|Publication number||US20050010270 A1|
|Application number||US 10/810,276|
|Publication date||Jan 13, 2005|
|Filing date||Mar 26, 2004|
|Priority date||Jun 10, 1998|
|Also published as||US6411852, WO1999064109A1|
|Publication number||10810276, 810276, US 2005/0010270 A1, US 2005/010270 A1, US 20050010270 A1, US 20050010270A1, US 2005010270 A1, US 2005010270A1, US-A1-20050010270, US-A1-2005010270, US2005/0010270A1, US2005/010270A1, US20050010270 A1, US20050010270A1, US2005010270 A1, US2005010270A1|
|Original Assignee||Asthmatx, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (3), Referenced by (42), Classifications (8), Legal Events (2)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This is a continuation of U.S. application Ser. No. 09/095,323 filed Jun. 10, 1998.
The invention relates to a method and apparatus for treating smooth muscle in the walls of body conduits, and more particularly, the invention relates to a method for treating medical conditions by reducing the bulk of smooth muscle surrounding a body conduit with radiant energy treatment of the smooth muscle.
Asthma is a disease which involves heightened reactivity of the tracheobronchial tree to numerous stimuli causing contraction of smooth muscle surrounding the airways of the lungs. The hyperreactivity of the airways can result from abnormal tissue reactions in the airways, which may be immunologically induced, or from a biochemical or neurohumoral imbalance of other normally functioning responses. In a healthy patient, the smooth muscle surrounding the airways contracts, such as when the patient coughs, to increase the localized airflow through the airways and expel inhaled particles which enter the lungs. In a patient with asthma, the airways are hyperreactive. With these hyperreactive airways a very small amount of pollen, allergen, or other material in the air will stimulate a large amount of smooth muscle contraction or spasm. This repeated contraction of the smooth muscles exercises the muscle causing the muscle to hypertrophy and become larger. Because the tissue surrounding the smooth muscle is relatively rigid, the hypertrophied smooth muscle expands into the airways shrinking the inner diameter of the airways for passage of air. For example, a healthy person has smooth muscle thicknesses surrounding the airways of about 0.01 mm while the smooth muscle thickness in an asthma patient may enlarge to up to about 2 or 3 mm. Correspondingly, the inner diameter of the airways may be reduced from about 2 to 3 mm for a healthy person to about 0.5 mm or less for an asthma patient. This narrowing of the airways causes the whistling or wheezing sound associated with asthma.
Asthma is also characterized by the excessive secretion of mucus by glands lining the airways. The disease is currently treated by inhalation of bronchodilating drugs to enlarge the airways and atropine and similar compounds to reduce mucus secretion. Bronchodilating drugs are typically beta agonists which react with beta receptors in the smooth muscle causing the smooth muscle to relax, opening the airways. However, if the smooth muscle is already hypertrophied and enlarged the bronchodilating drugs which cause the muscle to relax do little to increase the airway inner diameter.
An additional disadvantage of the inhaled asthma drugs is that these drugs must be used repeatedly and regularly. Even with regular use of asthma drugs, patients frequently require hospitalization for more intensive therapy and sometimes die from severe bronchospasms and mucus plugging.
Accordingly, it would be desirable to provide an asthma treatment which enlarges the airways and reduces mucus plugging without the need for repetitive drug treatments.
In addition to the airways of the lungs, other body conduits such as the esophagus, ureter, urethra, and coronary arteries, are also subject to periodic spasms which cause hypertrophy of the smooth muscle around these body conduits reducing the inner diameter of the conduits.
The present invention relates to a device and method for treating bodily conduits by application of radiant energy to the smooth muscle tissue of the conduit walls to prevent the smooth muscle tissue from replicating. The treatment of the smooth muscle tissue causes a reduction in the amount of smooth muscle tissue over time which increases the inner diameter of the body conduit and prevents smooth muscle spasms.
In accordance with one aspect of the present invention, an apparatus for the treatment of body conduits includes an elongated body configured to be inserted into a body conduit, the elongated body having a proximal end and a distal end, and a source of energy for emitting energy from the elongated body in an intensity which, when applied to walls of the body conduit causes a change in smooth muscle tissue which prevents the smooth muscle tissue from replicating.
In accordance with another aspect of the present invention, an apparatus for the treatment of walls of airways in a patient's lungs includes an elongated body configured to be inserted into the airways of a patient's lungs, the device having a proximal end and a distal end, and a source of energy for emitting energy from the distal end of the elongated body in an intensity which, when applied to the walls of the airway causes a change in smooth muscle tissue which prevents the smooth muscle tissue from replicating.
When the source of energy is a light source the apparatus further includes a light transmitting fiber extending from the proximal end to the distal end of the elongated body for transmitting light from the light source into the patient's lungs, a connector on the distal end of the elongated body for connecting the elongated body to the source of light, and a light directing member positioned at a distal end of the elongated device for diffusing or redirecting the light from the light transmitting fiber in a substantially radial pattern from the distal end of the elongated device.
In accordance with an additional aspect of the present invention, a method of treating asthma to control bronchospasms includes irradiating the walls of an airway in a lung in a wavelength and intensity which causes a change in smooth muscle tissue cells and prevents the smooth muscle tissue cells from replicating, and controlling bronchospasms by reduction or elimination of smooth muscle tissue.
In accordance with a further aspect of the invention, a method of treating respiratory conditions to control mucus plugging includes irradiating the walls of an airway in a lung in a wavelength and intensity which causes a change in mucus gland cells and prevents the mucus gland cells from replicating, and preventing mucus plugging by reduction or elimination of mucus glands.
In accordance with another aspect of the present invention, a method of treating an esophagus, an ureter, or an urethra to control spasms includes irradiating the walls of a conduit to cause a change in smooth muscle cells and prevent the smooth muscle cells from replicating.
The present invention provides advantages of a treatment for asthma or other enlargement or spasm of the smooth muscle by irradiation. The treatment enlarges airways, reduces or eliminates mucus plugging, and reduces or eliminates bronchospasm.
The invention will now be described in greater detail with reference to the preferred embodiments illustrated in the accompanying drawings, in which like elements bear like reference numerals, and wherein:
The energy delivery device 10 and method according to the present invention provide a more permanent treatment for asthma than the currently used bronchodilating drugs and drugs for reducing mucus secretion. In asthma patients, the cross sectional diameter of the airways are reduced due to bulking of the smooth muscle surrounding the airways.
The energy delivery device 10 is used to irradiate the smooth muscle surrounding the airways causing the DNA of the smooth muscle cells to become cross linked. The treated smooth muscle cells with cross linked DNA are incapable of replicating. Accordingly, over time, as the smooth muscle cells die, the total thickness of smooth muscle decreases because of the inability of the cells to replicate. The programmed cell death causing a reduction in the volume of tissue is called apoptosis. This treatment does not cause an immediate effect but causes shrinking of the smooth muscle and opening of the airway over time and substantially prevents regrowth. The irradiation by the energy delivery device 10 of the walls of the airway also causes a cross linking of the DNA of the mucus gland cells preventing them from replicating and reducing mucus plugging over time.
As shown in
The energy used may be coherent or incoherent light in the range of infrared, visible, or ultraviolet. The light source 22 may be any known source, such as a UV laser source. Preferably the light is ultraviolet light having a wavelength of about 240-280 nm or visible light in the red visible range. The intensity of the light may vary depending on the application. The light intensity should be bright enough to penetrate any mucus present in the airway and penetrate the smooth muscle cells and mucus gland cells to cause cross linking of the cell DNA. The light intensity may vary depending on the wavelength used, the application, the thickness of the smooth muscle, and other factors. Alternatively, a beta or gamma radiation source may be used instead of the light source as described in further detail below with respect to
The light directing members 20 having a reflective surface as illustrated in
As an alternative to the reflective light directing members of
According to one alternative embodiment of the invention, the energy delivery device 10 can be used in conjunction with photo-activatable substances such as those known as psoralens. These light activatable compounds, when activated, enhance the ability of light to cross link the DNA in the smooth muscle tissue and mucus glands. The light activatable compound may by injected intravenously. The light delivered by the light delivery device 10 is matched to the absorption spectrum of the chosen light activatable compound such that the light exposure activates the compound. When such light activatable substances are employed, a lower light intensity may be used to achieve cross linking of the DNA than the light intensity required to achieve cross linking without the light activatable compounds.
In use, the embodiment of
The cross linking of the smooth muscle and mucus gland DNA according to the present invention will reduce or eliminate the smooth muscle and the secreting glands such as mucus glands from the area of the airway which is treated by preventing the treated cells from replicating. This light treatment provides improved long term relief from asthma symptoms for some asthma sufferers. However, over time, some amount of smooth muscle or mucus gland cells which were not affected by an initial light treatment may regenerate and treatment may have to be repeated after a period of time such as one or more months or years.
Although the present treatment has been described for use in debulking enlarged smooth muscle tissue to open up the airways, it may also be used for eliminating smooth muscle altogether. The elimination of the smooth muscle tissue prevents the hyperreactive airways of an asthma patient from contracting or spasming, completely eliminating this asthma symptom.
The light delivery device 10 may also be used for treatment of other conditions by reducing the volume of smooth muscle tissue surrounding other body conduits. For example, the treatment system may be used for reducing smooth muscle and spasms of the esophagus of patients with achalasia or esophageal spasm, in coronary arteries of patients with Printzmetal's angina variant, for ureteral spasm, for urethral spasm, and irritable bowel disorders.
While the invention has been described in detail with reference to the preferred embodiments thereof, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention.
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|U.S. Classification||607/88, 607/94|
|Cooperative Classification||A61N5/0601, A61N5/1014, A61B2018/00541, A61N2005/0604|
|Jul 24, 2007||AS||Assignment|
Owner name: ASTHMATX, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LAUFER, MICHAEL D.;BRONCUS TECHNOLOGIES, INC.;REEL/FRAME:019603/0870;SIGNING DATES FROM 19991124 TO 20031226
|Aug 31, 2010||AS||Assignment|
Owner name: BRONCUS TECHNOLOGIES, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:LAUFER, MICHAEL D.;REEL/FRAME:024918/0786
Effective date: 19991124
Owner name: ASTHMATX, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BRONCUS TECHNOLOGIES, INC.;REEL/FRAME:024918/0866
Effective date: 20031226