JP2013517847A - 除神経のための方法、装置、及び薬剤 - Google Patents
除神経のための方法、装置、及び薬剤 Download PDFInfo
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Abstract
【選択図】図9F
Description
本願は、2010年1月26日に出願された米国仮特許出願第61/336,838号明細書の利益を主張し、これは参照により援用される。
最初に標的部位を取り囲む血管に血管収縮剤(抗利尿ホルモン(ADH又はバソプレッシン)又はテトラヒドロゾリン)を投与して、プライミング薬剤又は二次薬剤の漏出を最小限に抑える。
最初に標的部位を取り囲む血管に血管収縮剤(抗利尿ホルモン(ADH又はバソプレッシン)又はテトラヒドロゾリン)を投与して、プライミング薬剤又は二次薬剤の漏出を最小限に抑える。
最初に標的部位を取り囲む血管に血管収縮剤(抗利尿ホルモン(ADH又はバソプレッシン)又はテトラヒドロゾリン)を投与して、プライミング薬剤又は二次薬剤の漏出を最小限に抑える。
最初に標的部位を取り囲む血管に血管収縮剤(抗利尿ホルモン(ADH又はバソプレッシン)又はテトラヒドロゾリン)を投与して、プライミング薬剤又は二次薬剤の漏出を最小限に抑える。
最初に標的部位を取り囲む血管に血管収縮剤(抗利尿ホルモン(ADH又はバソプレッシン)又はテトラヒドロゾリン)を投与して、プライミング薬剤又は二次薬剤の漏出を最小限に抑える。
Claims (71)
- 腎動脈壁内にある複数の腎神経標的部位に薬剤を標的化して送達するための装置において、前記腎神経標的部位が、(1)腎動脈口に対する長手方向位置、(2)腎動脈の周囲に対する半径方向位置、及び(3)前記腎動脈の内壁に対する深さに関連し、前記装置が、
カテーテルと、
前記カテーテルに摺動自在に結合する送達要素であって、前記送達要素が少なくとも部分的に前記腎動脈内に位置決めされるように構成され、前記送達要素が、前記送達要素に結合する複数の送達先端を含み、前記送達要素が格納構成を有し、この構成では前記送達先端が格納されており、前記送達要素が展開構成を有し、この構成では前記送達先端が、前記腎動脈の内壁に侵入し、且つ前記薬剤を前記腎神経標的部位に実質的に同時に送達する能力を有する、送達要素と、
を含み、
前記送達先端が、前記腎神経標的部位の長手方向位置、半径方向位置、及び深さに対応するパターンで構成されることを特徴とする、装置。 - 請求項1に記載の装置において、前記送達要素が送達チューブであり、及び前記送達先端が前記送達チューブの外表面に結合されることを特徴とする装置。
- 請求項1に記載の装置において、前記送達要素がコイルであり、及び前記送達先端が前記コイルの外側に向いた表面に結合されることを特徴とする装置。
- 請求項1に記載の装置において、前記送達要素がバルーンであり、及び前記送達先端が前記バルーンの外表面に結合されることを特徴とする装置。
- 請求項1に記載の装置において、前記送達要素が自己拡張式構造であり、及び前記送達先端が前記自己拡張式構造の開口から突き出ることを特徴とする装置。
- 請求項5に記載の装置において、前記自己拡張式構造が自己拡張式メッシュであることを特徴とする装置。
- 請求項1に記載の装置において、前記パターンが予め決められたものであることを特徴とする装置。
- 請求項1に記載の装置において、前記パターンが使用者により選択されることを特徴とする装置。
- 請求項1に記載の装置において、前記パターンが非円周方向であることを特徴とする装置。
- 請求項1に記載の装置において、前記送達先端が、極めて少量の前記薬剤を送達するように構成されることを特徴とする装置。
- 請求項1に記載の装置において、前記送達先端の各々が、前記薬剤を送達する送達ルーメンを含み、前記送達ルーメンは前記腎動脈口からの距離に従いサイズが変化し、前記送達ルーメンは前記腎動脈口からの距離に従い異なる量の前記薬剤を送達することを特徴とする装置。
- 請求項1に記載の装置において、前記送達先端の1つ以上が中実であり、且つ前記薬剤を被覆したことを特徴とする装置。
- 請求項1に記載の装置において、前記カテーテルが、フラッシュ剤を前記腎動脈に送達することが可能なフラッシュポートを画定し、前記フラッシュ剤は、前記腎神経標的部位から漏出する前記薬剤の任意の少なくとも一部分を中和する能力を有することを特徴とする装置。
- 請求項1に記載の装置において、
前記送達要素に結合されたエネルギー源であって、前記薬剤のバイオアベイラビリティを向上させるため前記送達先端を介してエネルギーを送達することが可能なエネルギー源
をさらに含むことを特徴とする装置。 - 請求項14に記載の装置において、前記エネルギー源が超音波エネルギー源であることを特徴とする装置。
- 請求項14に記載の装置において、前記エネルギー源が熱的エネルギー源であることを特徴とする装置。
- 腎動脈壁内にある複数の腎神経標的部位に薬剤を標的化して送達する方法において、
前記腎神経の位置を決定するステップと、
前記腎神経の位置に基づき複数の腎神経標的部位を選択するステップであって、前記腎神経標的部位が、(1)腎動脈口に対する長手方向位置、(2)腎動脈の周囲に対する半径方向位置、及び(3)前記腎動脈の内壁に対する深さに関連するステップと、
送達要素を選択するステップであって、前記送達要素が、前記送達要素に結合する複数の送達先端を含み、前記送達先端が、前記腎神経標的部位の長手方向位置、半径方向位置、及び深さに対応する構成を有するステップと、
前記腎動脈において前記送達要素を展開するステップと、
前記送達先端を前記腎動脈の内壁の中へと付勢して前記腎動脈の内壁に侵入させるステップと、
前記送達先端を介して前記薬剤を前記腎神経標的部位に送達するステップと、
を含むことを特徴とする方法。 - 請求項17に記載の方法において、
前記カテーテルにおけるフラッシュポートを介して前記腎動脈にフラッシュ剤を送達するステップであって、前記フラッシュ剤が、前記腎神経標的部位から漏出する前記薬剤の任意の少なくとも一部分を中和する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項17に記載の方法において、
前記送達要素に結合された超音波エネルギー源を使用して、前記送達先端を介して超音波エネルギーを送達するステップであって、それにより前記薬剤のバイオアベイラビリティを向上させるステップ
をさらに含むことを特徴とする方法。 - 請求項17に記載の方法において、前記位置をマッピングするステップが、電気マッピングカテーテルを使用することを含むことを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
刺激薬により誘導される興奮シグナルの毒性作用を増強するのに十分な量の増強薬を前記神経細胞に局所的に送達するステップと、
前記神経細胞を過度に刺激して前記神経細胞のアポトーシスを促進するのに十分な量の刺激薬を前記神経細胞に局所的に送達するステップと、
を含むことを特徴とする方法。 - 請求項21に記載の方法において、前記薬剤が強心配糖体であることを特徴とする方法。
- 請求項23に記載の方法において、前記強心配糖体がジゴキシン、プロシラリジン、又はウアビン(ouabin)であることを特徴とする方法。
- 請求項21に記載の方法において、前記刺激薬がグルタメート又はドーモイ酸であることを特徴とする方法。
- 請求項21に記載の方法において、前記刺激薬が強心配糖体であることを特徴とする方法。
- 請求項21に記載の方法において、前記刺激薬が神経成長因子(NGF)受容体に対する抗体であることを特徴とする方法。
- 請求項21に記載の方法において、前記増強薬が、神経特異的受容体に対して親和性を有する向神経性リガンドに連結されることを特徴とする方法。
- 請求項21に記載の方法において、前記刺激薬が、神経特異的受容体に対して親和性を有する向神経性リガンドに連結されることを特徴とする方法。
- 請求項21に記載の方法において、
前記神経細胞を取り囲む組織にフラッシュ剤を送達するステップであって、前記フラッシュ剤が、任意の過剰な増強薬又は刺激薬を中和する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項29に記載の方法において、前記フラッシュ剤がジゴキシン免疫Fabであることを特徴とする方法。
- 請求項21に記載の方法において、
前記増強薬を送達する前に、前記神経細胞を取り囲む組織に準備薬剤を送達するステップであって、前記準備薬剤が、前記神経細胞を取り囲む前記組織に対する前記増強薬及び前記刺激薬の効果を低減する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項31に記載の方法において、前記準備薬剤が血管収縮剤であることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
チャネル遮断薬の毒性作用を増強するのに十分な量の増強薬を前記神経細胞に局所的に送達するステップと、
前記神経細胞の活動電位及び再分極を遮断するのに十分な量のチャネル遮断薬を前記神経細胞に局所的に送達するステップと、
を含むことを特徴とする方法。 - 請求項33に記載の方法において、前記増強薬が強心配糖体であることを特徴とする方法。
- 請求項34に記載の方法において、前記強心配糖体がジゴキシン、プロシラリジン、又はウアビン(ouabin)であることを特徴とする方法。
- 請求項33に記載の方法において、前記チャネル遮断薬が代謝産物であることを特徴とする方法。
- 請求項36に記載の方法において、前記代謝産物がテトロドトキシン、コノトキシン、又は他の毒素であることを特徴とする方法。
- 請求項33に記載の方法において、前記チャネル遮断薬が小分子であることを特徴とする方法。
- 請求項38に記載の方法において、前記小分子がベラパミル、カルバマゼピン、アムロジピン、又はジルチアゼムであることを特徴とする方法。
- 請求項33に記載の方法において、前記チャネル遮断薬が競合イオンであることを特徴とする方法。
- 請求項40に記載の方法において、前記競合イオンがリチウムであることを特徴とする方法。
- 請求項33に記載の方法において、前記増強薬が、神経特異的受容体に対して親和性を有する向神経性リガンドに連結されることを特徴とする方法。
- 請求項33に記載の方法において、
前記神経細胞を取り囲む組織にフラッシュ剤を送達するステップであって、前記フラッシュ剤が、任意の過剰な増強薬を中和する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項43に記載の方法において、前記フラッシュ剤がジゴキシン免疫Fabであることを特徴とする方法。
- 請求項33に記載の方法において、
前記増強薬を送達する前に、前記神経細胞を取り囲む組織に準備薬剤を送達するステップであって、前記準備薬剤が、前記神経細胞を取り囲む前記組織に対する前記増強薬の効果を低減する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項45に記載の方法において、前記準備薬剤が血管収縮剤であることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
前記神経細胞を過度に刺激して前記神経細胞のアポトーシスを促進するのに十分な量の刺激薬を前記神経細胞に局所的に送達するステップと、
前記神経細胞の活動電位及び再分極を遮断するのに十分な量のチャネル遮断薬を前記神経細胞に局所的に送達するステップと、
を含むことを特徴とする方法。 - 請求項47に記載の方法において、前記刺激薬がグルタメート又はドーモイ酸であることを特徴とする方法。
- 請求項47に記載の方法において、前記刺激薬が強心配糖体であることを特徴とする方法。
- 請求項47に記載の方法において、前記刺激薬が、神経成長因子(NGF)受容体に対する抗体であることを特徴とする方法。
- 請求項47に記載の方法において、前記チャネル遮断薬が代謝産物であることを特徴とする方法。
- 請求項51に記載の方法において、前記代謝産物がテトロドトキシン、コノトキシン、又は他の毒素であることを特徴とする方法。
- 請求項47に記載の方法において、前記チャネル遮断薬が小分子であることを特徴とする方法。
- 請求項53に記載の方法において、前記小分子がベラパミル、カルバマゼピン、アムロジピン、又はジルチアゼムであることを特徴とする方法。
- 請求項47に記載の方法において、前記チャネル遮断薬が競合イオンであることを特徴とする方法。
- 請求項55に記載の方法において、前記競合イオンがリチウムであることを特徴とする方法。
- 請求項47に記載の方法において、前記刺激薬が、神経特異的受容体に対して親和性を有する向神経性リガンドに連結されることを特徴とする方法。
- 請求項47に記載の方法において、
前記神経細胞を取り囲む組織にフラッシュ剤を送達するステップであって、前記フラッシュ剤が、任意の過剰な刺激薬を中和する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項47に記載の方法において、
前記増強薬を送達する前に、前記神経細胞を取り囲む組織に準備薬剤を送達するステップであって、前記準備薬剤が、前記神経細胞を取り囲む前記組織に対する前記刺激薬の効果を低減する能力を有するステップ
をさらに含むことを特徴とする方法。 - 請求項59に記載の方法において、前記準備薬剤が血管収縮剤であることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
前記神経細胞を死滅させるのに十分な量の強心配糖体を前記神経細胞に局所的に送達するステップ
を含むことを特徴とする方法。 - 請求項61に記載の方法において、前記強心配糖体がジゴキシンであることを特徴とする方法。
- 請求項62に記載の方法において、前記量が0.0001〜10mMであることを特徴とする方法。
- 請求項61に記載の方法において、前記強心配糖体がプロシラリジンであることを特徴とする方法。
- 請求項64に記載の方法において、前記量が0.0001〜10mMであることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
前記神経細胞を死滅させるのに十分な量のドーモイ酸を前記神経細胞に局所的に送達するステップ
を含むことを特徴とする方法。 - 請求項66に記載の方法において、前記量が0.00005〜0.005mMであることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
前記神経細胞を死滅させるのに十分な量のコノトキシンを前記神経細胞に局所的に送達するステップ
を含むことを特徴とする方法。 - 請求項68に記載の方法において、前記量が0.00005〜0.001mMであることを特徴とする方法。
- 哺乳動物の標的神経細胞を死滅させる方法において、
前記神経細胞を死滅させるのに十分な量のアフラトキシンを前記神経細胞に局所的に送達するステップ
を含むことを特徴とする方法。 - 請求項70に記載の方法において、前記量が0.00001〜0.003mMであることを特徴とする方法。
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EP2528649A1 (en) | 2012-12-05 |
CN105640501A (zh) | 2016-06-08 |
CA2787062C (en) | 2017-07-11 |
EP3246035A1 (en) | 2017-11-22 |
WO2011094367A1 (en) | 2011-08-04 |
US8975233B2 (en) | 2015-03-10 |
JP5952195B2 (ja) | 2016-07-13 |
US9056184B2 (en) | 2015-06-16 |
US20120108517A1 (en) | 2012-05-03 |
CA2787062A1 (en) | 2011-08-04 |
CN102892454B (zh) | 2016-01-20 |
US20110184337A1 (en) | 2011-07-28 |
JP2016199559A (ja) | 2016-12-01 |
US20110182912A1 (en) | 2011-07-28 |
CN102892454A (zh) | 2013-01-23 |
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