IPC분류정보
국가/구분 |
United States(US) Patent
등록
|
국제특허분류(IPC7판) |
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출원번호 |
UP-0788906
(2004-02-27)
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등록번호 |
US-7840263
(2011-01-22)
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발명자
/ 주소 |
- Girouard, Steven D.
- Ross, Jeffrey
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출원인 / 주소 |
|
대리인 / 주소 |
Schwegman, Lundberg & Woessner, P.A.
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인용정보 |
피인용 횟수 :
18 인용 특허 :
253 |
초록
▼
A gene regulatory system controls gene therapy by emitting one or more forms of energy that regulate gene expression by triggering promoters. The system includes a sensor to sense a signal indicative of a need for the gene therapy as well as responses to the gene therapy. The regulation of the gene
A gene regulatory system controls gene therapy by emitting one or more forms of energy that regulate gene expression by triggering promoters. The system includes a sensor to sense a signal indicative of a need for the gene therapy as well as responses to the gene therapy. The regulation of the gene expression is controlled based on the sensed signal and/or a user command. In one embodiment, the system delivers one or more electrical therapies in conjunction with the gene therapy.
대표청구항
▼
What is claimed is: 1. A system, comprising: an implantable gene regulatory signal delivery device that emits, in response to a gene regulatory control signal, a regulatory signal which regulates transcription from a regulatable transcriptional control element; an implantable cardiac rhythm managem
What is claimed is: 1. A system, comprising: an implantable gene regulatory signal delivery device that emits, in response to a gene regulatory control signal, a regulatory signal which regulates transcription from a regulatable transcriptional control element; an implantable cardiac rhythm management (CRM) device including: a sensor to sense a physiological signal indicative of a predetermined cardiac condition; an event detector configured to detect the predetermined cardiac condition from the sensed physiological signal and produce one or more condition parameters related to one of a type and a degree of the predetermined cardiac condition; and a controller coupled to the sensor and electrically connected to the gene regulatory signal delivery device, the controller configured to produce the gene regulatory control signal, transmit the gene regulatory signal to the gene regulatory signal delivery device to trigger an emission of the regulatory signal in response to a detection of the predetermined cardiac condition, and quantitatively control the emission of the regulatory signal based on the one or more condition parameters; and one or more implantable leads providing for electrical connections between the implantable gene regulatory signal delivery device and the implantable CRM device, wherein the controller is electrically wired to the gene regulatory signal delivery device through the electrical connections, and wherein the regulatory signal is selected to regulate the regulatable transcriptional control element in a vector having the regulatable transcriptional control element operably linked to an open reading frame, the expression of which treats the predetermined cardiac condition. 2. The system of claim 1, wherein the gene regulatory signal delivery device comprises an electric field generator which emits an electric field as the gene regulatory signal. 3. The system of claim 1, wherein the gene regulatory signal delivery device comprises an electromagnetic field generator which emits an electromagnetic field as the gene regulatory signal. 4. The system of claim 1, wherein the gene regulatory signal delivery device comprises a light emitter which emits a light having a predetermined wavelength and energy. 5. The system of claim 1, wherein the gene regulatory signal delivery device comprises a speaker which emits an acoustic energy. 6. The system of claim 1, wherein the gene regulatory signal delivery device comprises a drug delivery device which contains a chemical agent. 7. The system of claim 1, wherein the gene regulatory signal delivery device comprises a thermal radiator which emits a thermal energy. 8. The system of claim 1, wherein the sensor comprises an electrogram sensing circuit, and the event detector comprises an arrhythmia detector. 9. The system of claim 8, wherein the event detector comprises an atrial fibrillation detector. 10. The system of claim 8, wherein the event detector comprises a ventricular fibrillation detector. 11. The system of claim 1, wherein the sensor comprises a sensor sensing a physiological signal indicative of ischemia, and the event detector comprises an ischemia detector. 12. The system of claim 1, wherein the sensor comprises a metabolic sensor adapted to sense a signal indicative of a cardiac metabolic level. 13. The system of claim 12, wherein the sensor comprises at least one of a pH sensor, an oxygen pressure (PO2) sensor, a carbon dioxide pressure (PCO2) sensor, a glucose sensor, a creatine sensor, a C-creative protein sensor, a creatine kinase sensor, and a creatine kinase-MB sensor. 14. The system of claim 1, wherein the sensor comprises an impedance sensor to sense tissue impedance. 15. The system of claim 14, wherein the impedance sensor comprises a pulmonary impedance sensor. 16. The system of claim 15, wherein the impedance sensor comprises a respiratory sensor. 17. The system of claim 1, wherein the sensor comprises a pressure sensor to sense a pressure in a cardiovascular system. 18. The system of claim 17, wherein the pressure sensor comprises at least one of a left atrial pressure sensor, a left ventricular pressure sensor, an artery pressure sensor, and a pulmonary arterial pressure sensor. 19. The system of claim 18, wherein the event detector comprises a systolic dysfunction detector. 20. The system of claim 18, wherein the event detector comprises a diastolic dysfunction detector. 21. The system of claim 1, wherein the sensor comprises a stroke volume sensor. 22. The system of claim 1, wherein the sensor comprises a neural activity sensor. 23. The system of claim 22, wherein the neural activity sensor comprises a neurohormone sensor to sense a neurohormone level. 24. The system of claim 22, wherein the neural activity sensor comprises an action potential recorder to sense neural electrical activities. 25. The system of claim 1, wherein the sensor comprises a heart rate variability detector. 26. The system of claim 1, wherein the sensor comprises a renal function sensor. 27. The system of claim 26, wherein the renal function sensor comprises at least one of a renal output sensor, a filtration rate sensor, and an angiotensin II level sensor. 28. The system of claim 1, wherein the sensor comprises an acoustic sensor adapted to sense at least one of heart sounds and respiratory sounds. 29. The system of claim 28, wherein the event detector to detect the predetermined cardiac condition when third heart sound (S3) amplitude exceeds a predetermined threshold. 30. The system of claim 1, wherein the controller is adapted to quantitatively control the emission of the regulatory signal using parameters defining type and energy of the regulatory signal. 31. A system, comprising: an implantable gene regulatory signal delivery device that emits, in response to a gene regulatory control signal, a regulatory signal which regulates transcription from a regulatable transcriptional control element; and an implantable medical device system including: a sensor to sense a physiological signal indicative of a predetermined cardiac condition; an event detector configured to detect the predetermined cardiac condition from the sensed physiological signal and produce one or more condition parameters related to at least one of a type and a degree of the predetermined cardiac condition; an implant telemetry module to receive an external command; and an implant controller coupled to the sensor and the implant telemetry module, the implant controller configured to quantitatively control the emission of the regulatory signal based on the one or more condition parameters and the external command; one or more implantable leads providing for electrical connections between the implantable gene regulatory signal delivery device and the implantable medical device, wherein the implant controller is electrically wired to the gene regulatory signal delivery device through the electrical connections; and an external system including: an external telemetry module to transmit the external command to the implant telemetry module; a user input device adapted to receive the external command; and an external controller adapted to automatically analyze signals acquired by the implantable medical device and generate the external command when deemed necessary as a result of the analysis, wherein the regulatory signal is selected to regulate a regulatable transcriptional control element in a vector having the regulatable transcriptional control element operably linked to an open reading frame, the expression of which in an effective amount treats the predetermined cardiac condition. 32. The system of claim 31, wherein the gene regulatory signal delivery device comprises an electric field generator which emits an electric field being the regulatory signal. 33. The system of claim 31, wherein the gene regulatory signal delivery device comprises an electromagnetic generator which emits an electromagnetic field as the gene regulatory signal. 34. The system of claim 31, wherein the gene regulatory signal delivery device comprises a light emitter which emits a light having a predetermined wavelength and energy. 35. The system of claim 31, wherein the gene regulatory signal delivery device comprises a speaker which emits an acoustic energy. 36. The system of claim 31, wherein the gene regulatory signal delivery device comprises a drug delivery device which contains a chemical agent. 37. The system of claim 31, wherein the gene regulatory signal delivery device comprises a thermal radiator which emits a thermal energy. 38. The system of claim 31, wherein the sensor comprises an electrogram sensing circuit, and the event detector comprises an arrhythmia detector. 39. The system of claim 38, wherein the event detector comprises an atrial fibrillation detector. 40. The system of claim 38, wherein the event detector comprises a ventricular fibrillation detector. 41. The system of claim 31, wherein the sensor comprises a sensor sensing an physiological signal indicative of ischemia, and the event detector comprises an ischemia detector. 42. The system of claim 31, wherein the sensor comprises a metabolic sensor adapted to sense a signal indicative of a cardiac metabolic level. 43. The system of claim 42, wherein the sensor comprises at least one of a pH sensor, an oxygen pressure (PO2) sensor, a carbon dioxide pressure (PCO2) sensor, a glucose sensor, a creatine sensor, a C-creative protein sensor, a creatine kinase sensor, and a creatine kinase-MB sensor. 44. The system of claim 31, wherein the sensor comprises an impedance sensor to sense tissue impedance. 45. The system of claim 44, wherein the impedance sensor comprises a pulmonary impedance sensor. 46. The system of claim 45, wherein the impedance sensor comprises a respiratory sensor. 47. The system of claim 31, wherein the sensor comprises a pressure sensor to sense a pressure in a cardiovascular system. 48. The system of claim 47, wherein the pressure sensor comprises at least one of a left atrial pressure sensor, a left ventricular pressure sensor, an artery pressure sensor, and a pulmonary arterial pressure sensor. 49. The system of claim 48, wherein the event detector comprises a systolic dysfunction detector. 50. The system of claim 48, wherein the event detector comprises a diastolic dysfunction detector. 51. The system of claim 31, wherein the sensor comprises a stroke volume sensor. 52. The system of claim 31, wherein the sensor comprises a neural activity sensor. 53. The system of claim 52, wherein the neural activity sensor comprises a neurohormone sensor to sense a neurohormone level. 54. The system of claim 52, wherein the neural activity sensor comprises an action potential recorder to sense neural electrical activities. 55. The system of claim 31, wherein the sensor comprises a heart rate variability detector. 56. The system of claim 31, wherein the sensor comprises a renal function sensor. 57. The system of claim 56, wherein the renal function sensor comprises at least one of a renal output sensor, a filtration rate sensor, and an angiotensin II level sensor. 58. The system of claim 31, wherein the sensor comprises an acoustic sensor adapted to sense at least one of heart sounds and respiratory sounds. 59. The system of claim 58, wherein the event detector to detect the predetermined cardiac condition when third hear sound (S3) amplitude or activity exceeds a predetermined threshold level. 60. The system of claim 31, wherein the implantable medical device system further comprises a pacing circuit coupled to the implant controller, and wherein the implant controller includes a pacing control module adapted to control a delivery of pacing pulses in conjunction with the emission of the regulatory signal. 61. The system of claim 60, wherein the pacing control module is further adapted to control the delivery of pacing pulses based on at least the external command. 62. The system of claim 60, wherein the implantable medical device system further comprises a cardiac resynchronization therapy (CRT) circuit coupled to the implant controller, and wherein the implant controller includes a CRT control module adapted to control a delivery of CRT in conjunction with the emission of the regulatory signal. 63. The system of claim 60, wherein the implantable medical device system further comprises a remodeling control (RCT) therapy circuit coupled to the implant controller, and wherein the implant controller includes a RCT therapy control module adapted to control a delivery of RCT therapy in conjunction with the emission of the regulatory signal. 64. The system of claim 60, wherein the implantable medical device system further comprises a defibrillation circuit coupled to the implant controller, and wherein the implant controller includes a defibrillation control module adapted to control a delivery of cardioversion/defibrillation shocks in conjunction with the emission of the regulatory signal. 65. The system of claim 64, wherein the defibrillation control module is further adapted to control the delivery of cardioversion/defibrillation shocks based on at least the external command. 66. The system of claim 64, further comprising at least one atrial defibrillation lead coupled to the defibrillation circuit to deliver the defibrillation shocks to one or more atria, and wherein the defibrillation control module comprises an atrial defibrillation control module. 67. The system of claim 64, further comprising at least one ventricular defibrillation lead coupled to the defibrillation circuit to deliver the defibrillation shocks to one or more ventricles, and wherein the defibrillation control module comprises a ventricular defibrillation control module. 68. The system of claim 31, wherein the implantable medical device system comprises a hermetically sealed can to house at least the implant controller and the implant telemetry module. 69. The system of claim 68, wherein the hermetically sealed can further houses the sensor. 70. The system of claim 68, wherein the sensor is external to the hermetically sealed can. 71. The system of claim 31, wherein the external system comprises: a presentation device to present the sensed physiological signal; and a user input device to receive the external command. 72. The system of claim 71, wherein the external system comprises a programmer. 73. The system of claim 71, wherein the external system comprises an advanced patient management system including: an external device wirelessly coupled to the implantable medical device system via telemetry; a remote device to provide for access to the implantable medical device system from a distant location; and a network connecting the external device and the remote device. 74. The system of claim 73, wherein the external device comprises the user input. 75. The system of claim 73, wherein the remote device comprises the user input. 76. The system of claim 1 or 31 wherein the vector is not part of an implantable device. 77. The system of claim 1 or 31 wherein the controller comprises a timer adapted to time a predetermined period of delivery time during which the gene regulatory signal delivery device emits the regulatory signal.
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