Methods, agents, and devices for local neuromodulation of autonomic nerves

Inventors

Bright, Corinne • VENKATESWARA-RAO, Kondapavulur T. • STEIN, Emily

Abstract

Methods, agents, and devices to treat medical conditions through local chemical neuromodulation of the autonomic nervous system are described. Drug formulations may be injected at or near ganglia, nerve plexi, ganglionated plexi, and nerves to treat different diseases. Target sites for the treatment of cardiac and other disease conditions may include extrinsic stellate (cervicothoracic) and cervical ganglia of the sympathetic chain, and intrinsic cardiac nerves and ganglionated plexi innervating the myocardium.

Core Innovation

The invention relates to local chemical neuromodulation of the autonomic nervous system by delivering small-volume drug formulations at or near autonomic nerve targets. The targets include sympathetic chain ganglia such as the stellate ganglion and cervicothoracic ganglion, intrinsic cardiac nervous system ganglionated plexi, and nerve fibers or rami communicantes. The approach locally affects autonomic nerve function to treat disease states associated with autonomic dysfunction.

A central aspect is delivering a composition locally to the stellate ganglion of a patient in an amount sufficient to affect function of the stellate ganglion and alleviate one or more symptoms of angina. Example compositions explicitly include amiodarone, and related aspects include measuring electrical signals directly transmitted from the stellate ganglion before and after delivering the composition.

The disclosure further includes locally delivering alternative drug classes to the stellate ganglion, including a dihydropyridine calcium antagonist. The drug class examples explicitly include amlodipine and nifedipine. Local sustained-release formulation concepts are described, including hydrogel and polymer delivery forms, and additives such as contrast agents and local anesthetics are described as part of locally deliverable compositions.

Claims Coverage

The partial set identifies three independent claims, each focused on local treatment of angina via delivery to a stellate ganglion, with one independent claim further requiring direct electrical-signal measurement from the stellate ganglion and another independent claim specifying a different drug class.

Across the independent claims, the inventive coverage centers on local delivery of an agent to a stellate ganglion to affect stellate ganglion function and alleviate angina symptoms, with additional coverage in one claim for directly measuring electrical signals transmitted from the stellate ganglion and another claim for using a dihydropyridine calcium antagonist class.

Stated Advantages

Documented Applications