CN1170603C - 增强透皮物剂流量的装置 - Google Patents

增强透皮物剂流量的装置 Download PDF

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CN1170603C
CN1170603C CNB988119897A CN98811989A CN1170603C CN 1170603 C CN1170603 C CN 1170603C CN B988119897 A CNB988119897 A CN B988119897A CN 98811989 A CN98811989 A CN 98811989A CN 1170603 C CN1170603 C CN 1170603C
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sheet
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M·朱克
J·C·特劳特曼
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M·J·N·科米尔
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H·L·基姆
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    • A61M37/00Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
    • AHUMAN NECESSITIES
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    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M37/00Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
    • A61M37/0015Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
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    • A61B5/14514Measuring 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 for interstitial fluid using means for aiding extraction of interstitial fluid, e.g. microneedles or suction
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    • A61N1/20Applying electric currents by contact electrodes continuous direct currents
    • A61N1/30Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
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    • A61M37/00Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
    • A61M37/0015Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
    • A61M2037/0046Solid microneedles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M37/00Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
    • A61M37/0015Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
    • A61M2037/0053Methods for producing microneedles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/20Applying electric currents by contact electrodes continuous direct currents
    • A61N1/30Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
    • A61N1/303Constructional details
    • A61N1/306Arrangements where at least part of the apparatus is introduced into the body

Abstract

一种装置(2),它包括一皮肤穿刺部件(6)和基本上不能压缩的物剂贮器支架(15),所述的皮肤穿刺部件(6)具有许多微突(4)用于穿刺皮肤,物剂贮器支架(15)与皮肤穿刺部件(6)接触并延伸越过皮肤穿刺部件(6),供传递施加于皮肤穿刺部件(6)的下压力,使微突(4)在病人身体正常运动期间和运动以后能维持在穿刺的皮肤内。

Description

增强透皮物剂流量的装置
技术领域
本发明涉及透皮物剂的释放传递和采样。本发明特别涉及诸如肽和蛋白质的物剂通过皮肤透皮传递,以及透皮采样来自身体的物剂,如葡萄糖,其他的身体分析物和一些滥用的物质,如酒精和违禁药品。
技术背景
随着越来越多的医用肽、蛋白质和寡核苷酸能以量大、纯度高的形式为人所得,人们对透皮传递诸如肽,蛋白质和寡核苷酸的高分子量有利的物剂进入人体的兴趣不断上升。但肽,蛋白质和寡核苷酸的透皮传递仍面临着一些重大的问题。在许多场合下,这类物剂通过皮肤的传递速率或流量不足以产生理想的治疗效果,因为它们大体积/大分子量,导致不能由自然通途(孔,毛囊等)穿越皮肤。另外,多肽和蛋白质在穿越皮肤过程中,在到达靶细胞之前容易被降解。同样,水溶性小分子(例如200至500道尔顿)的物剂被动流动常常受到限制。
提高物剂透皮传递的一种方法基于电流通过体表的应用或称为“电转运”。“电转运”通常指有益的物剂,如药物或药物前体的通过诸如皮肤、粘膜、指甲等的体表。施加一个电位能诱导或增强物剂的转运,其导致施加电流来传递或增强物剂的传递。可以多种方式完成电转运物剂通过体表,一种广泛使用的电转运方式,离子电渗疗法,它涉及电诱导带电荷离子的转运。电渗透是另一种电转运方式,它涉及在电场的影响下带有物剂的溶液通过膜的迁移。还有一种电转运类型是电穿孔(Electroporation),它涉及物剂通过由高电压电脉冲在膜上形成的孔。许多例子中,可能多种方式以不同的程度同时发生。因此,本文中所述术语“电转运”给予可能的最广泛的解释,包括电诱导的或增强的至少一种带电或不带电荷的物剂或其混合物的转运,不管实际上转运物剂的特殊机制如何。这与被动的或无电相助的穿越皮肤传递有关,电转运递送通常能提高物剂的传递,尤其是大分子量的物剂(例如多肽)的传递速率。然而,在穿越皮肤过程中进一步提高穿越皮肤传递速率和减少多肽降解是非常令人想望的。
提高物剂穿越皮肤传递速率的一种方法包括用一种皮肤渗透增强剂预处理皮肤或协同有益的物剂传递。本文广泛应用的术语“渗透增强剂”,描述当应用于传递物剂的体表时能提高物剂流量的物质。其机制可能包括减少体表对物剂通过的电阻,提高体表的选择通透性和/或渗透性,产生通过体表的亲水途径和/或电转运期间减少物剂的降解(例如皮肤酶参与的降解)。
已作许多努力企图机械破坏皮肤以增强穿越皮肤的流量,如授予Ganderton等的美国专利3814097,授予Gross等的5279544,授予Lee等的5250023,授予Gerstel等的3964482,授予Kravitz等的美国专利Re 25637和PCT申请WO96/37155。尽管Gerstel揭示了其它形状的应用,但这些典型的装置通常利用管状或圆柱形结构穿刺皮肤的外层。这些参考文献中揭示的穿刺元件一般从薄的平面元件如垫片或金属片垂直伸展。
最近,已企图把这些装置的很小的穿刺元件锚在皮肤内以维持药物传递通道的开放,该通道是由微突刺穿角质层形成的。例如见Cormier等人的WO97/48440。不幸的是,因为这些微突相当小,所以在微突上形成倒钩和相似的锚元件是成问题的。
WO97/48440中描述的微突排列为其上多个传递物剂开口的金属片形式。该金属片有皮肤近端表面和皮肤远端表面,许多蚀刻的和冲压的微突从片的皮肤远端表面近似垂直地延伸出来。适合容纳(在传递物剂的情况下)或收集(在采样的情况下)物剂的贮器位于该片的皮肤远端表面上。然后,如图1所示,把微突排列物和物剂贮器用粘性的覆盖物或相似的保护装置压在皮肤表面并保持在皮肤上。这样,具有从皮肤远端表面延伸出来的微突4的皮肤穿刺部件6被放在皮肤上,微突刺入皮肤表面。在皮肤穿刺部件6的皮肤远端侧有物剂贮器27。通过覆盖物3将该结构放置在皮肤30上,所述的覆盖物3在至少的外周表面9上有粘合剂。
图1装置中的物剂贮器27趋于由柔软的依从性的材料,如凝胶体构成。这类柔软依从的甚至能流动的材料用于皮肤穿刺部件6是优选的,因为凝胶体材料能容易地流入皮肤穿刺部件6的开口以便与皮肤30直接接触。
发明的叙述
遗憾的是,当使用图1所描述的结构时,发现是在病人正常身体活动的情况下。如图2所示,微突4最终不断地从皮肤30出来,从而兹穿角质层的通道迅速恢复最终封闭,致使进一步物剂传递有了问题。物剂贮器27的可压缩性也与该问题部分有关。
本发明提供了适用于增加透皮流量的一种装置。该装置具有能刺入体表(如皮肤)以增强物剂的传递或采样的微突。本发明的装置能用于导入物剂(例如药物)进入体表如皮肤,或者能用于从体表如皮肤中取出物剂(如身体分析物)。装置包括有许多微突的体表穿刺部件,这些微突从部件的近体表部分延伸出来。这些微突适合于穿刺体表,深度达大约500μm。因此,当应用于皮肤时,这些微突能合适地至少刺过角质层。该装置进一步包括一个支架,该支架包含了供放置被递送的或采样得到的物剂的贮器。支架是与穿刺部件接触的独立部件,或与穿刺部件形成整体,并维持贮器里传递的物剂与被穿刺的皮肤相连。该支架的特征在于在垂直于体表的方向上有可压缩性,压缩度至少约250μm。该装置还包括一个固定部件,它被用于把装置固定于体表。
本发明提供了一种用于通过体表导入或取出物剂的装置,它包括:
皮肤穿刺部件,所述的皮肤穿刺部件具有多个从所述体表穿刺部件的近体表部分延伸出来的微突,所述的微突适合穿刺到最深500微米的体表里,
供导入或取出物剂的物剂贮器,所述的物剂贮器与皮肤穿刺部件相邻,并放置在被穿刺的体表附近,从而使物剂被传递通过被穿刺的体表,
和将装置固定在体表上的覆盖物,装置有一个供容纳物剂贮器的支架,其特征在于,所述的支架具有压缩性,在体表的垂直方向处的压缩小于250μm。
本发明的一个方面,穿刺部件和支架是分开独立的元件。穿刺部件包含一个有多个用于转运物剂的开口的薄片,该片具有近身体表面,它适于对着身体放置,所述的多个微突从近身体表面延伸出来的。支架适合于延伸越过至少一部分,最好越过整个片,越过片的远身体的表面。
本发明的另一方面,穿刺部件包括一具有近身体边缘的薄片,有适合向体表放置的多个微。该片的平面大致垂直于被穿刺的体表。支架由多个所述的片组成,这些片互相间隔一定空间,为了在邻近片之间产生含有空间的贮器。
较好的是,在垂直于体表的方向上刺入,支架的压缩度低于约50μm。最好的是,支架由多孔烧结高密度聚乙烯或开孔的聚氨酯泡沫或开孔的聚乙烯醇泡沫构成,其压缩性低于约25μm,孔隙体积约10-60%。
本发明的装置能用于物剂传递,物剂采样或二者兼有的情况。尤其是,本发明的装置用于药物的透皮传递,分析物的透皮采样二者兼有的情况。用于本发明的传递装置包括,但不限于,电转运装置,被动装置,渗透装置和压力驱动装置。本发明使用的采样装置包括,但不限于,反相电转运装置,被动装置,负压驱动和渗透装置。
附图简述
在附图中,相同的标号指相同的构件。
图1是在皮肤穿刺时现有技术装置的剖视图;;
图2是图1的装置稍后时的剖视图,它显示微突从体表退出;
图3是本发明不可压缩的贮器支架和皮肤穿刺部件沿图4中III-III线剖开的放大剖面图;
图4是图3装置的顶端平面视图,为便于叙述,去除了固定用覆盖物;
图5是根据本发明的皮肤穿刺部件底部的一个实施方案的放大透视图;
图6,8和9是不可压缩的支架和皮肤穿刺部件的其它实施方案的顶端平面视图,为便于叙述,去除了固定用覆盖物;
图7是具有固定用覆盖物的完整的不可压缩支架和皮肤穿刺部件的分解透视图;
图10是根据本发明的不可压缩的贮器支架和皮肤穿刺部件的另一个实施方案的侧视图;
图11是本发明不可压缩贮器支架的另一个实施例方案的顶端平面视图,为便于叙述,去除了固定用的覆盖物;
图12是本发明不可压缩的贮器支架的另一个实施方案的透视图;
图13是本发明的不可压缩的贮器支架另一实施方案的透视图;
图14是根据本发明另一实施方案的优选的不可压缩的贮器支架的透视图;
图15是根据本发明一个技术方案的电转运物剂传递/采样系统的分解透视图;
图16是图15的电转运物剂传递/采样系统的底部平面视图;
图17是图15的电转运物剂传递/采样系统的右视图;
图18是图15的电转运物剂传递/采样系统的背视图;
图19是图17的电转运物剂传递/采样系统沿19-19行的剖开的剖视图;
图20根据本发明的一个技术方案,被动物剂传递/采样系统的剖视示意图;
图21是另一个完整的不可压缩的贮器支架和皮肤穿刺部件的分解透视图;
图22显示了用微突排列物刺入活的无毛豚鼠皮肤以后染色1小时的通道百分数的图;
图23显示了用微突排列物刺入活的无毛豚鼠皮肤以后通道关闭与时间的函数图;
图24显示了用微突刺入活的无毛豚鼠皮肤以后通道关闭与时间的函数图。
实施本发明的方式
下面详细参见附图,图3显示的本发明装置2包括皮肤穿刺部件6和支架15组成。装置2用来增加物剂的透皮传递或采样。术语“物质”、“物剂”和“药物”在本文中可互换地使用,广泛地包括人类和灵长类等哺乳动物,鸟类,有价值的家养,运动场或农场动物,或供实验用的动物,诸如大小白鼠、豚鼠等产生局部或全身效应的生理或药理活性物质。这些术语也包括象葡萄糖这样的物质,在组织中,间质液和/或血液中发现的其他分析物质,乙醇,合法的物质和违禁的物剂等,这些物质能够通过皮肤采样。
物剂(例如被传递药物和被采样的分析物)透皮流通的主要屏障是最外层(即角质层)。表皮内层一般包含三层,通常称为颗粒层、表皮生发层和生发层。要通过颗粒层、表皮生发层和生发层转运或吸收一种物剂,应基本上没有或者没有阻力。由坚硬的支架部件15和柔软的皮肤穿刺部件6(见图5,图中的装置2为显示其微突而处倒置位置)构成,它具有许多向外延伸的微突4。装置2被压到皮肤的一个区域,通过这里物剂被透皮传递或采样。微突4在皮肤上形成的裂缝并至少能穿过角质层,这样,物剂很少或没有阻碍地通过皮肤而被传递。典型情况下,微突穿刺皮肤可深达500μm深度,一般也可达50至300μm。为了穿刺皮肤或体表,微突4可以是微刀片状(图3和5)、针状(未显示)或其他各种形状。当用压力加到支架15的顶部(即,远皮肤侧)时,微突4穿刺表皮的角质层,即能增加物剂通过体表的给药或采样。本文使用的术语“体表”通常指人或动物的皮肤、粘膜和指甲,和植物的外表面。微突4穿刺体表使物剂从系统很好地传导进入体表,反之亦然。
在图3-5显示的实施方案中,皮肤穿刺部件6与许多开口8构成一体,每个开口8至少有一个微突4沿着其边缘。微突4在角质层中割开一个微小裂缝,从而增加了从由多个空穴7容纳的物剂贮器27透皮释放的物剂,或收集在由多个空穴7容纳的物剂贮器27里物剂的透皮流量。
皮肤穿刺部件6可以由金属、硅或塑料构成,以金属如不锈钢和钛为佳。由于皮肤穿刺部件6相当的薄,因而是柔软的和易弯曲的,例如当皮肤穿刺部件6由金属如不锈钢或钛构成时,它将只有大约5μm至100μm厚度,一般大约为25-50μm。
根据本发明,基本上不可压缩的支架15被交叉地安置在皮肤穿刺部件6上(图3和4)。然后用粘性的固定覆盖物3把支架15牢牢地固定于体表上,该覆盖物3(图7和10)由片材料构成,为了与病人的皮肤30接触,该片材料覆盖了支架15,并延伸越过支架15的周边边缘。典型地这样使用装置2:向皮肤按压入装置2,引起组织移位。在这种情况下,覆盖物3的边缘粘附在围绕装置2的皮肤30上。然后解除人工压力引起皮肤和皮下组织部分恢复到原来状态。然而,覆盖物3把支架15牢牢地系在皮肤30上,使皮肤30处于部分移位的情况下,如图10所示。因为支架15是基本上不可压缩的,所以即使在病人正常运动期间微突4能被保持穿刺皮肤。这样,用不可压缩的支架15即可避免现有技术装置的问题,即如图2所示微突4从皮肤渐渐地退出的问题。因为贮器支架15基本上不可压缩,所以固定下压力可通过固定覆盖物3施加,而不会导致典型地由粘稠液体、凝胶或相似的半固体/柔软材料构成的物剂贮器物质流动,或象现有技术装置(图1和2)产生变形,使微突4退出皮肤。
支架部件15可以是各种不同的形状,例如,但不限于,图3,4,和6-14所显示的形状。在图3和4中显示的实施方案中,支架15是不可压缩的结构,它形成了多个空穴7,延伸通过支架部件的整个厚度,空穴7共同容纳物剂贮器27(图3)供被释放的物剂或被采集来的物剂放置。在空穴7之间是多个支承件或横梁5,它们与皮肤穿刺部件6连接并跨越了皮肤穿刺部件6的宽度或长度延伸出去。横梁5传送通过覆盖物3施加于支架15顶部的下压力。当使用透皮电转运装置时,皮肤穿刺部件6和/或支架15优选的是与电转运装置的电导元件(例如电极)电学上分离或者绝缘,以避免物剂贮器短路。这可以通过使用电绝缘材料或对皮肤穿刺部件6和/或支架15涂覆来达到此目的。
覆盖物3可以是由一片有或无柔韧性的片材料构成。无柔韧性的片材料的例子包括聚乙烯对苯二酸酯薄膜和其他的织物加强聚合物薄膜。柔韧性覆盖物的例子是MedpanTM。优选的是柔韧性覆盖物片材料。
如本文所用的,当提到支架15时,用术语“不可压缩的”意思是由固定用的覆盖物3施加下压力时,支架15在垂直于皮肤表面方向上仅有很小程度的压缩性。优选的是,当固定覆盖物3施加下压力时,优选的是支架15被压缩距离在低于250μm,最好低于50μm。
支架15可以用具有前述的低压缩性的任何材料制成。合适的材料包括金属,合金,陶瓷,玻璃,不可压缩的塑料,不可压缩的聚合物泡沫和不可压缩的加强(例如加强的碳纤维)聚合物。特别好的不可压缩的支架材料是PorexTechnologies,Inc.(Fairburn,GA)出售的商品Porex,这是一种多孔烧结的高密度聚乙烯。另外可例举的材料是多孔性烧结聚合物、开孔聚合物泡沫、多孔性聚合物片、聚合物筛、织物聚合物纤维、多孔陶瓷和波纹聚合物片。
支架15可能既坚硬又柔软,但最好是柔软灵活的,这样比较容易顺应病人体表(例如病人手臂上的皮肤)。优选的是,当支架15具有一扁平的近皮肤表面时,支架15能针对覆盖物3施加的下压力反应,弯曲成曲线结构。最好是,支架15弯曲(针对施加的下压力的反应)成一定程度,使支架15的近皮肤表面的弯曲半径低于约10cm。另外,支架能被排列成单个坚硬的部件,相邻的部件之间用铰链连接在一起。
图3-4和图6-14图解说明了贮器支架15的各个实施方案。在图3-4,6-9和15中所显示的实施方案里,支架15由周围的(例如环状的)壁53组成,它至少有一个横梁5延伸越过支架部件15,这样就产生许多收集贮存物剂的空穴7,并将下压力充分均匀地传递到皮肤穿刺部件6上而不使支架15压缩。图6、8和15中的横梁通常沿对角线延伸于由支架15的外壁所限定的整个空间。本文所用的对角线,表示与下述横梁不同的实施方案(即不指横梁连接直线形的两个不相邻的顶点,或者通过多面体两条不相邻的边),正如这些图中所示的实施方案的情况。如图中所见,横梁包括倾斜的(图8)和不倾斜的(图9)横梁以及蜂窝状的结构(图4)。横梁的数目依赖于各种因素,皮肤穿刺部件6和支架15的相对的结构完整性或柔性,整个支架部件15的距离,物剂贮器接触皮肤面积的大小,以及物剂贮器的容积。一般,当使用非常薄的金属制成皮肤穿刺部件6时,在支架15上相邻横梁5之间的最大距离,与皮肤穿刺部件6上的相邻微突4之间的距离相比,将不大于约4倍,而最好不大于约2倍。图9描述支架部件15可由经许多横梁5与外环壁53连接的多个内环壁55构成。
图7描述皮肤穿刺部件6可供选择的实施方案,其微突4从薄的皮肤穿刺部件6的机体接触边缘49向外延伸。在这个实施方案中,使用期间皮肤穿刺部件6的平面大致沿与体表垂直的方向伸展。皮肤穿刺部件6具有螺旋状形态,它限定了空穴51,空穴内有含有物剂或接受物剂的贮器(图7未示)。也可使用的皮肤穿刺部件6的形状是卷绕形、折叠形(未显示)和弯曲形(未显示)以及其它形状,通常从它的平面状态沿着它的长度形成具有许多空穴51的结构。这样,图7的皮肤穿刺部件6形成了整体化的物剂贮器支架和皮肤穿刺部件。
像图7的整体化的支架/皮肤穿刺部件一样,图21也显示了一个整体化的不可压缩的贮器支架和标号为2’的皮肤穿刺部件。每一个片件106有一对孔102,103,向这对孔插入螺钉105。分隔件(例如空心的圆柱形部件或垫圈)107位于片件106之间形成空穴127。被分隔的片件106被螺钉105端的固定螺帽104或其它已知的紧固件夹持在一起。如图3中的装置,适合于包含被传递的有益物剂或接收被采样的身体分析物的凝胶物质能充满空穴127。与皮肤表面近似垂直的各个皮肤穿刺部件6由垂直于皮肤表面方向上根本不压缩的金属构成。因此,用粘性的覆盖物3(图21示示)将下压力施加于皮肤穿刺部件6的顶端/远皮肤边缘,不会引起片件在垂直于皮肤表面的方向上明显压缩。
在图3和14中显示出与皮肤穿刺部件6的远皮肤侧面/边缘接触的支架部件15的表面通常是平坦的(即成平面)。然而,与皮肤穿刺部件6连接的支架部件15的表面最好具有凸面或曲线形(例如圆柱形状)表面54(如图10所示)。凸面或圆柱形表面54的曲率半径最好大于约5cm,大于约10cm更佳。
图11描述了支架部件15的另一个实施方案,在该实施方案中,支架部件15由许多具有波形结构(如正弦曲线)的长条组成,并且均对皮肤穿刺部件6的平面垂直定向。皮肤穿刺部件6的结构与图5相同,其上有开口8,并与微突4联系(图11未示)。波形长条91,93在其连接点95处最好被固定在一起,如长条91,93由金属或塑料制成时用焊接固定。相邻的长条91,93的波形结构形成空穴97,在这中间容纳适当的贮器材料。这样,长条91和93的高度将部分地由装入空穴97的贮器材料的厚度的支配。
图12,又描述了支架部件15的另一种实施方案,该实施方案中支架部件15由波形薄片101构成,波形薄片101适合与皮肤穿刺部件6的远皮肤侧面接触。如有必要,覆盖片(图12未示)覆盖了波形片101的远皮肤侧面,或沿着波形薄片101侧边的轨道(图12未示)能提供额外的刚性并在向薄片101的远皮肤侧面施力时,阻止薄片101沿波纹折叠弯曲或折叠的任何趋势。任选的是,在波形薄片101上可以有许多开口(图10未示),因此,物剂通过波形薄片101的流动成为可能。开口的大小和数量是可变的,只要波形薄片101的结构完整性和不可压缩性不受损害即可。片101里的开口将有可能在与薄片101的远皮肤侧面相邻的空穴104里安置额外的贮器材料。如在其它实施方案中一样,贮器材料能被装进波纹物和下面的皮肤穿刺部件6之间形成的空穴103中(图10未示)。
图13揭示波纹片101的另一种实施方案,在波纹片101内波纹折叠不都是相互平行的。与图12的装置相似,如有必要,图13装置也能提供波纹片101的皮肤远侧面上的覆盖片,或者围绕波纹片101的环状轨道,以提高波纹片101结构的不可压缩性。比图12装置更进一步的是,为允许物剂经那里传递,图13装置给波纹片101内提供了许多开口(图13未示)。这类开口使之能利用空穴104容纳物剂贮器材料。
图14中揭示的贮器支架15的另一个实施方案包括柔韧的,多孔但基本上不可压缩的材料,如多孔烧结的高密度聚乙烯,一般其空穴体积为约10-60%,最好为约30-40%。利用已知的泵技术能容易地把液体溶液,凝胶或其它半固体物剂贮器材料引进到这些烧结的多孔材料的空穴内。一个例子是Porex Technologies of Fairburn,G.A.出售Porex烧结的多孔高密度聚乙烯。
微突或微刃4通常由一片材料构成,而且对于至少穿刺皮肤的角质层是足够尖锐,有足够长度。在一个实施方案中,微突4和皮肤穿刺部件6对物剂通过基本上是不渗透的或不能渗透的。每个微突的宽度可以是任何宽度范围。在一批微突插入以后,微突和体表的相交处的微突宽度一般至少约为25mm。所需要的刀刃长度由被穿刺的体表的差异确定,至少相当于角质层的天然厚度,因为本发明的主要特征之一是微突至少要穿过角质层进入表皮层。通常,微突要有一定的长度和结构,要使其穿刺的深度达到大约25-400mm,应用最多的穿刺深度在大约50-200mm之间。微突4能够倾斜(即能形成一角度)使边缘64(图5)进一步减少按压微突进入皮肤组织所需要的穿刺力。每个微突4的前沿都处于适合穿刺皮肤的相同角度或不同角度。或者,每个微突的前沿可以形成曲线,例如形成凸形或凹形或被分成任何数目的倾斜片断,例如第一段比较垂直,第二段与垂直成圈套的角度。
如同WO97/48440中阐明的,先用照相制板术,再用化学蚀刻术,然后用微冲压术能生产皮肤穿刺部件6,在此引证并包括这些揭示。图5所描述的皮肤穿刺部件6的具体实施方案需要使平面的皮肤穿刺部件6形成所期望的空穴形状的附加步骤(即螺旋形,蜿蜒形,同心圆等等)。利用已知的金属片弯曲,辊压,折叠和/或成形的技术能达到目的。
通常,冲压以后微突4与皮肤穿刺部件6的近体表部分48成大约90度的角(图5),但是能安排它们从垂直位置成向前和向后的任何角度以利于穿刺角质层。
从具有足够强度和制造微突能力的材料,例如玻璃,陶瓷,坚硬的聚合物,加强的(如碳纤维加强)聚合物、金属和金属合金,制造皮肤穿刺部件6和微突4。金属和金属合金的例子包括,但不限于不锈钢,铁,钢,锡,锌,铜,金,铂,铝,锗,锆,钛和钛合金。每一片件和每个微突都可具有一薄层金、铂、铱、钛或铑镀层。玻璃的例子包括二氧化硅和像Corning公司(美国NY)供应的“Photoceram”这样的反玻璃化的玻璃。聚合物的例子包括,但不限于,聚苯乙烯,聚甲基丙烯酸甲酯,聚丙烯,聚乙烯,“Bakelite”(“酚醛塑料”),醋酸纤维素,乙基纤维素,苯乙烯/丙烯腈共聚物,苯乙烯/丁二烯共聚物,丙烯腈/丁二烯/苯乙烯(ABS)共聚物,聚氯乙烯和包括聚丙烯酸酯和聚甲基丙烯酸酯的丙烯酸聚合物。
皮肤穿刺部件6的任何实施方案的微突4和开口8的数目,随所需的流速,被采样或递送的物剂,所用的传递或采样的装置(即电转运,被动扩散,渗透,压力驱动等)和对本领域普通技术人员显然的其他因素而有差异。
可预先安置一种可供选择的联系介质(未显示)在具有如WO98/28037所说的图3-5中所显示的该结构的皮肤穿刺部件6的近体表部分48上。这种联系介质,如果使用,是作为物剂的管道,作为含药贮器或物剂收集贮器与皮肤之间的桥梁而起作用,由此允许物剂无阻碍地经那里被传递。
可与本发明一起使用的一种穿越皮肤传递/采样的装置,依赖于通过体表的电流或“电转运”的应用。在本领域中的那些工作将正确地评价本发明能与各种电转运系统联合使用,因为在这方面本发明不局限于任何方式。电转运系统的例子可以参考Theeuwes等的US专利5147296,Theeuwes等的5080646,Theeuews等的5169382,Phipps等的5423739,Haak等的5385543,Gyory等的5310404和Gyory等的5169383,其中任何被揭示的电转运系统都能用于本发明。
图15-19阐明一代表性的电转运传递/采样装置10,按照本发明,该装置10可以与支架部件15和皮肤穿刺装置2合用。装置10包括一个上罩16,一个电路板组件18,一个下罩20,供体电极22,反电极24,供体物剂贮器27,反贮器28和与皮肤相容的粘合剂30。上罩16有侧翼31,该侧翼协助保持装置10在病人皮肤上。印刷电路板组件18包含一个与分立组件40和电池(组)32匹配的集成电路19。借助通过开口13a和13b的支柱33(图17中仅显示一个)把电路板组件18附着在罩子16上,为了把电路板组件18热固定在罩16上,支柱的末端被加热/熔化。借助粘合层30把下罩20附着在上罩16上,粘合层30的上表面34既附着于下罩20又附着于包括侧翼31的底表面的上罩16。在电路板组件置18下表面上显示出(部分地)钮扣电池32。根据需要也可应用其他类型的电池启动装置10。
本发明的不可压缩的贮器支架15的体积和形状能隐蔽地放在下罩20内的凹陷25’内。供体电极22也适合放在贮器支架15的远皮肤表面邻近的凹陷25内。在这实施方案中,重要的是电极22也是由诸如金属箔的真正不可压缩的材料构成。与图5所示相似,有许多微突4的皮肤穿刺部件6位于贮器支架15近皮肤表面相邻处。因此,当装置10被放在病人的皮肤上时,微突4向下延伸并适合刺入病人皮肤的最外层(如图17-19所示)。下罩20由不能伸展的、模压材料,如聚丙烯构成。下罩20与凹陷25’的组合包围了装置2与粘合层30的组合,前者包括将支架15和具有微突4的皮肤穿刺部件2固定在病人皮肤上的另一个装置的实例。
装置10一般由电池32,电子电路系统19,40,电极22,24,反贮器28,安置供体物剂贮器27的支承件15和皮肤穿刺装置2组成。所有这些部件被合并成整套装在一起的统一体。下罩20包括电极22,24和物剂贮器27,28。电路板组件18的输出(图15未示)用导电胶带42,42’通过下罩20中形成的凹陷25,25’的开口23,23’与电极24和22进行电连接。电极22和24’依次与物剂贮器27和28的顶端面44’,44直接进行机械和电相接。反贮器28的底面46通过粘合层30的开口29与病人的皮肤接触。供体物剂贮器27的底面46’通过皮肤穿刺装置2中的许多开口8与病人的皮肤接触,如图3所示。供体物剂贮器27中的物剂一般是溶液状态,最好是水溶液,在诸如亲水性聚合物基质的固体基质(如水凝胶)里含有这种水溶液,该基质允许物剂通过而自由流动。贮器基质材料充满了横梁5和皮肤穿刺部件6的开口8之间的空穴(图15未示),而使物剂贮器与体表相接触,如图3所示。如上述讨论,可把一层联系介质放在皮肤穿刺部件6的近皮肤侧面,微刃4通过那里。可任意选择的连系介质提供了供体物剂贮器27和皮肤之间更均一的物剂流动通道。通常,因为扩散或因为贮器和联系介质有相同的物质,故物剂最初存在于贮器和联系介质内。
装置10借助四周的粘合层30(粘合层有上粘合面34和连接机体的粘合面36)粘附于病人的体表(例如皮肤),且可任意将这里讨论的任何实施方案中装置2上的元件固定。而且,为了帮助维持界面与皮肤的接触,联系介质65可任意选择有点粘的或是粘的。粘合面36覆盖了除装置2和反电极贮存器28所占地位以外装置10的整个下侧面。粘合面36具有粘合性,该性质保证装置10在使用者正常活动期间保持在机体上,然而,在预定的(如24小时)使用期以后允许合理地移动。上粘合面34粘附在下罩20上,并且保持电极和物剂贮器在罩的凹陷25,25’之内并维持装置2与下罩20相连,下罩20与上罩16相连。
在物剂传递/采样装置的一个实施方案中,为了让装置不用时保持粘合层30的完整性,在装置10上有一剥离层衬垫(未示)。使用时,在装置用于皮肤之前剥去剥离层。装置10也有一个按钮开关12,当按下开关钮时,装置10开动了,通过LED14变亮可使使用者知道。在预定的传递时间内,由电转运传递物剂通过病人的皮肤(如臂上)。
本发明的其他实施方案中,把支架部件15预先安排在皮肤穿刺部件6的顶面(即远皮肤面)上,使用被动的透皮传递或采样装置。本技术领域的工作者将能了解,本发明能与各种被动的透皮系统连用,因为本发明在这方面并不受限制。例如被动系统的例子,可能必须参考,但并不限于,Campbell等的US专利4379454,Gale等的4588580,Gampbell等的4832953,Gale等的4698062,Campbell等的4867982和Hunt等的5268209,本发明可与这些专利中揭示的任何系统合用。图20显示了被动透皮传递/采样装置的一个例子。具有装在其外环形壁53内的皮肤穿刺部件6边缘的支架部件15被装在能施加(如粘附)到体表的泡沫衬垫57中。皮肤穿刺部件6的边缘不需要被装在外环形壁内,因为如前面实施方案所叙,皮肤穿刺部件6能被连接在支架15上。延伸在整个环形壁53和横梁5上的是顶盖59。顶盖59被牢牢地粘附在外环形壁53和泡沫垫57的一端。泡沫衬垫57的近皮肤表面涂上粘合剂,特别是皮肤接触粘合剂粘附在皮肤上。因此,泡沫衬垫57和顶盖59的组合还包括另一将贮器支架15固定在病人皮肤上的装置。被动传递/采样装置在泡沫衬垫57的接触身体面上有四周粘附剂和在部件2的接触身体表面上有一粘附的界面凝胶(未示)。
本领域中的人员将会了解,本发明也能与各种渗透和压力驱动系统结合使用,因为本发明在这方面不限于特殊装置。渗透和压力驱动装置的例子,可能必须参考Eckenhoff的US专利4340480,Theeuwes等的4655766,Eckenhoff的4753651,Gross等的5279544,Theeuwes的4655766,Gross等的5242406,和Eckenhoff的4753651,其中任一个都可与本发明结合使用。
本发明对通常通过体表和膜包括经皮肤传递各类药物是有用的。一般,它包括所有治疗领域中的药物。本发明也用于天然存在的,化学合成的或重组生产的蛋白质,肽类及其片段的透皮传递。另外,本发明可以与疫苗,包括寡核苷酸类、聚核苷酸类药物的核苷酸类药物和基因的透皮传递。这些物质一般分子量至少有300道尔顿左右,典型的是至少大约300至40,000道尔顿。如以上提及的,本发明装置2也可与采样装置联用,所述的采样装置包括,但不限于,逆向电转运(即在不带电荷的物质如葡萄糖采样的情况下,反向离子电渗和/或电渗透),渗透和反向被动扩散。例如可以参考Eckenhoff等的US专利4756314,Schoendorfer的5438984,Glikfeld等的5279543和Guy等的5362307。
实施例1
用氯胺酮/甲苯噻嗪麻醉无毛豚鼠,用肥皂和水清洗皮肤,吹干,然后用异丙醇垫轻轻地擦拭。用手把动物的皮肤向两边伸展并把泡沫支架(3.8cm外径,1.6cm内径和1.6mm厚度)用于伸展的皮肤位点。微突排列物(具有许多开口的不锈钢片),25μm厚,微突长500μm,微突密度75个微突/cm2,和皮肤接触面积为2cm2,(圆形,直径1.6cm)被嵌进泡沫支架的中心,微突边向下。硬塑料按钮(直径1.6cm)安置在微突排列物的远皮肤侧面。通过在已放置支架和微突排列的皮肤的折皱把微突压进皮肤。拇指放在按钮上,食指低于皮瓣,正好在微突排列物的下面。手向下压(大约2kg/cm2)10秒钟左右。每次加压在每个时间点上重复应用三次。
作为预处理,在用手工施加后去掉微突,并从泡沫支架去掉松开衬垫。用350微升凝胶灌满小室,所述的凝胶由含3%羟乙基纤维素(HEC凝胶)的水性磷酸盐缓冲液或含23%聚乙烯醇(PVOH凝胶)的水性磷酸盐缓冲液组成。松开衬垫顶盖(3.8cm直径)被粘附在泡沫支架的顶部。用VetrapTM粘附带把动物包扎起来,直至指定的佩戴时间结束时让它们恢复原样。
作为原位处理,在手工施加后,在适当的位置留下微突排列物。从泡沫支架上去掉松开衬垫,将亲水性多孔的烧结的高密度聚乙烯基质(2cm2面积,1.6cm直径和1.6mm厚度,HDPE基质)对着微突排列物的远皮肤侧安置。把磷酸缓冲液吸进小室(250μl)。将松开衬垫顶部粘附在泡沫支架的顶端。粘附于皮肤的泡沫支架和粘附在泡沫支架上的松开衬垫顶盖的组合包括一向下压的装置,以便将HDPE基质牢牢地固定对着微突排列物。用胶带包扎动物,直至指定的佩戴时间结束时才让其恢复原样。
在佩戴时间(0,0.5,1,2和24小时)结束时,除去包扎和装置系统。用纱布垫把多余的凝胶或液体擦净。药棉签吸收墨汁(Higgins,黑墨汁)直到浸透,用手轻轻地舒展被处理的地点,把染料用力擦入这些地点。以来回运动方式施加染料,两个相反的方向施加约15秒。用纱布衬垫擦净多余的染料。然后用异丙醇除去皮肤上的染料直至要见微突排列物产生的着色微切口/通道。用电视观察镜拍下这些位点的照片。继之,麻醉动物,切取这些点的皮肤并冰冻之,用8mm活组织检查冲头检查每一个冰冻的皮肤点。把这些活组织安放在低温恒温器夹头上,平行于组织表面,进行切片,第一片20μm,余者50μm。此后,每一片皮肤切片放在显微镜载玻片上,分别在每一片内计数着色的空洞。从这些数据和微突排列物里的微突密度,计算出一片特殊的皮肤切片内着色的通道百分数,并相对深度作出它们的函数图。每一个数据点代表三个测定数的平均值及其标准误差。在16%和84%的通道被着色(D16,D50,D84)的点上推算出的平均深度及其标准误差。
染料进入皮肤表明微突已刺入皮肤,其产生通道是开放的。因此,该技术可用来计算在施加了微突排列物后,微突刺入皮肤以及通道衰落关闭对时间的函数关系。图22显示施加微突排列物后一小时,着色通道的百分数对深度(即从皮肤外表面测定的深度)的函数关系。图22显示使用HDPE基质和固定用的覆盖物可以使微突排列物留在原位,此时的通道要比施加微突排列物然后从皮肤上除去(即,用微突排列物进行预处理)时更开放和更深。这表明HDPE基质和固定用的覆盖物能维持微突在穿刺的皮肤内,由此推迟了通道的关闭。
在图23中用D50点作为施加微突排列物后作为通道衰退关闭的动力学,它对时间的函数关系如图23所示。这些数据显示在预处理施加微突排列物后通道迅速发生关闭(例如一小时内)。使用HDPE基质和固定用的覆盖物使微突留在原位时抑制了通道的关闭。这表明HDPE基质和固定用的覆盖物维持微突处于穿刺皮肤状态,150μm以上的深度的,持续至少2小时。图24显示用HDPE基质佩戴最多达24小时时间,可获得相同的动力学。24小时后,50%通道(D50)还是开放的,其深度约150μm。
本领域中的一般技术人员将会了解,本发明可以其它特殊的形式实施,而不偏离它的精神和基本特征。因此这里揭示的实施方案,应该认为在所有方面都是说明性而不具有限制性。

Claims (26)

1.一种用于通过体表导入或取出物剂的装置(2),它包括:
皮肤穿刺部件(6),所述的皮肤穿刺部件(6)具有多个从所述皮肤穿刺部件的近体表部分(48)延伸出来的微突(4),所述的微突(4)适合穿刺到最深500微米的体表里,
供导入或取出物剂的物剂贮器(27),所述的物剂贮器(27)与皮肤穿刺部件(6)相邻,并放置在被穿刺的体表附近,从而使物剂被传递通过被穿刺的体表,
和将装置(2)固定在体表上的覆盖物(3),装置(2)有一个供容纳物剂贮器(27)的支架(15),其特征在于,支架(15)具有压缩性,在体表的垂直方向处的压缩小于250μm。
2.根据权利要求1所述的装置,其中支架(15)与皮肤穿刺部件(6)的整个近体表部分(48)接触并延伸穿越所述的整个近体表部分(48)。
3.根据权利要求1所述的装置,其中所述的覆盖物(3)是粘性覆盖物。
4.根据权利要求1所述的装置,其中覆盖物(3)选自带和条。
5.根据权利要求4所述的装置,其中所述的带是粘性带。
6.根据权利要求1所述的装置,其中支架(15)的压缩性低于50μm。
7.根据权利要求1所述的装置,其中支架(15)由选自多孔性烧结聚合物、开孔聚合物泡沫、多孔性聚合物片、聚合物筛、织物聚合物纤维、多孔陶瓷和波纹聚合物片的材料构成。
8.根据权利要求1所述的装置,其中支架(15)具有足够的柔韧性,形成弯曲形状作为对由覆盖物(3)施加的下压力的应答。
9.根据权利要求8所述的装置,其中支架(15)由选自多孔性烧结聚合物、开孔聚合物泡沫、多孔性聚合物片、聚合物筛、织物聚合物纤维和波纹聚合物片的材料构成。
10.根据权利要求1所述的装置,其中覆盖物(3)包含粘合剂。
11.根据权利要求10所述的装置,其中粘合剂是皮肤接触粘合剂。
12.根据权利要求1所述的装置,其中支架(15)是由多个部件组成,每个部件在对由覆盖物施加下压力应答时具有非柔韧性,部件相互间通过铰链连接。
13.根据权利要求7所述的装置,其中支架(15)由多孔性烧结的高密度聚乙烯构成。
14.根据权利要求7所述的装置,其中支架(15)由开孔的聚氨酯泡沫构成。
15.根据权利要求7所述的装置,其中支架(15)由开孔的聚乙烯醇泡沫构成。
16.根据权利要求1所述的装置,其中物剂是一种被导入体表的药物,物剂贮器(27)是药物贮器。
17.根据权利要求16所述的装置,其中物剂贮器(27)含有透皮吸收的药物制剂。
18.根据权利要求1所述的装置,其中物剂是从体表取出的身体分析物,该物剂贮器(27)是分析物收集贮器。
19.根据权利要求18所述的装置,其中的身体分析物是葡萄糖。
20.根据权利要求1所述的装置,其中的皮肤穿刺部件包括厚度为5至100μm的片件,所述的片件具有许多开口(8),近体表部分(48)适合于对着体表放置,所述的多个微突(4)从近体表部分(48)延伸出来。
21.根据权利要求20所述的装置,其中的片件由金属构成。
22.根据权利要求21所述的装置,其中的金属选自不锈钢和钛。
23.根据权利要求1所述的装置,其中皮肤穿刺部件包括厚度为5至100μm的片(106),片(106)具有机体接触边缘(49),所述的机体接触边缘带有所述多个微突(4),适合于对着所述的体表放置。
24.根据权利要求23所述的装置,其中片(106)由金属构成。
25.根据权利要求24所述的装置,其中金属选自不锈钢和钛。
26.根据权利要求1所述的装置,其中微突(4)在正常运动过程中保持与皮肤表面的穿刺关系。
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ATE302041T1 (de) 2005-09-15
KR20010032925A (ko) 2001-04-25
CN1281376A (zh) 2001-01-24
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EP1037686B1 (en) 2005-08-17
CA2313698C (en) 2008-04-15
DE69831268D1 (de) 2005-09-22
CA2313698A1 (en) 1999-06-17
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US6083196A (en) 2000-07-04
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