INTERVENTIONAL DRUG DELIVERY SYSTEM AND ASSOCIATED METHODS
A delivery system for local drug delivery to a target site of internal body tissue is provided. The delivery system comprises a source electrode adapted to be positioned proximate to a target site of internal body tissue. A counter electrode is in electrical communication with the source electrode, and is configured to cooperate with the source electrode to form a localized electric field proximate to the target site. A reservoir is configured to be disposed such that the reservoir is capable of interacting with the localized electric field. The reservoir is configured to carry a cargo capable of being delivered to the target site when exposed to the localized electric field. Associated methods are also provided.
This is a continuation application of U.S. application Ser. No. 14/748,361, filed Jun. 24, 2015, which is a continuation of U.S. application Ser. No. 13/202,810, filed Aug. 23, 2011, which is a national phase application of International Application No. PCT/US2010/025416, filed Feb. 25, 2010, which claims priority to U.S. Provisional Application No. 61/155,880, filed Feb. 26, 2009, the entire contents of each of which are incorporated by reference herein in their entireties for all purposes.
FEDERALLY SPONSORED RESEARCH OR DEVELOPMENTThis invention was made with government support under Grant Number CHE-9876674 awarded by the National Science Foundation. The government has certain rights in the invention.
BACKGROUND Field of the InventionEmbodiments of the present invention relate to an interventional drug delivery system, and more particularly, to a system for facilitating delivery of various cargos, such as, for example, therapeutic agents, to target sites of internal body tissue in vivo, and methods associated therewith, wherein the system implements an electric field to drive cargo through tissue as in iontophoretic approaches.
Description of Related ArtMany techniques exist for the delivery of drugs and therapeutic agents to the body. Traditional delivery methods include, for example, oral administration, topical administration, intravenous administration, and intramuscular, intradermal, and subcutaneous injections. With the exception of topical administration which permits more localized delivery of therapeutic agents to particular area of the body, the aforementioned drug delivery methods generally result in systemic delivery of the therapeutic agent throughout the body. Accordingly, these delivery methods are not optimal for localized targeting of drugs and therapeutic agents to specific internal body tissues.
As a result, other methods, such as endovascular medical devices, Natural Orifice Translumenal Endoscopic Surgery (NOTES)-based devices, and iontophoresis, have been developed to provide localized targeting of therapeutic agents to a particular internal body tissue. Iontophoresis is a form of drug delivery that uses electrical current to enhance the movement of charged molecules across or through tissue. Iontophoresis is usually defined as a non-invasive method of propelling high concentrations of a charged substance, normally therapeutic or bioactive-agents, transdermally by repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle. In some instances, one or two chambers are filled with a solution containing an active ingredient and its solvent, termed the vehicle. The positively charged chamber (anode) repels a positively charged chemical, while the negatively charged chamber (cathode) repels a negatively charged chemical into the skin or other tissue. Unlike traditional transdermal administration methods that involve passive absorption of a therapeutic agent, iontophoresis relies on active transportation within an electric field. In the presence of an electric field, electromigration and electroosmosis are the dominant forces in mass transport. As an example, iontophoresis has been used to treat the dilated vessel in percutaneous transluminal coronary angioplasty (PTCA), and thus limit or prevent restenosis. In PTCA, catheters are inserted into the cardiovascular system under local anesthesia and an expandable balloon portion is then inflated to compress the atherosclerosis and dilate the lumen of the artery.
The delivery of drugs or therapeutic agents by iontophoresis avoids first-pass drug metabolism, a significant disadvantage associated with oral administration of therapeutic agents. When a drug is taken orally and absorbed from the digestive tract into the blood stream, the blood containing the drug first passes through the liver before entering the vasculature where it will be delivered to the tissue to be treated. A large portion of an orally ingested drug, however, may be metabolically inactivated before it has a chance to exert its pharmacological effect on the body. Furthermore it may be desirable to avoid systematic delivery all together in order to allow high doses locally while avoiding potential side effects elsewhere, wherein local delivery is desirable for localized conditions. Existing medical device technologies that enable localized placement of therapeutics fail to provide the opportunity to embed/secure therapeutics in the tissue(s) of interest.
Accordingly, it would be desirable to provide an improved system and method for selectively and locally targeting delivery of various drugs and therapeutic agents to an internal body tissue, and fixing such cargos in the tissue(s) of interest in vivo.
SUMMARYThe above and other needs are met by aspects of the present invention which provide, in one instance, a delivery system, and in particular, a delivery system for local drug delivery to a target site of internal body tissue. The delivery system comprises a source electrode adapted to be positioned proximate to a target site of internal body tissue. A counter electrode is in electrical communication with the source electrode. The counter electrode is configured to cooperate with the source electrode to form a localized electric field proximate to the target site. An electrode deployment device may be used and is configured to insert at least one of the source electrode and the counter electrode proximate to the target site of internal body tissue in vivo. A reservoir is capable of interacting with the localized electric field. The reservoir is configured to carry a cargo capable of being delivered to the target site when exposed to the localized electric field formed between the source electrode and the counter electrode. In some aspects, the drug reservoir is capable of being remotely filled with the cargo.
Another aspect provides a method for delivering a cargo to a target site of internal body tissue. Such a method comprises disposing a source electrode proximate to a target site of internal body tissue in vivo using an electrode deployment device, and disposing a counter electrode in electrical communication with the source electrode, wherein the counter electrode is configured to cooperate with the source electrode to form a localized electric field proximate to the target site. The method further comprises disposing a reservoir such that the reservoir is capable of interacting with the localized electric field. The reservoir is configured to carry a cargo capable of being delivered to the target site when exposed to the localized electric field formed between the source electrode and the counter electrode. In some aspects, the drug reservoir is capable of being remotely filled with the cargo. The method further comprises applying a voltage potential across the source and counter electrodes to form an electric field, thereby delivering at least a portion of the cargo to the target site.
Yet another aspect provides a method of treating a target site of internal body tissue. Such a method comprises delivering a therapeutic agent to a body cavity of a patient for storage thereof. The method further comprises positioning a first electrode proximate to a target site of body tissue, and positioning a second electrode such that the second electrode is in electrical communication with the first electrode. The method further comprises applying a voltage potential across the first and second electrodes to drive the therapeutic agent from the body cavity to the target site.
As such, embodiments of the present invention are provided to enable highly targeted and efficient delivery of various cargos to predetermined target sites. In this regard, aspects of the present invention provide significant advantages as otherwise detailed herein.
In order to assist the understanding of embodiments of the invention, reference will now be made to the appended drawings, which are not necessarily drawn to scale. The drawing is exemplary only, and should not be construed as limiting the invention.
Embodiments of the present invention now will be described more fully hereinafter with reference to the accompanying drawings. The invention may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like numbers refer to like elements throughout.
Embodiments of the present invention are directed to systems and methods for delivering treatment or therapeutic agents (otherwise referred to herein as “cargo”) to specific locations, including intracellular locations in a safe and effective manner. Such systems may deliver the agents to a diseased site in effective amounts without endangering normal tissues or cells and thus reduce or prevent the occurrence of undesirable side effects. Further, such systems may electrically enhance the local delivery of treatment agents into the wall tissues or cells of the living body. These systems are designed to target certain tissue and cell locations and deliver the treatment agents directly to those locations, while minimizing any effects on non-targeted tissues and cells. In particular, embodiments of the present invention relate to systems which provide an electrical driving force that can increase the rate of migration of drugs and other therapeutic agents out of a reservoir into body tissues and cells using iontophoresis and other approaches.
More particularly, embodiments of the present invention rely on the transport of charged and uncharged species under the influence of a localized electric field generated at the site of interest. The overall transport of charged and uncharged species is based upon three characteristic driving forces, which includes passive diffusion, electroosmosis, and electromigration. Passive diffusion involves the movement of a chemical species from a region of high concentration to an area of low concentration. Electroosmosis is the movement of a solute species via a solvent flow accompanied by the movement of an extraneous charged species. Electroosmosis encompasses the solvent flow referred to as hydrokinesis. Electromigration is the movement of a charged species through an applied electric field to an electrode of opposite polarity. Transport of a neutrally charged species is driven by passive diffusion and electroosmosis only, whereas all transport modalities, passive diffusion, electroosmosis, and electromigration contribute to the flux of a charged species.
In this regard, embodiments of the present invention may provide an interventional drug delivery system and methods for localized delivery of therapeutic agents to internal locations in the human body using a controlled electrical field. The systems may be constructed to deliver the agents specifically to the site of interest, improving penetration of the agent while limiting effect upon non-targeted tissue. Embodiments of the present invention may be fashioned to deliver the agents via intravascular, intraperitoneal, minimally invasive surgery, and natural orifice transluminal endoscopic surgery (NOTES) modalities. The action of the electric field may be controlled through a programmable power supply or a function generator. By using various electrode designs and placement configurations, highly localized and focused delivery of cargo to the tissue of interest may be achieved. The overall controlled release characteristics of the delivery system may be dependent upon the charge, size, conductivity, concentration, and pKa of the chemical species and nanoparticles, pH of the surrounding environment, resistance of the site of interest, current and voltage applied, electrode design and amount of extraneous ions at site of interest.
Embodiments of the present invention may be implemented in the delivery of therapeutic agents for such diverse areas as oncology, pulmonary, gastrointestinal (GI), and neurology applications. Embodiments of the present invention find application in the field of interventional oncology for the treatment of various cancers, which may include, for example, pancreatic cancers, lung cancer, esophageal cancers, bladder cancers, colorectal cancers, liver cancers, hepatic metastases, bile duct cancers, renal cancers, cervical cancers, prostate cancers, ovarian cancer, thyroid cancers, uterine cancers, and leukemia. In particular, accessing bone marrow tissue may be advantageous. Other applications may cover pulmonary diseases, neurological disorders as well as cardiovascular applications.
In some instances, embodiments of the present invention may employ an approach using iontophoresis. As used herein, the term “iontophoresis” means the migration of ionizable molecules through a medium driven by an applied low level electrical potential. This electrically mediated movement of molecules into tissues is superimposed upon concentration gradient dependent diffusion processes. If the medium or tissue through which the molecules travel also carries a charge, some electro-osmotic flow occurs. However, generally, the rate of migration of molecules with a net negative charge towards the positive electrode and vice versa is determined by the net charge on the moving molecules and the applied electrical potential. The driving force may also be considered as electrostatic repulsion. Iontophoresis usually requires relatively low constant DC current in the range of from about 2-5 mA. The applied potential for iontophoresis will depend upon number of factors, such as the electrode configuration and position on the tissue and the nature and charge characteristics of the molecules to be delivered.
The present invention relates to the delivery of cargo including, but not limited to, therapeutic agents such as drug molecules, proteins, peptides, antibodies, antibody scaffolds or fragments of antibodies, nucleotides, contrast agents and dyes (including radiolabels, fluorophores and chelated magnetic species), liposomes, micelles, nanoparticles, multi-molecular aggregates (such as, for example, albumin/paclitaxel or Abraxane™) and combinations thereof, with or without cargo and/or targeting capabilities. Small molecules may include chemotherapeutic agents such as alkylating agents, anti-metabolites, plant alkaloids and terpenoids, vinca alkaloids, podophyllotoxin, taxanes, topoisomerase inhibitors, and antitumor antibiotics, as well as analgesics and local anesthetics. Embodiments of the present invention also covers the delivery of pro-drugs, small molecules and nanoparticles, in some instances having neutral charge before delivery, that may be subsequently charged or triggered to release cargo under physiological conditions.
Furthermore, the cargo may include small ionic molecules, nucleic acids, proteins, therapeutic agents, diagnostic agents, and imaging agents as well as organic nanoparticles which may encapsulate a wide range of therapeutic, diagnostic, and imaging agents. The cargo may be configured to traffic preferentially based on size, shape, charge and surface functionality; and/or controllably release a therapeutic. Such cargos may include but are not limited to small molecule pharmaceuticals, therapeutic and diagnostic proteins, antibodies, DNA and RNA sequences, imaging agents, and other active pharmaceutical ingredients. Further, such cargo may include active agents which may include, without limitation, analgesics, anti-inflammatory agents (including NSAIDs), anticancer agents, antimetabolites, anthelmintics, anti-arrhythmic agents, antibiotics, anticoagulants, antidepressants, antidiabetic agents, antiepileptics, antihistamines, antihypertensive agents, antimuscarinic agents, antimycobacterial agents, antineoplastic agents, immunosuppressants, antithyroid agents, antiviral agents, anxiolytic sedatives (hypnotics and neuroleptics), astringents, beta-adrenoceptor blocking agents, blood products and substitutes, cardiac inotropic agents, contrast media, corticosteroids, cough suppressants (expectorants and mucolytics), diagnostic agents, diagnostic imaging agents, diuretics, dopaminergics (antiparkinsonian agents), haemostatics, immunological agents, therapeutic proteins, enzymes, lipid regulating agents, muscle relaxants, parasympathomimetics, parathyroid calcitonin and biphosphonates, prostaglandins, radio-pharmaceuticals, sex hormones (including steroids), anti-allergic agents, stimulants and anoretics, sympathomimetics, thyroid agents, vasodilators, xanthines, and antiviral agents. In addition, the cargo may include a polynucleotide. The polynucleotide may be provided as an antisense agent or interfering RNA molecule such as an RNAi or siRNA molecule to disrupt or inhibit expression of an encoded protein.
Other cargo may include, without limitation, MR imaging agents, contrast agents, gadolinium chelates, gadolinium-based contrast agents, radiosensitizers, such as, for example, 1,2,4-benzotriazin-3-amine 1,4-dioxide (SR 4889) and 1,2,4-benzotriazine-7-amine 1,4-dioxide (WIN 59075); platinum coordination complexes such as cisplatin and carboplatin; anthracenediones, such as mitoxantrone; substituted ureas, such as hydroxyurea; and adrenocortical suppressants, such as mitotane and aminoglutethimide.
In other embodiments, the cargo may comprise Particle Replication In Non-wetting Templates (PRINT) nanoparticles (sometimes referred to as devices) such as disclosed, for example, in PCT WO 2005/101466 to DeSimone et al.; PCT WO 2007/024323 to DeSimone et al.; WO 2007/030698 to DeSimone et al.; and WO 2007/094829 to DeSimone et al., each of which is incorporated herein by reference. PRINT is a technology which produces monodisperse, shape specific particles which can encapsulate a wide variety of cargos including small molecules, biologics, nucleic acids, proteins, imaging agents. Cationically charged PRINT nanoparticles smaller than 1 micron are readily taken up by cells over a relatively short time frame, but penetration of the particles throughout the tissue is a longer process. For the delivery of PRINT nanoparticles throughout the tissue to be effective, the penetration needs to occur within a reasonable operational time frame. As such, the delivery system may be used to achieve such penetration by employing iontophoresis, in which charged PRINT nanoparticles are driven into body tissue using repulsive electromotive forces. The PRINT particles may or may not contain a therapeutic. In some instances, the particle may be comprised of PLGA. In addition, the PRINT nanoparticles may be engineered to achieve a certain mission, and design-in handles that permit remote control for externally turning the cargo “on” or switching it “off”. As such, the cargo may be manipulated using ultrasound, low-dose radiation, magnetics, light and other suitable mechanisms. The particles may be coated with gold such as, for example, gold nano-shells for thermal ablation therapy.
As described previously, the delivery apparatus 100 which may deliver cargo iontophoretically to target sites for localized treatment. In general, iontophoresis technology uses an electrical potential or current across a target site (e.g., a semipermeable barrier) to drive ionic fixatives or drugs (or drive nonionic fixatives or drugs) in an ionic solution. Iontophoresis facilitates both transport of the fixative or drug across the target site and enhances tissue penetration. In the application of iontophoresis, two electrodes, a source electrode and a counter electrode (in some instances, the electrodes may be positioned on opposing sides of the target site, though such a configuration or arrangement is not required), are utilized to develop the required potential or current flow. The positioning of the electrodes may be accomplished using an electrode deployment device 150. The electrode deployment device 150 may be capable of positioning the source electrode, the counter electrode, and the reservoir such that the therapeutic agents may be delivered through intravascular, intraperitoneal, and natural orifice transluminal endoscopic surgery (NOTES) modalities. Some embodiments of the present invention may employ the technique of reverse iontophoresis, wherein a small molecule or other substance may be extracted from the surrounding medium. In this manner, toxic substances or excess cargo materials may be removed from locations in vivo.
In some instances, the electrode deployment device 150 may comprise a catheter device to be deployed in vivo using the intravascular route. In other embodiments, the electrode deployment device 150 may comprise an endoscopic device for deployment via natural orifices in the body. In other instances, the electrode deployment device 150 may comprise a laparoscopic device for minimally invasive surgical intervention. In other embodiments, the electrode deployment device 150 may be surgically implanted in a suitable location in vivo, such as, for example, the peritoneal cavity. In yet other instances, the electrode deployment device 150 may implement combinations of two or more of the embodiments listed above. According to some embodiments, the electrode deployment device 150 may locate the source electrode, counter electrode, and/or reservoir at the target site of interest through use of an imaging system.
In another embodiment, the mesh arrangement 225 source electrode 200 may be configured to encase part or a portion of the target tissue (e.g., a conical mesh encasing the tail of the pancreas, as shown in
According to some embodiments, the source electrode 200 may include an array of multi-functional probes, combining imaging and drug delivery functionalities, as illustrated in
In some instances, the source electrode 200 may have one or more insulating layers or members 250a, 250b, 25c and 250d attached, connected, or otherwise engaged therewith. The insulating members 250a, 250b, 25c and 250d are provided to confer directionality to the transport profile of the cargo 60 with respect to the target site, as shown in
According to some aspects of the present invention, a plurality of source electrodes and indicated by reference numbers 200a, 200b and 200c may be provided, wherein each source electrode 200a, 200b or 200c is independently controlled with respect to the other source electrodes 200a, 200b and 200c. In this manner, the delivery system 100 may be manipulated to target various sites for delivery of the cargo 60, as shown in
Referring to
In one embodiment, as illustrated in
With reference to
Referring to
In some instances, as shown in
In some instances, the counter electrode 500 can have an ion selective membrane portion 502 for the movement of ions to and from the counter electrode 500. In some instances, the counter electrode 500 may have a coolant device 510 for use therewith to maintain the temperature of the counter electrode 500 and to minimize the potential for tissue burns, as illustrated in
Embodiments of the present invention further comprise a reservoir (see, for example,
In one particular embodiment of the present invention, the intraperitoneal cavity may serve as the drug reservoir. In this regard, the peritoneal cavity may be flooded with a cargo or drug of choice in an appropriate buffer. The source and counter electrodes 200, 500 may be positioned proximate to the target site of the pancreas, such as, for example, in a pancreatic duct and at an appropriate location or locations at the exterior of the pancreas near the tumor. Various arrangements of the source and counter electrodes may be implemented so that the cargo is positioned to interact with the electric field, upon actuation thereof, to drive the cargo to the target site of the pancreas. That is one, both, or neither of the electrodes may be positioned substantially within the pancreas. For example, both electrodes may be positioned exterior to the pancreas and on opposite sides thereof. In one particular example, one of the electrodes may be arranged as a wire mesh arrangement that can be positioned on and contact an exterior surface of the pancreas. A current may then be applied to drive the cargo (e.g., drug or therapeutic agent) from the peritoneal cavity to the pancreas and the site of the tumor. In another instance, the reservoir may be implanted in the intraperitoneal cavity such that the reservoir is provided remotely from the source electrode 200 and the counter electrode 500.
However, embodiments of the present invention may also be used in association with other cavities of the body, wherein at least some of these cavities are internal body cavities, while others are not. For example, the cargo may be delivered to the cranial cavity (brain cancers), the oral cavity (head and neck cancers, thyroid cancers), the thoracic cavity or mediastinum (thymus cancer, esophageal cancers and heart disease), the pleural cavity (lung cancers, cystic fibrosis, pulmonary fibrosis, emphysema, adult respiratory distress syndrome (ARDS), and sarcoidosis), the abdominopelvic cavity or peritoneal cavity (pancreatic cancer, liver cancers and metastases, stomach cancer, small bowel cancer, genital warts, inflammatory bowel diseases (Crohn's disease and ulcerative colitis), renal cancers and metastases, splenic cancers, and Hodgkin's disease), and the pelvic cavity (testicular cancer, prostate cancer, ovarian cancer fallopian tube, cervical cancer, endometrial cancer, uterine cancers, Kaposi's sarcoma, colorectal cancers, and urinary bladder cancer).
In order to apply a voltage potential across the source electrode 200 and the counter electrode 500, the source electrode 200 and the counter electrode 500 are in electrical communication. In this regard, the source electrode 200 and the counter electrode 500 are connected to a power source (not shown). In some instances, the power source may comprise a programmable power supply and function generator capable of generating both direct current and pulsed waveforms at various voltages and for various time intervals. The power source can generate the potential difference between the source electrode 200 and the counter electrode 500 necessary to induce electromigration and electroosmosis of the cargo (e.g., the therapeutic agent). A function generator allows for manipulation of the wave generated from the power source. Square, triangular, sawtooth, multi-step wave forms may be used to drive a direct current through the source and counter electrodes 200, 500.
As described above, the disclosed iontophoretic techniques may take either an inside-out or an outside-in approach in driving the cargo toward the target site of tissue. That is, reverse iontophoretic techniques may be employed in all of the embodiments described hereinabove, and as described, for example, in Example 8. In this regard, the source electrode may be disposed exterior to a duct, organ, tissue, or target site, while the counter electrode is positioned within a duct, lumen, organ, etc. such that the cargo is driven from outside the target site inwardly toward the target site.
Many modifications and other embodiments of the invention will come to mind to one skilled in the art to which this invention pertains having the benefit of the teachings presented in the foregoing description; and it will be apparent to those skilled in the art that variations and modifications of the present invention can be made without departing from the scope or spirit of the invention. Therefore, it is to be understood that the invention is not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
The following examples are presented by way of illustration, not by way of limitation.
EXPERIMENTAL Example 1: Delivery of Rhodamine 6G Dye into Agarose PhantomsA cylindrical tube of 2% (w/v) agarose gel in deionized (D.I.) water was fabricated as a phantom with an outer diameter (o.d.)=2.5 cm and length ˜3-4 cm. A concentric reservoir for holding the dye (o.d=0.8 cm, length ˜2 cm) was cored out from the top surface along the longitudinal axis of the gel cylinder. Electrodes were fabricated out of aluminum foil (width 0.5 cm, length ˜15 cm, thickness ˜0.1 cm). A solution of 0.5% Rhodamine 6G in D.I. water was used to model the delivery of a small molecule drug. The dye was filled inside the cored reservoir in the agarose phantom and the source electrode (anode, in this case) was inserted into the dye reservoir. The other end of the anode was hooked to a DC power source with an alligator clip. The agarose phantom was immersed in a beaker containing 0.25×PBS solution, as shown in
Unshielded electrode configurations were developed for demonstrating control over delivery to specific in vivo locations. These include electrodes fabricated out of metal wire (silver, silver chloride), metal foil (silver, platinum, aluminum) and wire mesh (aluminum), as shown in
An insulated electrode was developed to demonstrate control over targeted delivery to specific in vivo locations. By insulating a portion of the electrode surface, it is possible to control the delivery to the tissue or organ systems in a well defined fashion. For example, the flux of drug or particles will be attenuated corresponding to the insulated areas of the electrode. Aluminum foil was folded into a long rectangular shape of appropriate dimensions (length ˜10 cm, width ˜0.4 cm, thickness ˜0.1 cm). Insulating tape (width ˜1 cm) was wrapped around the foil in alternating sections. This insulated electrode was immersed in the central reservoir of an agarose phantom (2% agarose w/v in deionized water), as shown in
Since it may not be possible to confine the drug to be delivered within a localized cavity or lumen in the target tissue, electrodes with built-in drug reservoirs were developed. Such examples were fabricated by encapsulating insulated foil electrodes described earlier within an agarose gel matrix. The agarose gel containing the 0.5% Rhodamine 6G solution, serving as a model drug, was first poured into a glass test-tube of diameter 1.2 cm. The insulated electrode was then inserted into the gel solution. The gel was allowed to solidify, and the electrode was extracted by breaking the test tube. An agarose gel phantom with a central reservoir of inner diameter ˜1.5 cm was prepared. This electrode was then inserted into the phantom and tested for iontophoretic delivery at a constant current of 5 mA for 10 minutes. The results show zones of controlled delivery through the gel that are visible under short wave UV light, as shown in
A soft-gel electrode was fabricated from 2% (w/v) agarose gel containing 5% Rhodamine 6G solution in D.I. water by casting the gel in a test tube (o.d.=13 mm and length 25 mm) with an aluminum foil electrode inserted along the central axis. Chicken breast was chosen as a representative tissue to demonstrate iontophoretic delivery in accordance with one embodiment of the present delivery system. A cylindrical core was removed from the center of the tissue sample to produce a drug reservoir of o.d.=15 mm. The soft-gel electrode was then placed in the reservoir inside the tissue sample and the source electrode (anode, in this case) was hooked to a DC power source with an alligator clip. The tissue sample was immersed in a beaker containing deionized water. The cathode, a regular aluminum foil electrode without gel, was placed in the PBS beside the tissue sample and hooked up to the DC power source. In the negative control, passive diffusion of the dye into the tissue was allowed without any passage of current for 30 minutes. In the experimental condition, a constant current of 10 mA (voltage ˜1.4 V) was driven through the electrodes for the same duration (30 minutes). To characterize the extent of iontophoretic transport, cross-sections of the tissue sample were taken every 0.5 cm along the depth of the sample, as shown in
Bovine fat was chosen as another representative tissue to demonstrate iontophoretic delivery. A cylindrical core was removed from the center of the tissue sample to produce a drug reservoir of o.d.=15 mm. A soft-gel electrode similar to the one described earlier, but with platinum foil (0.5 mm thick) as the source electrode, was then placed in the reservoir at the center of the tissue sample and was hooked to a DC power source with an alligator clip. The tissue sample was immersed in a beaker containing deionized water (mimicking filling the peritoneal cavity). A silver chloride electrode directly inserted into the tissue sample served as the cathode and was hooked up to the DC power source. In the negative control, passive diffusion of the dye into the fat tissue was allowed without any passage of current for 30 minutes. In the experimental condition, a constant voltage of 20 V was applied between the electrodes for the same duration (30 minutes). The current was allowed to increase from 5-15 mA to maintain constant potential difference. To characterize the extent of iontophoretic diffusion, cross-sections of the tissue sample were taken every 0.5 cm along the depth of the sample. The radial diffusion of the dye from the edge of the drug reservoir was quantified. In the negative control (0 V) dye was localized to the inner wall of the reservoir (not shown). In the experimental condition (20 V), a maximum penetration depth of ˜8 mm from the edge of the reservoir was achieved, as shown in
As described previously, the position of the counter electrode may be manipulated to exert control over targeted delivery to specific in vivo locations. In this example, two possible configurations are illustrated in
The ability to extract a small molecule from the surrounding medium (like filling the peritoneal cavity) into a reservoir located inside an agarose phantom was demonstrated by employing the principle of reverse iontophoresis. To allow diffusion from the outside surface of the gel to the central reservoir, the phantom was placed in a solution of Rhodamine 6G in deionized water. For this application, the polarity of the electrodes was switched, with the counter electrode being placed in the central drug reservoir, while the source electrode was placed in the dye solution outside the gel, as shown in
An assembly of two independently-powered, insulated electrodes was developed to demonstrate variable controlled delivery, as described previously. By allowing independent control over parameters for iontophoretic delivery such as current, voltage and time, we were able to demonstrate variable delivery zones at two distinct sites within the same lumen. Two insulated aluminum foil electrodes similar to the one shown in Example 3 above, were combined into a single assembly according to the schematic shown in
A variation of the double-electrode assembly previously described in Example 9 was developed with a built-in drug reservoir. The insulated double-electrode assembly was immersed in a test-tube of 2% agarose gel containing a 5 mg aqueous solution of Rhodamine 6G. The soft-gel electrode assembly was then inserted into an 2% agarose phantom having a cored out central cavity (diameter: 1.5 mm). The agarose phantom was immersed in a beaker containing 0.25×PBS solution, as shown in
A cylindrical tube of 2% (w/v) agarose gel in deionized (D.I.) water was fabricated as a phantom with an outer diameter (o.d.)=2.5 cm and length ˜3-4 cm. A concentric reservoir for holding the dye (o.d=0.8 cm, length ˜2 cm) was cored out from the top surface along the longitudinal axis of the gel cylinder. Electrodes were fabricated out of platinum foil (width 0.25 cm, length ˜3 cm, thickness ˜0.05 cm). A solution of 0.25% Doxorubicin in 4.875% DMSO and 94.875% DI water was used to model the delivery of a small molecule drug. The dye was filled inside the cored reservoir in the agarose phantom and the source electrode (anode, in this case) was inserted into the dye reservoir. The other end of the anode was hooked to a DC power source with an alligator clip. The agarose phantom was immersed in a beaker containing DI water. The cathode, a second piece of platinum foil, was placed in the PBS beside the agarose phantom and hooked up to the DC power source. In the negative control, passive diffusion of the dye was allowed without any passage of current for 5 minutes. In the experimental condition, a constant current of 5 mA (voltage ˜9.5V) was driven through the electrodes for the same duration (5 minutes). As shown in
As shown in
A soft-gel source electrode was fabricated from Liquified 2% (w/v) agarose gel containing 0.5% Rhodamine 6G solution in D.I. water by casting the gel in a Petri dish with an aluminum foil electrode inserted on top of gel. The source electrode was placed on one side of the pancreas, and the counter electrode was placed on the opposite side of the pancreas. The electrodes were hooked to a DC power source with alligator clips. The tissue sample was immersed in a beaker of DI water. In the experimental condition, a constant current of 5 mA (voltage ˜2.4 V) was driven through the electrodes for the same duration (30 minutes). As shown in
A soft-gel source electrode was fabricated from Liquified 2% (w/v) agarose gel containing 0.5% Rhodamine 6G solution in D.I. water by casting the gel in a test tube (o.d.=5 mm and length ˜25 mm) with platinum wire inserted along the central axis. The soft-gel source electrode was probed into the pancreatic duct, and the counter electrode, made of platinum foil, was placed on the outer surface of the pancreas, as shown in
A miniaturized agarose phantom was used to demonstrate the delivery of PRINT® nanoparticles using iontophoresis. A 2% agarose gel was poured into a small test tube (diameter 13 mm) and a capillary tube (o.d. 1 mm) was used to create a central reservoir. An aqueous solution of fluorescent polyampholyte PRINT® nanoparticles (size: 343 nm, charge: ˜59 mV, concentration: 9.5 mg/mL) was deposited into the reservoir. A platinum wire (diameter 0.25 mm) was inserted into the reservoir as anode and a similar wire served as a cathode outside the phantom. The phantom was then immersed in a solution of 0.25×PBS, and the electrodes were hooked up to a DC power source using alligator clips. In the negative control, the particles were allowed to passively diffuse into the gel without the application of current for 5 minutes. For iontophoretic delivery, the nanoparticles were driven into the gel by a constant current of 5 mA for the same duration. The phantoms were then cut into 1 mm thick transverse slices that were placed onto glass slides for imaging under a fluorescent microscope. The difference in the extent of migration due to the electric field is shown in
The following examples, which are not meant to be limiting, generally relate to proof-of-concept studies relating to electric field assisted delivery (EFAD), engineering of EFAD devices, exploratory studies in large animals have been performed, and methods of pharmacokinetic analysis for local delivery mechanisms have been developed. Proof-of-concept studies for EFAD were performed in tumor tissue surrogates and pancreatic tumor tissue. Two EFAD devices were designed and prototyped for different approaches to the primary pancreatic tumor, including endoductal, and surgically implantable. Four large animal models were evaluated for the different device approaches, and the canine model was chosen as the most amenable to all device approaches. A tissue sampling system and methods of pharmacokinetic analysis for tissue and plasma have also been developed. Overall, these devices could potentially offer an entirely new modality for the treatment of pancreatic cancer under the emerging field of interventional oncology. Moreover, the further development of these devices could translate directly into new treatments for other types of primary tumors and metastatic diseases.
Example 16: Examination of Gemcitabine Transport in Pancreatic Tissue and Tumor TissueTo assess and optimize the electrical transport parameters in tissue, a transport testing system was built (see
The laparoscopic implantable device was developed for surgical implantation onto the surface of the pancreas in proximity to the tumor. The device would be sutured or bioadhered to the pancreas. As seen in
As there are no readily available large animal models of pancreatic cancer, device development and evaluation will be performed in healthy large animals. Four large animal models, including goats, sheep, dogs, and pigs, were evaluated for three device approaches to the pancreas. Table 1 shows the relative assessment of each animal model. The dog was determined to be the most amenable to all device approaches.
The reservoir based system similar to that shown in
There were three arms for the large animal experiment: 1. Device with current; 2. Device without current; and 3. IV Infusion (see Table 2). The device was sutured onto the right lobe of the canine pancreas. Gemcitabine formulated at clinically relevant concentrations was pumped into and out of the device at ˜1.5 mL/min during the application of 10 mA of current applied for 60 minutes. Control experiments were run without current. After administration of therapy, the pancreas was excised and snap frozen for analysis. The gemcitabine was measured from the section tissue using UV-HPLC from established protocols in the literature (see Olive, K P, et al. Science 324 (2009) 1457-1461 and Kirstein M N, et al., J Chromatogr B Analyt Technol Biomed Life Sci. 835 (2006) 136-142). Shown in
In
Pharmacokinetics and Analysis in Tissue and Serum
The pharmacokinetic analysis for tissue and serum has been developed according to a method developed by Kirstein et al. A validated standard curve has been developed and will be used for future in vivo studies (data not shown).
Example 19: Endoductal DeviceA second device approach developed for the treatment of pancreatic cancer was an endoductal device. The device was modeled in a 3D CAD program (SolidWorks® to Dassault Systèmes SolidWorks Corporation) prior to prototyping. The endoductal approach was developed according to endoscopic retrograde cholangiopancreatography (ERCP) devices, which use a duodenoscope to access the major duodenal papilla. A double balloon catheter was designed, as seen in
The tubing of the catheter contained four lumens for saline, drug, and a conducting wire (see
Claims
1. A delivery system for local drug delivery to a target site of internal body tissue, comprising:
- a source electrode adapted to be positioned proximate to a target site of internal body tissue;
- a counter electrode in electrical communication with the source electrode, the counter electrode being configured to cooperate with the source electrode to form a localized electric field proximate to the target site; and
- a reservoir capable of interacting with the localized electric field, the reservoir being configured to carry a cargo capable of being delivered to the target site when exposed to the localized electric field formed between the source electrode and the counter electrode.
2. A delivery system according to claim 1, further comprising an electrode deployment device configured to insert at least one of the source electrode and the counter electrode proximate to the target site of internal body tissue in vivo.
3. A delivery system according to claim 2 further comprising a control system in communication with the electrode deployment device, the control system being configured to guide the electrode deployment device with placement of the source electrode and the counter electrode.
4. A delivery system according to claim 2 wherein the electrode deployment device comprises one of a catheter device, an endoscopic device, a laparoscopic device, an implantable device, and combinations thereof.
5. A delivery system according to claim 4 wherein the catheter device comprises a first and second expandable member serially disposed along a longitudinal axis of the catheter device, the source electrode being axially disposed between the first and second expandable members such that, upon inflation of the first and second expandable members to occlude the target site, the target site is isolated and the delivery of the cargo is contained to the target site.
6. A delivery system according to claim 4 wherein the catheter device comprises a perforated polymer sheath, the cargo being capable of exiting the catheter device through a plurality of perforations defined by the perforated polymer sheath, and the source electrode comprising an array of probes terminating at different lengths and being independently powered such that the probes are capable of being variably controlled, the source electrode further comprising a plurality of insulating members disposed about and between the probes so as to form cargo delivery zones substantially aligned with the perforations of the perforated polymer sheath.
7. A delivery system according to claim 4 wherein the endoscopic device comprises a proximal end and a distal end having the source electrode disposed thereabout for positioning proximate to the target site, the source electrode comprising a hollow needle member forming the reservoir, the proximal end having a port to fluidly connect the proximal and distal ends such that the reservoir is capable of being remotely filled with the cargo.
8. A delivery system according to claim 1 wherein the cargo comprises at least one of small ionic molecules, nucleic acids, proteins, organic nanoparticles, therapeutic agents, and imaging agents.
9. A delivery system according to claim 1 wherein the source electrode includes an array of probes comprising one of thin wires, foil, mesh, pellets, disks, stents, clamps, prongs, clips, needles, hollow tubes, and combinations thereof.
10. A delivery system according to claim 1 wherein the source electrode and the counter electrode are comprised of one of a metallic material, a conductive polymer material, and combinations thereof.
11. A delivery system according to claim 1 further comprising at least one insulating member at least partially disposed about the source electrode, the at least one insulating member being configured to confer directionality to the transport profile of the cargo released from the reservoir.
12.-25. (canceled)
26. A method of delivering a cargo to a target site of internal body tissue, the method comprising:
- disposing a source electrode proximate to a target site of internal body tissue in vivo;
- disposing a counter electrode in electrical communication with the source electrode, the counter electrode being configured to cooperate with the source electrode to form a localized electric field proximate to the target site;
- disposing a reservoir such that the reservoir is capable of interacting with the localized electric field, the reservoir being configured to carry a cargo capable of being delivered to the target site when exposed to the localized electric field formed between the source electrode and the counter electrode; and
- applying a voltage potential across the source and counter electrodes to form an electric field, thereby delivering at least a portion of the cargo to the target site.
27. A method according to claim 26, wherein disposing the source electrode comprises disposing the source electrode proximate to the target site of internal body tissue in vivo using an electrode deployment device.
28. A method according to claim 27 further comprising guiding the electrode deployment device with a control system in communication therewith, the control system being configured to guide the electrode deployment device for positioning of the source electrode and the counter electrode.
29. A method according to claim 27 wherein disposing a source electrode further comprises disposing a source electrode with an electrode deployment device comprising one of a catheter device, an endoscopic device, a laparoscopic device, an implantable device, and combinations thereof.
30. A method according to claim 29 wherein disposing a source electrode further comprises disposing a source electrode with an electrode deployment device comprising a catheter device having a first and second expandable member serially disposed along a longitudinal axis of the catheter device, the source electrode being axially disposed between the first and second expandable members such that, upon inflation of the first and second expandable members to occlude the target site, the target site is isolated and the delivery of the cargo is contained to the target site.
31. A method according to claim 29 wherein disposing a source electrode further comprises disposing a source electrode with an electrode deployment device comprising a catheter device having a perforated polymer sheath, the cargo being capable of exiting the catheter device through a plurality of perforations defined by the perforated polymer sheath, and the source electrode comprising an array of probes terminating at different lengths and being independently powered such that the probes are capable of being variably controlled, the source electrode further comprising a plurality of insulating members disposed about and between the probes so as to form cargo delivery zones substantially aligned with the perforations of the perforated polymer sheath.
32.-48. (canceled)
49. A method of treating a target site of body tissue, the method comprising:
- delivering a therapeutic agent to a body cavity of a patient for storage thereof;
- positioning a first electrode proximate to a target site of internal body tissue;
- positioning a second electrode such that the second electrode is in electrical communication with the first electrode; and
- applying a voltage potential across the first and second electrodes to drive the therapeutic agent from the body cavity to the target site.
50. A method according to claim 49 wherein delivering a therapeutic agent to a body cavity further comprises implanting a device within the body cavity, the device being configured to carry and release the therapeutic agent upon the voltage potential being applied between the first and second electrodes.
51. A method according to claim 49 wherein delivering a therapeutic agent to a body cavity further comprises delivering a therapeutic agent to one of a peritoneal cavity, a cranial cavity, an oral cavity, a pleural cavity, an abdominopelvic cavity, and a pelvic cavity.
52.-53. (canceled)
Type: Application
Filed: Jun 26, 2020
Publication Date: Dec 24, 2020
Inventors: Joseph DeSimone (Chapel Hill, NC), Mary Napier (Carrboro, NC), Jonathan Pillai (Chapel Hill, NC), James Byrne (Chapel Hill, NC), Lukas Miller Roush (Chapel Hill, NC), Jen Jen Yeh (Chapel Hill, NC), Matt Parrott (Carrboro, NC)
Application Number: 16/913,592
