JP2021525737A - 重要構造近くにおける放射線外科的神経調節 - Google Patents
重要構造近くにおける放射線外科的神経調節 Download PDFInfo
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Abstract
Description
本出願は、2018年5月30日に提出された米国仮出願第62/678,098号の35USC§119(e)に基づく利益を主張するものであり、その開示全体はすべての目的のためにその全体が参照により本明細書に組み込まれる。
Claims (30)
- 特定の脳細胞型に親和性を有する1つまたは複数の物質を血液脳関門を越えて投与して、標的組織での放射線効果を強化し、および/または前記脳の重要構造の非標的組織を防護すること、ならびに
治療線量で放射線を前記標的組織に送達し、それにより、前記1つまたは複数の物質の存在によって、前記脳の重要構造の非標的組織と比較して前記標的組織の治療が強化され、および/または前記脳の重要構造の非標的組織の変化が回避されること
を含む治療方法。 - 脳の障害を治療するための方法であって、
前記脳の神経回路内の標的ノードまたは経路に関連する標的組織の位置を特定すること、
隣接する重要構造とは異なる、前記標的組織の分子特性を特定すること、
前記血液脳関門を越え、細胞型特異性を有する1つまたは複数のコンジュゲート分子物質を選択すること、
前記1つまたは複数のコンジュゲート分子物質を前記血液脳関門を越えて送達すること、ならびに
定位放射線外科手術を放射線調節線量で標的位置に送達すること
を含む方法。 - 前記脳の神経回路内の標的ノードまたは経路に関連する標的組織を特定すること、
前記神経回路内の標的の空間位置を特定すること、
非侵襲性の解剖学的特異的血液脳関門透過装置を選択し、標的に指向させ、送達すること、
前記透過された血液脳関門を越えて解剖学的特異的に取り込まれる1つまたは複数の分子物質を送達し、前記1つまたは複数の物質が解剖学的特異性を有し、前記標的組織に対する放射線を強化し、および/または前記脳の重要構造の非標的組織に対する照射を抑制すること、ならびに
定位放射線外科手術により放射線を放射線調節線量で標的位置に送達すること
を含む脳障害を治療する方法。 - 前記コンジュゲート分子物質が、特定の細胞型に対して親和性を有する分子にコンジュゲートされた放射線増感剤である、請求項3に記載の方法。
- 前記透過装置が集束超音波である、請求項3に記載の方法。
- 脳の障害を治療する方法であって、
神経回路標的の少なくとも標的部分に物理的に近い重要構造を特定すること、
前記神経回路の標的部分とは異なる、その重要構造の分子特性を特定すること、
前記血液脳関門を越え、細胞型特異性を有するコンジュゲート分子物質を選択すること、
前記コンジュゲートを全身送達して、前記重要構造によって取り込ませること、ならびに
側坐核のドーパミン活性の量を変化させて薬物中毒の症状を軽減するために、細胞の致死量以下の量の電離放射線を前記患者の外部から前記患者の標的に伝達すること
を含む方法。 - 脳の障害を治療する方法であって、
神経回路標的に物理的に近い重要構造を特定すること、
前記神経回路内の重要構造の空間位置を特定すること、
非侵襲性の解剖学的特異的血液脳関門透過装置を選択し、前記脳の血液脳関門に指向させ、送達すること、
前記透過された血液脳関門を越えて重要構造において解剖学的特異的に取り込まれる1つまたは複数の分子物質を送達し、前記1つまたは複数の分子物質が前記重要構造に対する照射を抑制すること、ならびに
細胞の致死量以下の量の電離放射線を前記患者の外部から前記神経回路標的に伝達し、それによって治療線量の放射線を前記標的神経回路に送達しながら、前記重要構造に対する損傷を抑制すること
を含む方法。 - 前記放射線を伝達することが、前記電離放射線を、前記患者の外部の放射線源機械から、前記患者の頭蓋骨を通って、様々な方向から重要構造と交差するように指向された複数のビーム経路に沿って前記患者の脳に伝達することを含む、請求項7に記載の方法。
- 前記1つまたは複数の物質が特定の細胞型に対して親和性を有する、請求項7に記載の方法。
- 前記1つまたは複数の物質が、前記神経回路の標的組織において解剖学的特異的に取り込まれる物質をさらに含み、前記物質が特定の細胞型に親和性を有し、前記神経回路の標的組織において放射線を促進するための放射線増感剤を含む、請求項7に記載の方法。
- 前記解剖学的特異的BBB透過装置が集束超音波である、請求項7に記載の方法。
- 前記脳障害が疼痛である、請求項1〜11のいずれかに記載の方法。
- 前記脳障害が肥満に関連する過食症である、請求項1〜11のいずれかに記載の方法。
- 前記脳障害が薬物中毒である、請求項1〜11のいずれかに記載の方法。
- 前記標的組織または標的神経回路が側坐核にドーパミン産生ニューロンを含み、前記放射線を伝達することが、側坐核のドーパミン活性の量を変化させて薬物中毒の症状を軽減するために、前記患者の線条体に放射線を伝達することを含む、請求項7に記載の方法。
- 前記1つまたは複数の物質を送達することが、前記側坐核内のドーパミン作動性ニューロンに放射線増感剤を送達することを含む、請求項7に記載の方法。
- 前記1つまたは複数の物質を送達することが、前記側坐核内の非ドーパミン作動性ニューロンに放射線防護剤を送達することを含む、請求項7に記載の方法。
- 前記脳障害が摂食関連障害であり
前記標的組織または標的神経回路が、視床下部のニューロンを含み、ならびに
前記放射線を伝達することが、摂食関連障害の症状が軽減されるように、細胞の致死量以下の量の電離放射線を前記患者の外側から視床下部内側核に伝達することを含む、請求項1〜11のいずれかに記載の方法。 - 前記1つまたは複数の物質を送達することが、前記視床下部内のニューロンに放射線増感剤を送達することを含む、請求項18に記載の方法。
- 前記1つまたは複数の物質を送達することが、視床下部外側野に放射線防護剤を送達することを含む、請求項18または19に記載の方法。
- 障害を治療する方法であって、
特定の脳細胞型に親和性を有する1つまたは複数の物質を血液脳関門を越えて投与して、標的組織での放射線効果を強化し、および/または前記脳の重要構造の非標的組織を防護すること、ならびに
治療線量で前記標的組織に放射線を送達し、それにより、前記1つまたは複数の物質の存在によって、前記標的組織の治療が強化され、および/または前記脳の重要構造の非標的組織の変化が回避されること
を含む治療方法。 - 前記1つまたは複数の物質を投与することが、前記1つまたは複数の物質を血管内に導入すること、ならびに、血液脳関門透過装置を前記血液脳関門に送達して、前記血液脳関門を越えて前記1つまたは複数の物質の投与を促進することを含む、請求項21に記載の方法。
- 前記血液脳関門透過装置を送達することが、超音波エネルギーを前記血液脳関門に沿った選択された位置に指向させることを含む、請求項21に記載の方法。
- 脳の障害を治療する治療システムであって、
特定の脳細胞型に対して親和性を有する、前記障害に寄与する神経回路に関連する標的組織における放射線効果を強化する特性、および/または前記脳の重要構造の非標的組織の照射を抑制する特性を有する1つまたは複数の物質と、
血液脳関門に送達する場合、前記脳の前記血液脳関門を透過するように構成された血液脳関門透過装置と、
治療線量で前記標的組織に放射線を送達するように構成され、それにより、前記1つまたは複数の物質の存在によって、前記標的組織の治療が強化され、および/または前記脳の重要構造の前記非標的組織の変化が回避される放射線送達システム
を含む治療システム。 - 前記1つまたは複数の物質が、放射線増感剤および/または放射線防護剤を含む、請求項24に記載の治療システム。
- 前記患者の外部の前記放射線送達システムから、前記患者の頭蓋骨を通って、様々な方向から標的組織と交差するように指向された複数のビーム経路に沿って前記患者の脳に放射線を指向させるように構成されたプロセッサをさらに含む、
請求項24に記載の治療システム。 - 超音波送達システムと、
前記超音波送達システムから超音波を指向させて、前記血液脳関門を一時的に透過する位置を特定するための画像化システムと
をさらに含む、請求項24に記載の治療システム。 - 前記画像化システムが、放射線の伝達のための標的組織位置を特定するようにさらに構成される、請求項27に記載の治療システム。
- 前記画像化システムが、MRIシステムであり、前記超音波システムが、高周波超音波源を含む、請求項27に記載の治療システム。
- 前記プロセッサが、前記画像化システムにより前記血液脳関門に関連する位置を特定し、それに応じて前記血液脳関門を透過するように前記超音波源から超音波エネルギーを指向させ、前記1つまたは複数の物質が前記血液脳関門を越えて伝達可能にするようにさらに構成される、
請求項26に記載の治療システム。
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US201862678098P | 2018-05-30 | 2018-05-30 | |
US62/678,098 | 2018-05-30 | ||
PCT/US2019/034680 WO2019232227A1 (en) | 2018-05-30 | 2019-05-30 | Radiosurgical neuromodlation close to critical structures |
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