WO2001062336A1 - Regulation of genes via application of specific and selective electrical and electromagnetic signals - Google Patents
Regulation of genes via application of specific and selective electrical and electromagnetic signals Download PDFInfo
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- WO2001062336A1 WO2001062336A1 PCT/US2001/005991 US0105991W WO0162336A1 WO 2001062336 A1 WO2001062336 A1 WO 2001062336A1 US 0105991 W US0105991 W US 0105991W WO 0162336 A1 WO0162336 A1 WO 0162336A1
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- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
- C12N13/00—Treatment of microorganisms or enzymes with electrical or wave energy, e.g. magnetism, sonic waves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/326—Applying electric currents by contact electrodes alternating or intermittent currents for promoting growth of cells, e.g. bone cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
Definitions
- the present invention is directed to methods of regulating gene expression in target cells via the application of specific and selective electric and electromagnetic signals to the target cells for the treatment of injured or diseased tissue, cartilage, or bone, as well as devices for generating the signals.
- bioelectrical interactions and activity believed to be present in a variety of biological tissues and cells are one of the least understood of the physiological processes.
- Osteoarthritis also known as degenerative joint disease, is characterized by degeneration of articular cartilage as well as proliferation and remodeling of subchondral bone. The usual symptoms are stiffness, limitation of motion, and pain. Osteoarthritis is the most common form of arthritis, and prevalence rates increase markedly with age. It has been shown that elderly patients with self-reported osteoarthritis visit doctors twice as frequently as their unaffected peers. Such patients also experience more days of restricted activity and bed confinement compared to others in their age group. In one study, the majority of symptomatic patients became significantly disabled during an 8-year follow-up period. Massardo et al., Ann Rheum Dis 48: 893-7 (1989).
- Nonsteroidal anti-inflammatory drugs remain the primary treatment modality for osteoarthritis. It is unknown whether the efficacy of NSAIDs is dependent upon their analgesic or anti-inflammatory properties or the slowing of degenerative processes in the cartilage. There is also a concern that NSAIDs may be deleterious to patients. For example, NSAIDs have well known toxic effects in the stomach, gastrointestinal tract, liver and kidney.
- Bone comprises an organic component of cells and matrix as well as an inorganic or mineral component.
- the cells and matrix comprise a framework of collagenous fibers which is impregnated with the mineral component of calcium phosphate (85%) and calcium carbonate (10%) which imparts rigidity to the bone.
- osteoporosis is generally thought as afflicting the elderly, certain types of osteoporosis may affect persons of all ages whose bones are not subject to functional stress. In such cases, patients may experience a significant loss of cortical and cancellous bone during prolonged periods of immobilization. Elderly patients are known to experience bone loss due to disuse when immobilized after fracture of a bone, which may ultimately lead to a secondary fracture in an already osteoporotic skeleton. Diminished bone density may lead to vertebrae collapse, fractures of hips, lower arms, wrists, ankles as well as incapacitating pains. Alternative nonsurgical therapies for such diseases are needed.
- Pulsed electromagnetic fields (PEMF) and capacitive coupling (CC) have been used widely to treat nonhealing fractures and related problems in bone healing since approval by the Food and Drug Administration in 1979.
- the original basis for the trial of this form of therapy was the observation that physical stress on bone causes the appearance of tiny electric currents that, along with mechanical strain, were thought to be the mechanisms underlying transduction of the physical stresses into a signal that promotes bone formation.
- noninvasive technologies using PEMF and capacitive coupling where the electrodes are placed on the skin in the treatment zone
- Pulsed electromagnetic fields generate small induced currents (Faraday currents) in the highly conductive extracellular fluid, while capacitive coupling directly causes currents in the tissues; both PEMFs and CC thereby mimic endogeneous electrical currents.
- the present invention relates to regulating the gene expression of target cells via the application of specific and selective electric and/or electromagnetic signals.
- the present invention relates to methods of regulating the expression of genes via the application of such signals to target cells.
- a "specific and selective" signal is a signal that has predetermined characteristics of amplitude, duration, duty-cycle, frequency, and waveform that up-regulate or down-regulate a targeted gene or targeted functionally complementary genes (specificity). This allows one to choose different signals to up-regulate or down-regulate various gene expressions in order to achieve a given biological or therapeutic response (selectivity).
- the invention further relates to devices employing the methods described herein to generate specific and selective signals that up-regulate and/or down-regulate the target gene(s).
- the present invention relates to methods and devices for the treatment of bone defects, osteoarthritis, osteoporosis, cancer, and other diseases.
- the method of the invention also includes the methodology for determining the "specific and selective" signal for a particular target gene by methodically varying the duration of a starting signal known to increase or suspected to increase cellular production of a given protein. After selecting the optimal duration, the amplitude of the signal is varied for the optimal duration of time as determined by the gene expression of the protein of interest. The duty cycle, frequency, and waveform are varied methodically while keeping the other signal characteristics constant. This process is repeated until the optimal signal is determined that produces the greatest increase in the gene expression of the protein of interest.
- Figure 1 is a graphic representation of aggrecan mRNA production by articular cartilage chondrocytes stimulated with a 20mV/cm capacitively coupled electric field for various time durations.
- the response is time duration specific.
- Figure 2 is a graphic representation of the duration and magnitude of aggrecan mRNA up-regulation in articular cartilage chondrocytes following 30 minutes stimulation with a 20 mV/cm capacitively coupled electric field.
- Figure 3 is a graphic representation of aggrecan mRNA production in articular cartilage chondrocytes stimulated by various capacitively coupled electric field amplitudes, all for 30 minutes duration.
- the response is electric field amplitude specific.
- Figure 4 is a graphic representation of aggrecan mRNA production in articular cartilage chondrocytes stimulated by 20mV/cm capacitively coupled electric field using various duty cycles.
- the response is duty cycle specific, and the duty cycle is time-wise selective.
- Figure 5 is a graphic representation of Type II collagen mRNA production in articular cartilage chondrocytes stimulated by a 20mV/cm capacitively coupled electric field for various time durations. In this example, the response is time duration specific, similar to that of the complimentary aggrecan mRNA.
- Figure 6 is a graphic representation of the duration and magnitude of Type II collagen mRNA up-regulation in articular cartilage chondrocytes following 30 minutes stimulation with a 20mV/cm capacitively coupled electric field.
- Figure 7 is a graphic representation of Type II collagen mRNA production in articular cartilage chondrocytes stimulated by various capacitively coupled electric field amplitudes, all for 30 minutes duration. This example shows that the differences between the field amplitude specificity of aggrecan mRNA ( Figure 3) and the amplitude specificity of Type II collagen mRNA allow for selectivity of signals.
- Figure 8 is a graphic representation of the down-regulation of MMP-1 mRNA production by articular cartilage chondrocytes treated with IL- ⁇ j and stimulated with a 20mV/cm capacitively coupled field for various time durations. This example shows the selectivity and specificity of these electric fields whereby a specific signal must be used for a selected gene response.
- Figure 9 is a graphic representation of MMP-3 mRNA production by articular cartilage chondrocytes stimulated with a 20mV/cm capacitively coupled electric field for various time durations. This example illustrates the significance of time specificity in the application of these signals.
- Figure 10 is a diagram illustrating a device for the treatment of osteoarthritis of the knee, in accordance with preferred embodiments of the present invention.
- Figure 11 is a diagram illustrating a nonunion of the femur stabilized by an intramedullary rod that is locked by two transcortical screws, and a device for the treatment of bone defects, in accordance with preferred embodiments of the present invention.
- Figure 12 is a diagram illustrating a device for the treatment of malignant melanoma, in accordance with preferred embodiments of the present invention.
- gene expression governing the growth, maintenance, repair, and degeneration or deterioration of tissues or cells can be regulated in accordance with the invention via the application of specific and selective electric and /or electromagnetic signals so as to produce a salutary clinical effect.
- Such discoveries are useful in the development of treatment methods that target certain medical conditions including bone fractures and defects, osteoarthritis, osteoporosis, cancer and other diseases, as well as for developing devices employing such methods.
- the phrase “signal” is used to refer to a variety of signals including mechanical signals, ultrasound signals, electromagnetic fields and electric fields. It is to be understood that the phrase “signal” may refer to an electrical field whether it is a combined field or a pulsed electromagnetic field or generated by direct current, capacitive coupling or inductive coupling.
- remote is used to mean acting, acted on or controlled from a distance.
- Remote regulation refers to controlling the expression of a gene from a distance.
- providing a specific and selective signal from a remote source can refer to providing the signal from a source at a distance from tissue or a cell or from a source outside of or external to the body.
- specific and selective signal means a signal that has predetem ⁇ ned characteristics of amplitude, duration, duty-cycle, frequency, and waveform that up-regulate or down-regulate a targeted gene or targeted functionally complementary genes (specificity). This allows one to choose different signals to up-regulate or down-regulate various gene expressions in order to achieve a given biological or therapeutic response
- regulate means to control gene expression. Regulate is understood to include both up-regulate and down-regulate. Up-regulate means to increase expression of a gene, while down-regulate means to inhibit or prevent expression of a gene. "Functionally complementary” refers to two or more genes whose expressions are complementary or synergistic in a given cell or tissue.
- tissue refers to an aggregate of cells together with their extracellular substances that form one of the structural materials of a patient.
- tissue is intended to include muscle and organ tissue as well as bone or cartilage tissue. Also, the term “tissue” as used herein may also refer to an individual cell.
- Patient refers to an animal, preferably a mammal, more preferably a human.
- the present invention provides treatment methods and devices that target certain tissues, cells or diseases.
- the gene expression associated with the repair process in injured or diseased tissues or cells can be regulated by the application of electric signals that are specific and selective for the genes to be regulated in the target tissues or cells.
- Gene expression can be up-regulated or down-regulated by the application of signals that are specific and selective for each gene or each set of complementary genes so as to produce a beneficial clinical effect. For example, a particular specific and selective signal may up- regulate a certain desirable gene expression, while the same or another particular specific and selective signal may down-regulate a certain undesirable gene expression.
- a certain gene may be up-regulated by one particular specific and selective signal and down-regulated by another specific and selective signal.
- certain diseased or injured tissues can be targeted for treatment by regulating those genes governing the growth, maintenance, repair, and degeneration or deterioration of the tissues.
- the methods and devices of the present invention are based on identifying those signals that are specific and selective for the gene expression associated with certain targeted diseased or injured tissue.
- electricity in its various forms e.g., capacitive coupling, inductive coupling, combined fields
- the duration of time exposed to electricity can also influence the capability of electricity to specifically and selectivity regulate gene expression in targeted tissues or cells in a patient's body.
- Specific and selective signals may be applied to each gene systematically until the proper combination of frequency, amplitude, waveform, duty cycle, and duration is found that provides the desired effect on gene expression.
- a variety of diseased or injured tissues or disease states can be targeted for treatment because the specificity and selectivity of an electric field for a certain gene expression can be influenced by several factors.
- an electrical field of appropriate frequency, amplitude, waveform and/or duty cycle can be specific and selective for the expression of certain genes and thus provide for targeted treatments.
- Temporal factors e.g., duration of time exposed to the electrical field
- the regulation of gene expression may be more effective (or made possible) via the application of an electrical field for a particular duration of time.
- the present invention provides for varying the frequency, amplitude, waveform, duty cycle and/or duration of application of an electric field until the electric field is found to be specific and selective for certain gene expressions in order to provide for treatments targeting a variety of diseased or injured tissue or diseases.
- the present invention can provide for targeted treatments because it is possible to regulate expression of certain genes associated with aparticular diseased or injured tissue via the application of specific and selective signals including electric fields of appropriate frequency, amplitude, waveform and/or duty cycle for an appropriate duration of time.
- the specificity and selectivity of a signal including an electrical field may thus be influenced so as to regulate the expression of certain genes in order to target certain diseased or injured tissue or disease states for treatment.
- the present invention thereby provides for a multitude of targeted treatments including the treatment of bone defects, osteoarthritis, osteoporosis and cancer.
- the present invention further provides devices for the treatment of injured or diseased tissue as well as certain disease states.
- the present invention provides devices that include a source of at least one signal specific and selective for a certain gene expression.
- the devices of the present invention can provide for the production of such signals for application to the targeted cells by at least one electrode adapted to apply the specific and selective signal.
- the devices of the present invention are capable of applying specific and selective signals directly to diseased or injured tissue and/or to the skin of a patient.
- the devices of the present invention may also provide for the remote application of specific and selective signals (e.g., application of a signal at a distance from diseased or injured tissue), although it will be appreciated that capacitively coupled devices must touch the subject's skin.
- the devices of the present invention may include means for attaching the electrodes to the body of a patient in the vicinity of injured or diseased tissue.
- self-adherent conductive electrodes may be attached to the skin of the patient on both sides of a knee joint afflicted with osteoporosis as shown in Figure 10.
- the devices of the present invention may also include means for attaching the device to the body of a patient.
- the devices of the present invention may include electrodes attached to a power unit which has a Velcro patch on the reverse side such that the power unit can be attached to a Velcro strap fitted around the calf, thigh or waist.
- the devices of the present invention can be employed in a variety of ways.
- the devices of the present invention may be portable or may be temporarily or permanently attached to a patient's body.
- the devices of the present invention are preferably non-invasive.
- the devices of the present invention may be applied to the skin of a patient by application of electrodes adapted for contact with the skin of a patient for the application of predetermined specific and selective signals. Such signals may also be applied via coils in which time varying currents flow, thus producing specific and selective electromagnetic fields which penetrate the tissue.
- the devices of the present invention may also be capable of implantation in a patient, including implantation under the skin of a patient.
- the methods of the present invention may provide for bone growth and repair via regulation of gene expression in bone cells.
- the methods of the present invention can stimulate bone growth and repair in the vicinity of fresh fractures and non-union fractures. Bone growth and repair also can be stimulated in the vicinity of osteoarthritis or osteoporosis.
- a variety of cells can be targeted by the methods of the present invention including bone cells, cartilage cells, fibrous tissue cells, stem cells, and cancer cells.
- Cartilage growth and repair can be stimulated via signals specific and selective for the expression of certain genes.
- the methods of the present invention can stimulate articular cartilage repair in osteoarthritis patients and provide for the regulation of gene expression in cartilage cells.
- the methods of the present invention can provide for the up-regulation of genes that repair cartilage (e.g., genes encoding for aggrecan and Type II collagen), down-regulation of genes that destroy cartilage (e.g., genes encoding for metalloprotemase) and the up-regulation of genes that inhibit metalloproteinases that destroy articular cartilage (e.g., genes encoding for tissue inhibitors of metalloprotemase).
- a variety of cartilage cells can be targeted by the methods of the present invention including articular chondrocytes and including articular cartilage, hyaline cartilage, and growth plate cartilage.
- fetal articular chondrocytes have been exposed to a capacitively coupled 60 kHz electrical field of 20 mV/cm for 0.5, 2.0, 6.0 and 24.0 hours.
- a statistically significant incorporation of 35 S0 4 /ug DNA was found after only 0.5 hours of stimulation.
- An identical experiment was repeated and the levels of aggrecan mRNA, the messenger for the maj or cartilage proteoglycan, monitored.
- the methods of the present invention also provide for the treatment of certain diseases.
- the methods of the present invention can provide for the treatment of cancer.
- metalloprotemase is at least partly responsible for spread of the cancer.
- Metalloprotemase enzymatically breaks down fibrous walls or membranes erected by adjacent cells in an attempt to contain the cancer.
- tissue inhibitors of metalloprotemase may inhibit the production of such metalloproteinases.
- methods of the present invention can provide for the down-regulation of genes encoding for metalloprotemase and the up-regulation of genes encoding for tissue inhibitors of metalloprotemase ("TfMP").
- those genes that are functionally complementary may respond to identical or substantially similar signals.
- a signal may be specific and selective for functionally complementary genes.
- those genes encoding aggrecan and Type II collagen can both be regulated by a 20 mV/cm, 60 kHz capacitively coupled signal. Each of these genes regulates cartilage matrix formation and is thus believed to be functionally complementary.
- FIGS. 10-12 provide examples of the devices of the present invention.
- the devices of the present invention can include a source of specific and selective signals, a power unit and at least one electrode.
- the devices of the present invention can be portable.
- the electrodes may be attached to a power unit can be attached to a Velcro strap which can be fitted around the calf, thigh or waist.
- Such a device can be used to apply, e.g., a specific and selective electric field for 30 minutes or more per day so as to up-regulate the gene expression of, e.g., aggrecan or Type II collagen.
- the devices of the present invention can be provided in a variety of forms including a capacitively coupled power unit with programmed multiple switchable specific and selective signals for application to one pair or to multiple pairs of electrodes, electromagnetic coils attached to a power unit with switchable multiple specific and selective signals, and an ultrasound stimulator with a power supply for generating specific and selective signals.
- a capacitively coupled power unit with programmed multiple switchable specific and selective signals for application to one pair or to multiple pairs of electrodes electromagnetic coils attached to a power unit with switchable multiple specific and selective signals
- an ultrasound stimulator with a power supply for generating specific and selective signals.
- device preference is based on patient acceptance and patient compliance.
- the smallest and most portable unit available in the art at the present time is a capacitive coupling unit; however, patients with extremely sensitive skin may prefer to use inductive coupling units.
- ultrasound units require the most patient cooperation but may be desirable for use by certain patients.
- Chondrocyte cultures were prepared from fetal bovine articular cartilage. Chondrocytes (5 x 10 5 cells/cm 2 ) were plated onto specially modified Cooper dishes. The cells were grown to seven days with the medium changed just prior to beginning of the experimental condition. The experimental cell cultures throughout these studies were subjected to a capacitively coupled 60 kHz sine wave signal electric field with an output of 44.81 volts peak to peak. This produced a calculated-field strength in the culture medium in the dishes of 20 mV/cm with a current density of 300 ⁇ A/cm 2 . Control cell culture dishes were identical to that of the stimulated dishes except that the electrodes were not connected to a function generator.
- the optimal signal for the desired gene regulation was found systematically as follows. An electrical signal known to increase (or even just suspected to increase) cellular production of a given protein is taken as the starting signal for determining the specific signal for the gene expression (mRNA) of that protein. A dose-response curve is first performed by varying the duration of the signal while holding all the other signal characteristics constant
- a second dose-response curve is performed by varying the amplitude for the optimal duration of time. This determines the optimal amplitude for the optimal duration of time as determined by the gene expression of the protein of interest.
- a third dose-response curve is then performed, this time varying the duty-cycle from 100% (constant) to 1% or less while holding the optimal amplitude and other signal characteristics constant.
- a dose-response is repeated a fourth time (varying frequency) and a fifth time (varying waveform) each time keeping the other signal characteristics constant.
- Protein expression may be determined by any method known in the art, such as reverse transcriptase PCR, Northern analysis, immunoassays, and the like.
- Example 1 Aggrecan production by articular chondrocytes
- Figure 1 is a graphic representation of aggrecan mRNA production by articular cartilage chondrocytes (attomole per ⁇ l) stimulated with a 20mV/cm capacitively coupled electric field for time durations of 0 (control), 0.5, 2, 6, and 24 hours. In this example, 30 minutes stimulation was found to provide a significant increase (almost a two-fold increase) in aggrecan mRNA. The response is thus time duration specific.
- Figure 2 is a graphic representation of the duration and magnitude of aggrecan mRNA up-regulation in articular cartilage chondrocytes following 30 minutes stimulation with a 20 mV/cm (60 kHz) capacitively coupled electric field. As illustrated, it was found that the peak up-regulation occurs 3 hours following the cessation of the 30 minute stimulation period. Figure 2 also illustrates that the up-regulation is cyclic, with secondary, smaller peaks of up-regulation occurring 14 V% hours and 20 l A hours after cessation of the 30 minute stimulation period.
- Figure 3 is a graphic representation of aggrecan mRNA production in articular cartilage chondrocytes stimulated by various capacitively coupled electric field amplitudes, all for 30 minutes duration.
- 10-20 mV/cm showed significant increases in aggrecan mRNA production.
- the response is electric field amplitude specific.
- Example 2 Type II collagen production by articular chondrocytes
- Figure 5 is a graphic representation of Type II collagen mRNA production (attomole per ⁇ l) in articular chondrocytes stimulated by a 20mV/cm (60 kHz) capacitively coupled electric field for time durations of 0 (control), 0.5, 2, 6 and 24 hours.
- 0 control
- Figure 6 is a graphic representation of the duration and magnitude of Type II collagen mRNA up-regulation in articular chondrocytes following 30 minutes stimulation with a 20mV/cm capacitively coupled electric field.
- Figure 6 illustrates that peak up-regulation occurs 5 l A hours following cessation of the 30 minute stimulation period. It is noteworthy that aggrecan mRNA, a complementary gene, reached a maximum production of aggrecan mRNA at 3 X A hours after cessation of stimulation, 2 hours earlier than with Type II collagen mRNA ( Figure 2).
- Figure 7 is a graphic representation of Type II collagen mRNA production in articular chondrocytes amplitudes, all for 30 minutes duration.
- each of those genes encoding aggrecan or Type II collagen can be regulated by an identical 20 mV/cm, 60 kHz capacitively coupled signal.
- each of these gene transcripts regulates cartilage matrix formation and are functionally complementary. Accordingly, the findings of examples 1 and 2 are believed to support electrical therapy through gene regulation in accordance with the techniques described herein.
- Example 3 MMP-1 mRNA production in IL— ⁇ j treated articular chondrocytes
- FIG 8 is a graphic representation of MMP-1 mRNA production by articular cartilage chondrocytes treated with IL- ⁇ i and stimulated with a 20mV/cm (60 kHz) capacitively coupled field for time durations of 0 (control), 0.5, 2, 6, and 24 hours.
- MMP- 1 mRNA is dramatically down-regulated in all time durations of stimulation, but especially so at 30 minutes. This is significant when contrasted with the dramatic up- regulation of aggrecan mRNA ( Figures 1-4) and Type II collagen mRNA ( Figures 5-7) in the same 20mV/cm field. This shows the selectivity and specificity of these electric fields whereby a specific signal must be used for a selected gene response.
- Example 4 MMP-3 mRNA production in IL— ⁇ treated articular chondrocytes
- Figure 9 is a graphic representation of MMP-3 mRNA production by articular cartilage chondrocytes stimulated with a 20mV/cm (60 kHz) capacitively coupled electric field for time durations of 0 (control), 0.5, 2, 6, and 24 hours. As illustrated, there is significant down-regulation of MMP-3 mRNA with 30 minutes of stimulation and a dramatic up- regulation with 2 hours of stimulation. This points out the significance of time specificity in the application of these signals.
- a 20 mV/cm, 60 kHz capacitively coupled signal regulates bone cell genes encoding TGF- ⁇ i but fails to regulate genes encoding PDGF-A. It is presently believed that the expression of each of these genes participates in the regulation of different phases and physiologic processes of bone healing and are thus are not functionally complementary.
- a device 10 in accordance with preferred embodiments of the present invention is used to treat a patient with osteoarthritis of the knee.
- two circular, soft conductive, self-adherent electrodes 12 are placed on the skin on either side of the knee at the level of the joint line.
- the electrodes 12 are attached to a power unit 14 which has a Velcro patch 16 on the reverse side such that the power unit 14 can be attached to a Velcro strap (not shown) fitted around the calf, thigh or waist.
- the electrodes 12 may be placed on the skin before the patient goes to bed each evening or any other convenient time.
- the power unit is preferably small (e.g., 6-8 ounces) and powered by a standard 9-volt battery to emit a 5 volt peak-to-peak, 6-10 mAmp, 20 mV/cm, 60 kHz sine wave signal to the electrodes 12 placed on the skin.
- this signal provided 30 minutes per day with the proper time duration, field amplitude, and duty cycle should significantly up-regulate genes encoding aggrecan and Type II collagen. This treatment should prevent or minimize further articular cartilage deterioration as well as heal articular cartilage that already is damaged or degenerated.
- the power unit 14 also may be reconfigured to provide signals specific and selective for other genes.
- the power unit 14 may be reconfigured to provide signals for down-regulating the gene expression of metalloproteinase (MMP) as well as signals for up-regulating genes expressing tissue inhibitors of metalloproteinase ("TIMP") genes.
- MMP metalloproteinase
- TIMP tissue inhibitors of metalloproteinase
- the power unit 14 may be reconfigured to provide such signals in sequence with the aggrecan/Type II collagen signal.
- the patient may be treated through the up-regulation of genes that repair cartilage (e.g., aggrecan and Type II collagen genes), down-regulation of genes that destroy cartilage (e.g., metalloproteinase gene) and the up-regulation of genes that inhibit the metalloproteinases that destroy articular cartilage (e.g., tissue inhibitors of metalloproteinase).
- Example 7 Treatment of bone defects or osteoporosis
- a patient with a fracture, delayed union, nonunion or other bone defect may be treated with two circular, soft conductive electrodes 12 placed on the skin on opposite sides of the extremity at the level of the defect.
- the electrodes 12 are placed on the skin so as to span the bone defect.
- the electrodes 12 are attached to a power unit 14' which has a Velcro patch 16 on the reverse side such that the power unit 14' can be attached to a Velcro strap (not shown) fitted around the calf, thigh or waist.
- a nonunion of the femur may be stabilized by an intramedullary rod 18 locked by two transcortical screws 20, as shown in Figure 11.
- the power unit 14' provides a 20 mV/cm, 60 kHz sine wave signal to the electrodes 12 placed on the skin.
- the signal is provided for 6 hours per day as in example 5.
- the power unit 14' is differentiated from power unit 14 in the previous example since the same electrical signal as defined by time duration, field amplitude, and duty cycle is not necessarily applied. This technique should aid in the repair process by up-regulating TGF- ⁇ i, a gene important in the cartilage phase of bone repair.
- the power unit 14' may be reconfigured to provide other signals specific for certain genes.
- the power unit 14' may be reconfigured to provide other signals specific for certain genes.
- the power unit 14' may be reconfigured to provide other signals specific for certain genes.
- the power unit 14 may be reconfigured to provide signals for the up-regulation of PDGF-A, basic FGF and BMP-2 genes.
- the power unit 14 also may be reconfigured to provide in sequence those signals specific and selective for TGF- ⁇ j, PDGF-A, basic FGF, and BMP-2 genes. Therefore, the power unit 14 may be reconfigured to provide specific and selective signals that up- regulate genes necessary to heal bone defects.
- a patient with malignant melanoma may be treated with methods and devices according to preferred embodiments of the present invention.
- Figure 12 shows a patient with malignant melanoma that has not yet broken out of the skin into the underlying tissue.
- metalloproteinases which are produced by cancer cells.
- Metalloproteinases enzymatically break down the fibrous wall or membrane that adjacent cells establish in an attempt to contain the cancer.
- tissue inhibitors of metalloproteinase may inhibit the production of such metalloproteinases.
- the device 10" of the invention provides specific capacitively coupled electric fields via electrodes 12 for selectively down-regulating the gene encoding for metalloproteinase as discussed in the above examples and/or selectively up-regulating the gene encoding for tissue inhibitors of metalloproteinase ("TLMP").
- the device 10" can provide the electric field generated by power unit 14" so as to selectively down-regulate and up-regulate the genes sequentially for specific periods of time per day.
- the melanoma can be safely excised once the melanoma has been sufficiently encapsulated by the body's own defensive mechanism.
- genes encoding for tissue inhibitors of metalloproteinase may have improved specific dose responses at selective frequencies other than 60 kHz so as to provide specific and selective responses for applied signals at different frequencies with different time durations, field amplitudes, and duty cycles.
- tissue inhibitors of metalloproteinase TTMP
- inductively coupled signals, direct coupled signals, and pulsed electromagnetic fields may also be applied in lieu of capacitively coupled signals as described in the examples above. Accordingly, the scope of the invention is not intended to be limited to the preferred embodiment described above, but only by the appended claims.
Abstract
Description
Claims
Priority Applications (19)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/257,126 US7465566B2 (en) | 2000-02-23 | 2001-02-22 | Regulation of genes via application of specific and selective electrical and electromagnetic signals |
EP01913019A EP1261391A4 (en) | 2000-02-23 | 2001-02-23 | Regulation of genes via application of specific and selective electrical and electromagnetic signals |
JP2001561395A JP4455801B2 (en) | 2000-02-23 | 2001-02-23 | Regulation of genes by application of specific and selective electrical and electromagnetic signals |
AU2001241737A AU2001241737A1 (en) | 2000-02-23 | 2001-02-23 | Regulation of genes via application of specific and selective electrical and electromagnetic signals |
US10/255,241 US7374916B2 (en) | 2000-02-23 | 2002-09-26 | Regulation of aggrecan gene expression using specific and selective electrical and electromagnetic signals |
US10/267,708 US6919205B2 (en) | 2000-02-23 | 2002-10-09 | Regulation of type II collagen gene expression using specific and selective electrical and electromagnetic signals |
US10/457,167 US7022506B2 (en) | 2000-02-23 | 2003-06-09 | Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee |
US10/461,188 US7429471B2 (en) | 2000-02-23 | 2003-06-13 | Regulation of matrix metalloproteinase gene expression using specific and selective electrical and electromagnetic signals |
US10/603,226 US7130692B2 (en) | 2000-02-23 | 2003-06-25 | Portable electrotherapy device for treating osteoarthritis and other diseases, defects and injuries of the knee joint |
US10/585,718 US8017369B2 (en) | 2000-02-23 | 2005-01-11 | System and method of up-regulating bone morphogenetic proteins (BMP) gene expression in bone cells via the application of fields generated by specific and selective electric and electromagnetic signals |
US11/125,047 US7354748B2 (en) | 2000-02-23 | 2005-05-09 | Method for treating osteoarthritis and other diseases, defects and injuries of the knee joint |
US11/398,153 US7468264B2 (en) | 2000-02-23 | 2006-04-04 | Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee |
US11/444,179 US7465546B2 (en) | 2000-02-23 | 2006-05-31 | Regulation of transforming growth factor-beta (TGF-β) gene expression in living cells via the application of specific and selective electric and electromagnetic fields |
US11/880,422 USRE41391E1 (en) | 2000-02-23 | 2007-07-19 | Regulation of type II collagen gene expression using specific and selective electrical and electromagnetic signals |
US12/028,530 US7981611B2 (en) | 2000-02-23 | 2008-02-08 | Regulation of fibroblastic growth factor-2 (FGF-2) gene expression in living cells with the application of specific and selective electric and electromagnetic fields |
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US13/180,242 US20120184800A1 (en) | 2000-02-23 | 2011-07-11 | Regulation of matrix metalloproteinase (mmp) gene expression in tumor cells via the application of electric and/or electromagnetic fields |
US13/242,606 US20120016442A1 (en) | 2000-02-23 | 2011-09-23 | Regulation of genes via application of specific and selective electrical and electromagnetic signals |
US13/303,497 US8313908B2 (en) | 2000-02-23 | 2011-11-23 | Regulation of stem cell gene production with specific and selective electric and electromagnetic fields |
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US10/457,167 Continuation-In-Part US7022506B2 (en) | 2000-02-23 | 2003-06-09 | Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee |
US10/461,188 Continuation-In-Part US7429471B2 (en) | 2000-02-23 | 2003-06-13 | Regulation of matrix metalloproteinase gene expression using specific and selective electrical and electromagnetic signals |
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Also Published As
Publication number | Publication date |
---|---|
US20080269838A1 (en) | 2008-10-30 |
US7354748B2 (en) | 2008-04-08 |
US8065015B2 (en) | 2011-11-22 |
AU2001241737A1 (en) | 2001-09-03 |
US20050203591A1 (en) | 2005-09-15 |
USRE41391E1 (en) | 2010-06-22 |
US20120184800A1 (en) | 2012-07-19 |
US20120016442A1 (en) | 2012-01-19 |
EP1261391A4 (en) | 2005-01-26 |
JP4455801B2 (en) | 2010-04-21 |
US20030211084A1 (en) | 2003-11-13 |
JP2003523271A (en) | 2003-08-05 |
US7465566B2 (en) | 2008-12-16 |
EP1261391A1 (en) | 2002-12-04 |
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