example, 34° C.), the controller that has received the detection value may be configured to decrease the current and/or voltage flowing through the Peltier element of the cooling unit 16 to further decrease the cooling capacity.
Furthermore, the accompanying drawings and the detailed description have been provided in order to describe the embodiments. Therefore, the components illustrated in the accompanying drawings and described in the detailed description not only include components essential for solving the problem but also can include, to exemplify the techniques, components that are not essential for solving the problem. For this reason, it should not be immediately recognized that those unnecessary components are necessary only because those unnecessary components are described in the accompanying drawings or the detailed description.
Furthermore, since the above-described embodiments are intended to illustrate the technique in the present disclosure, various changes, replacements, additions, omissions, and the like can be made within the scope of the claims or equivalents thereof.
Filing Document | Filing Date | Country | Kind |
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PCT/JP2020/038764 | 10/14/2020 | WO |