WO2017116350A1 - Conception d'une lentille de contact permettant la détection du taux de glycémie dans les larmes - Google Patents

Conception d'une lentille de contact permettant la détection du taux de glycémie dans les larmes Download PDF

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Publication number
WO2017116350A1
WO2017116350A1 PCT/TR2016/050413 TR2016050413W WO2017116350A1 WO 2017116350 A1 WO2017116350 A1 WO 2017116350A1 TR 2016050413 W TR2016050413 W TR 2016050413W WO 2017116350 A1 WO2017116350 A1 WO 2017116350A1
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Prior art keywords
contact lens
glucose
glucose level
fluorescence
boronic acid
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PCT/TR2016/050413
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English (en)
Inventor
Canan Asli YILDIRIM
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Dokuz Eylul Universitesi Rektorlugu
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Publication of WO2017116350A1 publication Critical patent/WO2017116350A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14507—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue specially adapted for measuring characteristics of body fluids other than blood
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1468—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using chemical or electrochemical methods, e.g. by polarographic means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6814—Head
    • A61B5/6821—Eye
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29D—PRODUCING PARTICULAR ARTICLES FROM PLASTICS OR FROM SUBSTANCES IN A PLASTIC STATE
    • B29D11/00—Producing optical elements, e.g. lenses or prisms
    • B29D11/00009—Production of simple or compound lenses
    • B29D11/00038—Production of contact lenses
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/04—Contact lenses for the eyes
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29D—PRODUCING PARTICULAR ARTICLES FROM PLASTICS OR FROM SUBSTANCES IN A PLASTIC STATE
    • B29D11/00—Producing optical elements, e.g. lenses or prisms
    • B29D11/00009—Production of simple or compound lenses
    • B29D11/00317—Production of lenses with markings or patterns
    • B29D11/00346—Production of lenses with markings or patterns having nanosize structures or features, e.g. fillers

Definitions

  • the invention is intended for patients with diabetes, and relates to a type of contact lens by means of which tear glucose level is monitored thanks to a biosensor disposed thereon.
  • Diabetes mellitus is a metabolic disorder which takes place due to genetic and environmental factors combined, and results in an excessive increase in blood glucose levels (i.e. hyperglycemia). If not under control, Diabetes mellitus is one of the major causes of morbidity/mortality. It is essential that blood glucose levels are followed up closely in order to prevent diabetes-related complications. To that end, it is suggested for diabetic patients to monitor blood glucose levels by drawing blood from the finger tip (i.e. finger-stick procedure) about five times a day. A patient performing blood glucose level monitoring by finger-sticking technique five times a day has to pierce his/her finger tip 1800 times annually. This obligation, in turn, causes fears in the patients, at the same time bearing a risk of disorders and possible infections.
  • the glucose level in tear rises in direct proportion to blood glucose level.
  • Contact lens application is intended for estimating blood glucose level by tear glucose level determination and such contact lens designs exist in the state of the art.
  • the existing contact lenses capable of determining glucose level comprise electrochemical, crystalline colloidal array, holographic, or fluorescence emitting biosensors applied on the contact lens (3).
  • the patient tries to perform instant determination of reaction on 1-2 sensors on the lens by means of a separate device in order to be able to measure said value. All of these methods require a secondary external device for tear glucose level determination, and thus blood glucose level estimation.
  • Said secondary device may be an electrical circuit, a smartphone camera, or a handheld fluorophotometer.
  • the contact lens design according to the invention performs blood glucose level monitoring, thereby allowing a non-invasive blood glucose level monitoring. Hence, there is no longer any need to perform measurement by finger-sticking in order to be able to understand whether blood glucose level has increased or not.
  • the present invention is capable of giving signal itself once the tear glucose level exceeds a certain threshold value, without requiring the use of a separate external device for measurement. As said signal is given in the form of a visible wavelength color, continuous blood glucose level monitoring is achieved by a change in the color with which the patient sees the world and / or a change in the color of the pupils of the patients is visible from outside.
  • the aim of the contact lens design according to the invention is not to estimate and monitor blood glucose level by way of exact tear glucose level determination, but to produce the contact lens in a way to give a signal of hyperglycemia, and thus the patient draws blood sample only when necessary (in case of hyperglycemia when the contact lens "signals") and perform exact glucose level determination, and to plan precise treatment accordingly.
  • the present contact lens does not totally eliminate the need for blood glucose level determination by finger-sticking procedure, it reduces the necessity of blood drawing, as well as decreasing the number of finger prickling procedure performed. It is particularly useful for the patients, whose compliance with the treatment is reduced due to the inconvenience of drawing blood repetitively during the day, thereby increasing patient compliance. Moreover, it makes non- invasive and continuous blood sugar monitoring of diabetic patients possible. This will have two important effects economically. First of all, the need for blood drawing and blood glucose level measurement systems, which are costly, will be decreased. Only when the patients receive a signal regarding a possible increase in blood glucose level from the contact lens that they are wearing, will they apply blood glucose level determination for therapeutic purposes.
  • Fig. 1 Schematic view of the newly designed contact lens.
  • Boronic acid- containing fluorophore / azobenzene dye positioned around metal particles or in the close vicinity thereof ( ⁇ 10 nm) if needed, is applied to the entire inner (or outer) surface of the lens as a film layer or will be embedded into the polymer matrix of the contact lens material.
  • Main difference from previous contact lens designs of the same purpose is that the sensor is almost homogeneously present all over the lens and the lens reacts as a whole, instantly and spontaneously that the reaction is evident for the patient / from outside as a color change.
  • the biosensor may not be applied in the centre of the pupil, the visual axis, in a ⁇ 3 mm diameter area, or said biosensor may be less frequently applied in this region, in order that the density of metal particles will not affect the sight of the patient.
  • the invention relates to a contact lens design intended for patients with diabetes.
  • the biosensors disposed on the lens thanks to the biosensors disposed on the lens, the changes in glucose level can be monitored continuously and without any outside intervention.
  • boronic acid-containing fluorophores react with glucose and other carbohydrates of saccharide group, exhibiting high affinity, and that they emit fluorescence.
  • the fluorescence emitted is not at a visible wavelength or level, and so the emitted fluorescence needs to be increased by stimulating with an external fluorophotometer to be able to detect it.
  • boronic acid-containing azobenzene derivative dyes when combined with the glucose, also exhibit color changes at visible wavelength spectrum, and yet the concentration of glucose must reach levels as high as 100 mM in order for said fluorescence to be revealed (5).
  • MIFE Metal-induced fluorescence enhancement
  • this method leads to a change in the color of the contact lens in the presence of high concentration glucose; thus, the patients themselves or their relatives are given a warning signal with a change in the color with which the patient visions the world or a change in the color of the pupils of the patients visible from the outside.
  • Boronic acid derivatives reversible glucose affinity of which is high in aqueous (liquid) medium, serve as a glucose biosensor on the contact lens (7,8). Boronic acid derivatives are free of the disadvantages of toxicity or in vivo instability.
  • boronic acid-containing molecules as glucose sensor, the changes in the fluorescence emitted by the boronic acid-containing fluorophores, or in the color (colorimetry) in the presence of glucose using azobenzene dyes matched with boronic acid can be detected, as a result of glucose-boronic acid reaction.
  • the common problem regarding these two approaches is that the emitted fluorescence/colorimetry is not so intense to be observed from the outside, or that they require much higher glucose concentrations than already present in tear for a detectable fluorescence / colorimetry.
  • the resulting fluorescence / colorimetry is required to be made intense enough to be self-detectable in visible light wavelength with a view to overcome the aforementioned problem.
  • at least three methods can be developed making use of metal particles.
  • MIFE metal induced florescence enhancement
  • MIFE can be achieved by metals such as gold, silver, copper, nickel, and tin (10, 11). Compared to gold (Au) particles, silver (Ag) particles have a higher efficiency of scattering fluorescence upon facing with a stimulant with the same wavelength (16); therefore, silver island films (SIFs) on glass or plastic surface are frequently preferred, the methodologies regarding the preparation thereof are available in literature in detail (11).
  • MIFE works not only on glass- or silica-based surfaces, but also on modified plastic (i.e. treated polycarbonate) surfaces with a thickness of «50 ⁇ . It is assumed that it will also work when applied on (silicone) hydrogel-based soft contact lenses.
  • a boronic acid-containing fluorophore absorbs radiation at a certain wavelength, followed by releasing a photon with a lower energy (with longer wavelength). Since the stimulation and release photon wavelengths of the fluorescence is dependent on the chemical composition thereof, fluorescence is a molecule-specific sensing mode (17). Boronic acid-containing fluorophores have high glucose affinity and specificity.
  • Fluorescence dyes give signal via various mechanisms (for example, photo- induced electron transfer (PET), internal charge transfer (ICT), Forster resonance energy transfer (FRET)) (18). With the most frequently used FRET technique, the energy is distributed from the transmitting fluorophore to the receiving fluorophore in a distance-dependent manner (19). Contact lenses with glucose sensing property based on the fluorescence emitted by fluorophores have been dependent on fluorophore stimulation and fluorescence measurement performed by means of a handheld separate instrument so far (3). MIFE technique can be employed so that the fluorescence emitted upon the contact of boronic acid- containing fluorophores with glucose can be visible without requiring the use of a separate device like a fluorophotometer.
  • PET photo- induced electron transfer
  • ICT internal charge transfer
  • FRET Forster resonance energy transfer
  • a reaction visible from the outside may occur in case of contact with the tear and emission of fluorescence with high glucose concentration.
  • a self- inducible boronic acid-containing fluorophore which emits fluorescence at a wavelength and density visible from the outside can serve as a biosensor on the contact lens.
  • up-converting phosphors can also be utilized in order to bring the wavelength to a visible light range.
  • These phosphors transfers low-energy infrared (IR) radiation to high-energy visible light (3). This is achieved thereby due to a higher energy, shorter wavelength energy release, with the absorption of a number of photons, and then dopant-dependent phosphorescence (20).
  • the most efficient known up-converting substances are NaYF4/Er3Yb and NaYF4/Tm3Yb, which release red and green light upon stimulation at 980 nm (21).
  • the non-risky ones in terms of nanotoxicology can be used for bringing the wavelength of the fluorescence to a visible light range.
  • said dyes significantly change color due to the sensitivity of these dyes to glucose, wherein said dyes are obtained by the addition of boronic acid to the oposition of the azo group (5, 22-24).
  • the B-N point connection between the azo groups and the boronic acid belonging to a colorimetric sensor carries out a significant shift to red during maximum absorption, and following the addition of glucose to the medium this connection is broken and a significant color change occurs.
  • this significant color change on said sensors have been indicated on high sugar concentrations up to ⁇ and it seems that an additional reaction is required to obtain a significant color change in tear glucose levels.
  • Boronic acid derivatives are directly matched with inorganic nanoparticles (Without using a fluorophore or azo benzene dye) (25).
  • metal nano- particles allow the fabrication of bio-sensors which show adjustable color/shade changes in changing concentrations of glucose having size/shape dependent spectroscopic characteristics (26-28).
  • phenyl boronic acid modified silver nanoparticles can function as continuous glucose sensors.
  • a response dose in glucose concentrations between 0-20 nM concentration at 7.4 (physiological pH) can be adjusted for the silver nanoparticles coated with a molecule (i.e., 4- ((2-borono-4-phluorophenyl)amino)-3-mercapto-4-oxobutanoic acid) which is a phenylboronic acid group having high glucose determination ability and a thiol group having high silver binding ability, and said nanoparticles may function as a sensitive (having a threshold value of 89.0 ⁇ ) and specific colorimetric sensor (6).
  • a molecule i.e., 4- ((2-borono-4-phluorophenyl)amino)-3-mercapto-4-oxobutanoic acid
  • said nanoparticles may function as a sensitive (having a threshold value of 89.0 ⁇ ) and specific colorimetric sensor (6).
  • optical saccharide sensors have also been developed which provide the absorption range to shift to shorter wavelengths and for the dye to change color due to the steric effects created when boronic acids and glucose come together.
  • These polymers comprising amino acids such as poli(L- and D-lysine) besides boronic acid can also be used as colorimetric sensors (30-32). In the case that the obtained colorimetric change is at a level which can be detected on its own in tear glucose concentrations, these compounds also can be used as colorimetric sensors on the contact lens.
  • the designed contact lens has a silicone hydrogel (balafilcon, lortafilcon, sifilcon, comfilcon, galyfilcon, senofilcon etc.) structure and its oxygen transmission is planned to be high (min/t>70) and its water content to be between 25-50%.
  • the biosensor film layer applied on the surface of a lens or embedded in the polymer material can somewhat effect the oxygen transmissivity of a product, however the transmissivity will not be reduced to the level of hydrogel contact lenses without silicone (min/t «25).
  • Our contact lens can be produced using turning (Lathe-Cutting), casting (Spin- casting) or molding (Cast-molding) techniques having a plurality of basic curve and diameter parameters and our biosensor shall be preferably embedded into the hydrogel matrix (substance) of the contact lens or applied to the "entire" front / back surface.
  • turning (Lathe-Cutting) technique a polymerized soft contact lens material which has been dehydrated is turned on a cylindrical disk at a speed of 10000 RPM and the desired amount of material is removed from the disc and following this the material is polished (EP 2643152 ⁇ ). This production technique is difficult and expensive.
  • the casting (Spin-casting) process a concave mould and the front surface of the lens is established.
  • the bio-sensor which is our design can be embedded directly to the polymeric material of the contact lens, or applied on the surface by techniques such as the layer-layer sequenced adsorption (5) of polyelectrolytes by means of electrostatic interaction on the silicone hydrogel contact lens which is produced by means of one of the three techniques or polyvinyl alcohol multi layered films and phenyl boronic acid derivatives.
  • the final contact lens containing the biosensor might produce reversible or irreversible reaction and signaling with the glucose.
  • the color change of the contact lens upon reacting with glucose might be reversible preferably (i.e., when blood and tear glucose levels decrease, the color fades away and the contact lens is almost colorless and transparent again); or irreversibly (i.e., patient has to replace the contact lens when it changes color as a result of increased tear glucose concentration).
  • this product will be produced using one of the standard contact lens production techniques, it can also correct the refraction deficiency (diopter value) which the patients may be in need of correction.
  • the basic characteristics of this contact lens have been listed below:
  • This reaction is carried out without the need to be stimulated with another external device, and said reaction can be determined without the need to carry out a measurement with a separate device.
  • the change in color in the lens created by the increase in the tear glucose level is at such that the daily life of the patient shall not be disrupted acutely (the color scale can be titrated), and the patient can both track the color change with his/her own eye and the change can be observed from the outside as the change of color in the pupil.
  • These biosensors are 90% repeatable at each glucose concentration, 85% precise, 90% sensitive, have 85% specificity even in the presence of other saccharides such as fructose, and their response time is short ( ⁇ 30 sec).
  • the biosensors do not affect the chemical structure of the contact lens material, oxygen permeability, modulus, water content and optical force (to be tested in the lens production facility).
  • This reaction on the contact lens is preferably recyclable (reversible); in other words when the tear glucose concentration returns back to normal or when the lens is cleaned with lens disinfection systems it returns to its original color. If it cannot be recyclable, then disposable lenses (single use) will be produced.
  • the biosensor is not dissolved in the tear significantly that might lead absorption of the biosensor elements by the ocular surface or the lymphatics.
  • Asian K Geddes CD. Metal-Enhanced Chemiluminescence: Advanced Chemiluminescence Concepts for the 21st Century. Chem Soc Rev. 2009; 38(9): 2556-64.).

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Abstract

L'invention s'adresse à des patients souffrant de diabètes, et concerne un type de lentille de contact permettant la surveillance du taux de glycémie dans les larmes grâce à un biocapteur.
PCT/TR2016/050413 2015-12-30 2016-11-01 Conception d'une lentille de contact permettant la détection du taux de glycémie dans les larmes WO2017116350A1 (fr)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019025146A1 (fr) * 2017-08-01 2019-02-07 Starbreeze Ip Lux Ii S.À.R.L. Système de suivi oculaire pour affichage monté sur tête
CN109613717A (zh) * 2019-01-23 2019-04-12 中山大学附属第医院 角膜接触镜

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EP2643152A1 (fr) 2010-11-26 2013-10-02 Daysoft Limited Procédé de fabrication de lentilles de contact
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WO2003001400A2 (fr) 2001-06-22 2003-01-03 Enuvis, Inc. Synthese de sommes de correlation coherentes a une ou plusieurs frequences porteuses au moyen de sommes de correlation calculees avec un ensemble de resolution de frequences grossieres
US20100222657A1 (en) * 2005-09-28 2010-09-02 The Texas A&M University System Method for glucose monitoring using fluorescence quenching
US20110136929A1 (en) * 2008-07-09 2011-06-09 Pei Yong Edwin Chow Trapping glucose probe in pores of polymer
US20100113901A1 (en) * 2008-10-24 2010-05-06 Jin Zhang Contact lens integrated with a biosensor for the detection of glucose and other components in tears
EP2643152A1 (fr) 2010-11-26 2013-10-02 Daysoft Limited Procédé de fabrication de lentilles de contact
US20140350373A1 (en) * 2013-05-21 2014-11-27 Johnson & Johnson Vision Care, Inc. Ophthalmic lens with a passive event-based coloration system

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