COMPOSITION FOR TREATMENT OF VITREOUS DISEASE OR DISORDER
20210338595 · 2021-11-04
Inventors
- Stefaan De Smedt (Mariakerke, BE)
- Felix SAUVAGE (Roubaix, FR)
- Kevin BRAECKMANS (Lokeren, BE)
- Katrien REMAUT (Gent, BE)
- Marie-José TASSIGNON (Berchen, BE)
- Juan Fraire (Brussel, BE)
- Jerry SEBAG (Huntington Beach, CA, US)
Cpc classification
A61K9/0019
HUMAN NECESSITIES
B82Y5/00
PERFORMING OPERATIONS; TRANSPORTING
A61K9/5161
HUMAN NECESSITIES
International classification
Abstract
A composition includes particles for use in a method for the treatment of a vitreous disease or a vitreous disorder as a light sensitizing agent. Each particle has a surface selected for or adapted for providing mobility of the particle in the vitreous and for binding to collagen aggregates, such as floaters.
Claims
1.-18. (canceled)
19. A composition comprising particles for use in a method for the treatment of a vitreous disease or a vitreous disorder as a light sensitizing agent, wherein each particle comprises a surface selected for or adapted for providing mobility of said particle in the vitreous and for binding to collagen aggregates.
20. The composition according to claim 19, wherein each of said particles comprises a core and wherein said surface is provided by a coating on an exterior surface of said core.
21. The composition according to claim 20, wherein said coating is a negatively charged coating.
22. The composition according to claim 20, wherein said coating comprises hyaluronic acid and/or a derivative thereof.
23. The composition according to claim 19, wherein said particles are adapted for forming vapor nanobubbles in the vitreous when introduced therein and irradiated by laser light.
24. The composition according to claim 19, wherein the particles comprise or consist of a material suitable for the formation of light-induced mechanical forces.
25. The composition according to claim 24, wherein the particles comprise or consist of plasmonic metal.
26. The composition according to claim 19, wherein said particles have a diameter in the range of 1 nm to 500 nm.
27. Use of a composition according to claim 19 as a light sensitizing agent in a method for the treatment of a vitreous disease or a vitreous disorder, wherein said treatment is a laser ablation treatment, and wherein said treatment comprises injecting said composition into the vitreous of an eye of a human or animal subject.
28. The use according to claim 27, wherein said particles specifically bind to collagen in the vitreous and locally exert a mechanical force in the vitreous when irradiated by laser light in said laser ablation treatment.
29. The use according to claim 28, wherein said particles form vapor nanobubbles in the vitreous when being irradiated.
30. The use according to claim 29, wherein said particles cluster around a vitreous opacity to concentrate an energy deposition by said laser ablation treatment near and/or in the vitreous opacity, such that expansion and/or shrinking of said vapor nanobubbles releases said mechanical force to dislodge and/or break apart said vitreous opacity.
31. The use according to claim 27, wherein said laser ablation treatment comprises irradiating at least part of the vitreous by laser pulses.
32. The use according to claim 31, wherein said laser pulses consist of one to 100 laser pulses per vitreous opacity.
33. The use according to claim 31, wherein said laser pulses have a length in the range of 10 fs to 10 ns.
34. The use according to claim 33, wherein said laser pulses have each a power density of 107 to 1015 W/cm2.
35. The use according to claim 27, wherein said vitreous disease or vitreous disorder is myodesopsia.
36. A method of ablation of vitreous opacities comprising the steps of: injecting into the vitreous, the composition comprising particles in accordance with claim 19, specifically binding the particles to collagen fibrils in the vitreous, and locally exerting a mechanical force in the vitreous by irradiating the particles with laser light.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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[0074] The drawings are only schematic and are non-limiting. In the drawings, the size of some of the elements may be exaggerated and not drawn on scale for illustrative purposes.
[0075] Any reference signs in the claims shall not be construed as limiting the scope.
[0076] In the different drawings, the same reference signs refer to the same or analogous elements.
DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
[0077] The present invention will be described with respect to particular embodiments and with reference to certain drawings but the invention is not limited thereto but only by the claims. The drawings described are only schematic and are non-limiting. In the drawings, the size of some of the elements may be exaggerated and not drawn on scale for illustrative purposes. The dimensions and the relative dimensions do not correspond to actual reductions to practice of the invention.
[0078] Furthermore, the terms first, second and the like in the description and in the claims, are used for distinguishing between similar elements and not necessarily for describing a sequence, either temporally, spatially, in ranking or in any other manner. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other sequences than described or illustrated herein.
[0079] Moreover, the terms top, under and the like in the description and the claims are used for descriptive purposes and not necessarily for describing relative positions. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other orientations than described or illustrated herein.
[0080] It is to be noticed that the term “comprising”, used in the claims, should not be interpreted as being restricted to the means listed thereafter; it does not exclude other elements or steps. It is thus to be interpreted as specifying the presence of the stated features, integers, steps or components as referred to, but does not preclude the presence or addition of one or more other features, integers, steps or components, or groups thereof. The term “comprising” therefore covers the situation where only the stated features are present and the situation where these features and one or more other features are present. Thus, the scope of the expression “a device comprising means A and B” should not be interpreted as being limited to devices consisting only of components A and B. It means that with respect to the present invention, the only relevant components of the device are A and B.
[0081] Reference throughout this specification to “one embodiment” or “an embodiment” means that a particular feature, structure or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases “in one embodiment” or “in an embodiment” in various places throughout this specification are not necessarily all referring to the same embodiment, but may. Furthermore, the particular features, structures or characteristics may be combined in any suitable manner, as would be apparent to one of ordinary skill in the art from this disclosure, in one or more embodiments.
[0082] Similarly, it should be appreciated that in the description of exemplary embodiments of the invention, various features of the invention are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure and aiding in the understanding of one or more of the various inventive aspects. This method of disclosure, however, is not to be interpreted as reflecting an intention that the claimed invention requires more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects lie in less than all features of a single foregoing disclosed embodiment. Thus, the claims following the detailed description are hereby expressly incorporated into this detailed description, with each claim standing on its own as a separate embodiment of this invention.
[0083] Furthermore, while some embodiments described herein include some but not other features included in other embodiments, combinations of features of different embodiments are meant to be within the scope of the invention, and form different embodiments, as would be understood by those in the art. For example, in the following claims, any of the claimed embodiments can be used in any combination.
[0084] In the description provided herein, numerous specific details are set forth. However, it is understood that embodiments of the invention may be practiced without these specific details. For instance, in what follows, reference is made to particles having a coating with particular characteristics of mobility and binding. However, as explained above and as reflected in the claims, the present invention is not limited thereto, and covers also particles which inherently have these characteristics at their surface, e.g. because they have these characteristics throughout their core.
[0085] In other instances, well-known methods, structures and techniques have not been shown in detail in order not to obscure an understanding of this description.
[0086] Where in embodiments of the present invention reference is made to “myodesopsia”, reference is made to the perception of floaters. The perception of a floater may be characterized by shadow-like vision artefacts.
[0087] Where in embodiments of the present invention reference is made to a “floater” or “vitreous floater,” reference is made to a vitreous disorder in which the vitreous network is disrupted, e.g. by aggregates of collagen adhering to the vitreous framework in netlike masses that are disruptive of normal vision. A floater may be perceived as a linear structure with nodules, or a meshwork of linear structures, that appears to drift in front of the eye, caused by a shadow cast on the retina by vitreous opacities. Floater-causing vitreous opacities may be caused by embryological remnants, or may be acquired due to aging, trauma, iatrogenic, ocular or systemic metabolic pathologies.
[0088] The present invention relates to a composition comprising particles for use in a method for the treatment of a vitreous disease or a vitreous disorder as a light sensitizing agent, e.g. a laser-light sensitizing agent. Each particle comprises a coating adapted for providing mobility of the particle in the vitreous and for binding to collagen aggregates, e.g. collagen fibers.
[0089] An advantageous approach for the treatment and destruction or ablation of vitreous opacities and/or floaters, such as macroscopic floaters (e.g. having a length in the range of 0.5 mm to 5 mm, e.g. around 1 mm) is demonstrated in the present specification.
[0090] Laser irradiation, such as laser irradiation by pulsed lasers, e.g. pico-, femto- and/or nanosecond pulsed lasers, can be combined with a laser sensitizing agent in accordance with embodiments of the present invention to efficiently destroy collagen fibers in the vitreous, e.g. by laser-induced vapor nanobubble generation. Furthermore, as detailed hereinbelow, hydrophilic anionic coating of the nanoparticles, e.g. of gold nanoparticles, may provide an advantageously high diffusion in the vitreous, such that accumulation after injection (e.g. at the injection site) can be avoided or reduced and/or such that a good binding of the nanoparticles to targeted structures, e.g. floaters, can be achieved. However, while laser irradiation may be advantageous, irradiation by another (intense) light source is not necessarily excluded to achieve the same or similar effects.
[0091] Compared to prior-art laser treatments of vitreous opacities and/or floaters, e.g. using an Nd:YAG laser therapy, a greater efficacy may be achieved. Furthermore, fewer laser pulses and/or a lower laser energy can be used to destroy floater-causing vitreous opacities when compared to the conventional laser therapy (e.g. which may typically require up to 8 mJ and 200 pulses). Furthermore, the laser irradiation in a use in accordance with embodiments of the present invention may be performed using a laser emitting laser light in the visible spectrum, e.g. a wavelength of 561 nm, which advantageously makes the light visible to the clinician, e.g. as opposed to a prior-art Nd:YAG laser treatment to treat eye floaters that operates at 1064 nm, outside the visible spectrum. This may advantageously avoid the use of additional visualization means, such as a coaxial red helium neon laser beam for indicating the targeted position.
[0092] Referring to
[0093] Each particle 1 may comprise a core 2. In embodiments of the present invention, the invention not being limited thereto, each particle comprises a coating 3, e.g. provided on an exterior surface of the core. The coating is adapted for providing mobility of the particle 1 in the vitreous and for binding to collagen aggregates 5. This good binding to collagen aggregates despite the increased mobility of the particles through the vitreous, is unexpected and brings the advantageous effects of the present invention.
[0094] The core 2 may advantageously absorb laser irradiation, e.g. such as to locally enhance the energy deposition by laser. For example, the core may provide a surface plasmon resonance effect to advantageously locally enhance laser energy absorption. For example, the core may comprise a noble metal, such as gold, which has such advantageous surface plasmon resonance properties. The particles may bind to collagen fibres, e.g. vitreous floaters, and may be heated up to break or dislodge collagen aggregates, e.g. by locally generating vapor nanobubbles (VNBs).
[0095] It is an advantage that the particles may diffuse through the vitreous efficiently, and locally bind to collagen. Particularly, the particles may bind to collagen of floater structures to be destroyed by a laser irradiation 6. It is an advantage of the particles that these may generate a localized mechanical force in the vitreous when exposed to the laser light irradiation 6, e.g. while bound to a collagen structure. For example, upon laser illumination (e.g. pulsed laser, such as nanosecond laser pulses), the particles bound to the collagen quickly heat up to several hundred degrees. Consequently, the water of the surrounding environment evaporates to form VNBs emerging around the surface of the particles. Such VNBs will first expand and then collapse thereby generating high-pressure shockwaves, providing a localized mechanical force.
[0096] Thus, the released mechanical force can break collagen fibers apart 7, such that the collagen fragments influence the optical transmission of light through the eye in a lesser extent. Furthermore, the smaller collagen fragments may disperse through the eye to reduce local vision artefacts and/or may sediment such as not to substantially affect the vision.
[0097] In a composition for the use in accordance with embodiments of the present invention, the coating may be adapted for providing a good mobility of the particle in the vitreous. The coating may be an electrostatic coating.
[0098] For example, the coating may comprise a cationic coating, e.g. as illustrated in
[0099] The coating may be an anionic hydrophilic coating. It is an advantage of such anionic hydrophilic coating that a good mobility in the vitreous can be achieved.
[0100] In a composition for the use in accordance with embodiments of the present invention, the coating may comprise poly(ethylene)glycol (PEG) and/or a derivative thereof.
[0101] Furthermore, the core material, such as gold, may advantageously bind well to collagen fibers. This effect can be observed for different size ranges of the particle and different surface charge states.
[0102] Referring to
[0103] In a composition for the use in accordance with embodiments of the present invention, the core may comprise or consist of a noble metal, such as gold, platinum or silver. Alternatively, the core may comprise a polymer material, carbon, iron oxide, titanium oxide, e.g. TiO.sub.2, and/or titanium.
[0104] In a composition for the use in accordance with embodiments of the present invention, the particle may be a nanoparticle or microparticle.
[0105] In a composition for the use in accordance with embodiments of the present invention, the particle may be a nanosphere.
[0106] In a composition for the use in accordance with embodiments of the present invention, the particle may have a diameter in the range of 1 nm to 1000 nm, for instance 1 nm to 500 nm, e.g. in the range of 1 nm to 100 nm, preferably in the range of 1 nm to 50 nm, e.g. in the range of 1 nm to 20 nm. In embodiments of the present invention, the particle may have a diameter in the range of 2 nm to 500 nm, for instance 5 nm to 100 nm, such as 10 nm to 80 nm.
[0107] It is an advantage of smaller particle sizes, e.g. in the range of 1 nm to 50 nm, e.g. in the range of 1 nm to 20 nm that the mobility of the particles in the vitreous may be improved. Furthermore, a plurality of the particles may bind to a collagen structure of a floater, such as to locally cluster around the floater. Thus, the local energy deposition by laser excitation can be enhanced near or at the floater, while releasing energy to a lesser, or no substantial, extent throughout the vitreous where the particles do not cluster.
[0108] For example, the cores may be manufactured using the Turkevich method, as known in the art. The Turkevich method is based on the reduction properties of boiling citrate solutions. For example, gold nanoparticles may be synthesized, e.g. having a diameter in the range of 70 nm to 80 nm. In this example, a 150 mL 0.2 mM chloroauric acid solution (HAuCl.sub.4) may be reduced by the addition of 0.5 mL of a 0.01 M citrate solution (corresponding to a 1:1 Au/Citrate molar ratio) under heat and rapid stirring for 30 min. Particles may be overgrown to the desired size by addition of Au.sup.3+ and ascorbate solutions through capillary tubes and controlling the maximum in the Extinction spectrum by UV-vis spectroscopy. When the dipolar LSPR peak matched the LSPR peak of a predetermined desired size (e.g. between 538 nm and 542 nm for a particle size in the range of 70 nm to 80 nm) the synthesis can be stopped.
[0109] As another example, 10 nm gold nanoparticles may be synthesized using ascorbate as reducing agent. A typical synthesis may consist of adding Au to give a final concentration of 0.2 mM chloroauric acid solution (HAuCl.sub.4) with the addition of equimolar quantities of sodium ascorbate (final volume=100 mL) under rapid stirring and a reaction time of 30 min.
[0110] The particles, e.g. the particle size, may be characterized by UV-vis spectroscopy, dynamic light scattering (DLS), transmission electron microscopy (TEM), and/or electrodynamic modeling using Mie theory. The obtained concentration of the particles may be estimated using experimental extinction intensities at the maximum wavelength, and Mie theory calculations of the extinction cross section for spherical particles.
[0111] The coating may be provided on the particle core in accordance with known processes. For example, the particle cores may be functionalized with HA or PDDAC to achieve respectively negative or positive zeta potentials. Functionalization with HA may be performed by adding 3 mg of the polymer per 50 mL of a stock solution of the particles (e.g. a stock solution of the synthetized particles in pM concentration). Likewise, functionalization with PDDAC may be performed by addition of the polymer to a final concentration of 11.9 mg/mL to 50 mL of the synthetized particles. After reaction, e.g. overnight, the functionalized particles may be washed by centrifugation (e.g. 10 min at 13000 g for 10 nm particles and 5 min at 2000 g for 70-80 nm particles) and resuspended in water. Successful functionalization can be confirmed by DLS size and zeta potential measurements.
[0112] In a composition for the use in accordance with embodiments of the present invention, the vitreous disease or vitreous disorder may be myodesopsia.
[0113] In a composition for the use in accordance with embodiments of the present invention, the treatment may be, or may comprise, a laser ablation treatment 6. The treatment may comprise injecting the composition 1 into the vitreous of an eye of a human or animal subject, as illustrated in
[0114] A composition for use in accordance with embodiments of the present invention may have a concentration in the range of 10.sup.9 to 10.sup.14, e.g. in the range of 10.sup.10 to 10.sup.12, particles per ml.
[0115] In a composition for the use in accordance with embodiments of the present invention, the particles may be used for specifically binding to collagen in the vitreous, for example in the collagen fibers 8 causing vitreous opacities, and for locally exerting a mechanical force in the vitreous when irradiated by laser light in the laser ablation treatment.
[0116] In a composition for the use in accordance with embodiments of the present invention, the particles may be adapted for forming vapor nanobubbles 9 in the vitreous to exert the mechanical force. Thus, the released mechanical force can break collagen fibers apart 7.
[0117] In a composition for the use in accordance with embodiments of the present invention, the particles may be adapted for clustering around a vitreous floater to concentrate an energy deposition by the laser ablation treatment near and/or in the vitreous floater, such that a collapse of the vapor nanobubbles releases a mechanical force to dislodge and/or break apart the vitreous floater.
[0118] In a composition for the use in accordance with embodiments of the present invention, the laser ablation treatment may comprise irradiating at least part of the vitreous by laser pulses.
[0119] In a composition for the use in accordance with embodiments of the present invention, the vitreous floater being treated may have a length in the range of 1 mm to 3 mm, embodiments of the present invention not necessarily being limited thereto.
[0120] In a composition for the use in accordance with embodiments of the present invention, the vitreous floater being treated may be close to the retina or to the lens, e.g. at a distance in the range of 0 mm to 5 mm. For example, the floater may be present in the bursa premacularis. However, embodiments of the present invention are not necessarily limited to treating vitreous floaters that are close to the retina or eye lens.
[0121] In a composition for the use in accordance with embodiments of the present invention, the laser pulses may consist of one to 100 laser pulses, e.g. one to 20 laser pulses, per floater.
[0122] In a composition for the use in accordance with embodiments of the present invention, the laser pulses may have a length in the range of 10 fs to 1000 nl, for instance 10 fs to 10 ns, e.g. in the range of 10 fs to 1 ps or in the range of 1 ps to 10 ns.
[0123] In a composition for the use in accordance with embodiments of the present invention, the laser pulses may each have a power density in the range of 10.sup.7 to 10.sup.15 W/cm.sup.2, e.g. in the range of 10.sup.12 to 10.sup.15 W/cm.sup.2, or alternatively expressed a fluence in the range of 10 μJ/cm.sup.2 to 100 J/cm.sup.2, e.g. in the range 10 mJ/cm.sup.2 to 10 J/cm.sup.2.
[0124] In the examples hereinbelow, for illustrating embodiments of the present invention, compositions comprising 70-80 nm gold nanoparticles (AuNP) and 10 nm gold nanoparticles are discussed. The nanoparticles were synthesized using the processes as detailed in exemplary embodiments provided hereinabove. After synthesis, the particles were functionalized with HA or PDDAC, to obtain respectively anionic and cationic coatings, as described hereinabove.
[0125] In the examples hereinbelow, collagen aggregates were used as a model for floaters. To ensure that the prepared fibers were made up of collagen and to avoid confusion with dust or any other materials during dark field microscopic imaging, the fibers were stained with Col-F, a fluorescent probe able to stain collagen and elastin.
[0126] Collagen I was extracted from rat tail (GIBCO) and diluted in PBS (0.2 mg/ml). The pH was adjusted to 7.4, using NaOH (0.1N), and the suspension was incubated at 37° C. for one hour. To monitor the fibrillation process, turbidity measurements were performed, illustrated in
[0127] Nanoparticle tracking analysis (NTA) measurements were performed using a Nanosight instrument (Malvern, Worcestershire, UK). The cationic AuNPs were diluted in water (10.sup.10 particles/ml) and injected with a sterile syringe in the sample chamber. Measurements were made in scattering mode. All measurements were performed at room temperature.
[0128] Yellow-green fluorescent carboxylate polystyrene nanobeads (500 nm) (Invitrogen, Merelbeke, Belgium) were mixed with 70 nm cationic gold nanoparticles (c=2.10.sup.10 particles/ml). and injected in the vitreous by a sterile syringe with a 30 G needle. The concentration of the fluorescent nanoparticles was suitable for SPT experiments (10.sup.9 particles/ml). After 30 min of equilibration time, the sample was irradiated with a nanosecond laser and films were recorded in and outside the illuminated area. For each condition, 10 to 20 movies were recorded, comprising 100 frames each. The movies were analysed using an in-house developed software.
[0129] Dark field microscopy imaging can be used to locate and align the nanosecond laser on the collagen fibers or human vitreous opacities in the sample. To generate vapor nanobubbles, 7 ns laser pulses were used. The wavelength of the laser light was 561 nm which falls within the plasmon peak of 70-80 nm AuNPs. A beam expander (#GBE05-A, Thorlabs) combined with iris diaphragm (#D37SZ, Thorlabs) was used to adjust the diameter of the laser beam to 150 μm. The laser pulse energy was monitored by an energy meter (J-25 MB-HE&LE, Energy Max-USB/RS sensors, Coherent) synchronized with the pulsed-laser. The length of the collagen fibers was determined from the microscopy images using ImageJ software.
[0130] Highly concentrated suspension of AuNPs in water or after injection in bovine vitreous were irradiated using a nanosecond laser (at an intensity of 200 μJ). 5 μL of AuNPs suspension was placed on a microscopy slide in a single particle tracking (SPT) sticker. Samples were then laser-irradiated as explained above. Time series of pictures, i.e. films, were recorded (for 566 sec). Scattering recovery in the illuminated area was measured in a region of interest superimposed with the laser beam using NIS software.
[0131] The cationic gold nanoparticles of diameter of 70 nm (Cat-AuNPs) were mixed with the collagen fibers in water. The suspension was exposed to the nanosecond laser at different intensities with a different number of pulses. The laser beam was focused on the center of the targeted fiber. Fiber diameters before and after laser exposure were determined and averaged using the ImageJ image manipulation software.
[0132] To demonstrate the impact of vapor nanobubble (VNB) formation by the irradiated Cat-AuNPs on the bovine vitreous, e.g. in terms of the intactness of the vitreous network and the viscosity, single particle tracking (SPT) experiments were carried out outside and in the area where the laser beam meets the vitreous. Carboxylic-terminated fluorescent polystyrene nanospheres (PS COOH nanoparticles) with a size of 500 nm were tracked and used as a viscosity sensor. These nanoparticles can be considered to be substantially immobile in the vitreous due to hydrophobic interactions and steric effects and due to their size being close to the lattice size of the vitreous mesh (about 550 nm). For this example, 70 nm Cat-AuNPs were used. It can be observed that lines are formed after injection in the bovine vitreous, which provides a clear indication on their interaction with the vitreous network, as shown in
[0133] To evaluate the local impact of VNBs generation on the vitreous, the laser intensities that were used to break and/or move floaters in the example provided hereinabove, in water, were retained (i.e. 200 μJ (around 1.1 J/cm.sup.2) and 800 μJ (around 4.5 J/cm.sup.2). Application of the laser in the absence of the Cat-AuNPs did not induce any significant changes in the diffusion of the PS COOH nanoparticles. In the presence of Cat-AuNPs, one pulse at a laser intensity of 200 μJ (around 1.1 J/cm.sup.2) or 800 μJ (around 4.5 J/cm.sup.2) did not cause a clear observable change in diffusion, whereas 10 pulses at an intensity of 800 μJ (around 4.5 J/cm.sup.2) led to a clear increase in the diffusion coefficient of COOH PS nanoparticles (see
[0134] For example, local liquefaction around an eye floater may be useful to sediment floater residuals out of the field of view. This phenomenon is also observed with substantially higher laser intensities in a conventional prior-art therapy that uses the clinically-approved Nd:YAG laser, e.g. particularly when applied in the mid- and posterior vitreous humor.
[0135] It is an advantage of a composition comprising gold nanoparticles coated with HA, e.g. particularly smaller particles, that destruction of the vitreous mesh could be reduced, since these particles may not generate VNBs with such high intensity. For example, anionic hydrophilic particles having a small diameter may be more mobile in the vitreous network than the exemplary Cat-AuNPs described hereinabove, e.g. due to their smaller size and negative charge, which may imply smaller and/or less interactions with the collagen network.
[0136] The mobility of macromolecules and nanoparticles after intravitreal injection is clearly correlated to their size and their surface charge. These phenomena have a direct implication in ocular drug delivery. While cationic particles may aggregate at the injection spot in the vitreous, anionic particles may have a higher mobility. Different types of nanoparticles coated with poly(ethylene)glycol (PEG) or hyaluronic acid (HA) showed enhanced mobility and diffusion coefficient in vitreous when compared to non-coated particles. To break floater-causing vitreous opacities, the particles may need to be sufficiently mobile in the vitreous body to increase the probability of binding to vitreous opacities after injection and to avoid aggregation at the injection spot. While a potent destruction of the surrounding vitreous network with cationic particles, e.g. the Cat-AuNPs of the example hereinabove, may have useful medical applications in (locally) liquefying the vitreous, for other applications, such as inducing prophylactic post vitreous detachment (PVD) while for attempting to preserve the vitreous mesh, anionic particles, and particularly smaller sizes of anionic particles, may be preferable.
[0137] To examine whether particles can reach the floaters efficiently and to evaluate the impact of the particle coating on their mobility, a technique inspired from fluorescence recovery after photobleaching (FRAP) has been used in the following example. FRAP is a powerful tool to study the mobility of fluorescent particles or molecules in different media.
[0138] For SRAF mobility experiments in water, 5 μL of AuNPs suspension (10.sup.12 particles/ml in water) was placed on a microscopy slide. For measuring the mobility of the AuNPs in the vitreous through SRAF, 40 μL of a highly concentrated suspension of AuNPs (typically 10.sup.12 particles/ml in water) was injected in a bovine vitreous sample (200-400 μl) contained in a glass-bottomed dish and allowed to equilibrate for 30 min. Then samples were placed under the dark field microscope (10× objective) and illuminated with the nanosecond laser (Opolette HE 355 LD, OPOTEK Inc; 561 nm; 200 μJ (around 1.1 J/cm.sup.2); 1 pulse) to fragment the AuNPs; subsequently the increased intensity of scattered light in the fragmentation zone was recorded for about 10 min.
[0139] The applied technique is based on scattering recovery in an area where AuNPs were illuminated and destroyed by the nanosecond laser and imaged by dark-field microscopy without any fluorescent staining. This technique allows to determine the mobility of AuNPs without any fluorescent staining and offers an alternative to techniques such as NTA, which may affect vitreous integrity due to shear stress during injection. After a single laser pulse of 200 μJ (around 1.1 J/cm.sup.2) intensity, a hole is created. In this area, the scattering recovery of AuNPs can be measured and plotted as a function of time.
[0140] The diffusion coefficient D [μm.sup.2/s] can be determined by
where w [μm] refers to the radius of the laser beam and τ [s] refers to a half-life factor. The mobility k can be determined by the value of relative fluorescence intensity corresponding to the plateau.
[0141] The diffusion coefficient (D) and mobility (k) of HA-AuNPs (c=3.2×10.sup.10 particles/ml) in water were found to be around 3.18+/−0.07 μm.sup.2/s and 0.92+/−0.07 respectively, see
[0142] HA-AuNPs were shown to be mobile in water and bovine vitreous (k=0.99) but having a decreased diffusion coefficient D in bovine vitreous (D=1.86+/−0.40 μm.sup.2/s). However, Cat-AuNPs substantially remained at the injection spot in the vitreous, e.g. as shown by the images in
[0143] Referring to
[0144] The same experiment was carried out by injecting the collagen fibers in bovine vitreous. After 30 min, HA-AuNPs were injected at several locations with a maximum volume of 40 μL (to avoid local liquefaction of the vitreous due to the injection). Dark-field microscopy images of a collagen fiber showed breakage at a laser intensity of 800 μJ (around 4.5 J/cm.sup.2), confirming previous observations in water and a complete disappearance of the fiber after 7 pulses, see
[0145] Scattering efficiency may be an important criterion for the use of AuNPs intravitreally. Depending on the shape of the particles (e.g. spheres, rods . . . ) and size, AuNPs can scatter light to a different extent. Scattering may be generally considered as undesirable because the patient may experience a decrease in visual acuity or a blurred vision after injection. The examples hereinabove have demonstrated a good mobility in the vitreous for hyaluronan-coated particles. In this example, HA-coated AuNPs of a size of 10 nm were synthesized and their ability to break collagen fibers in water and bovine vitreous were studied. For a smaller size of 10 nm, simulated scattering efficiency substantially showed no scattering as compared to 80 nm AuNPs, see e.g.
[0146] The number of VNBs generated per laser pulse was determined by dark-field microscopy. Dispersions of HA-AuNPs in water (10.sup.10 nanoparticles/mL) were applied in a 50 mm glass bottom dish (MatTek Corporation, US). After an equilibration of 1 hour, a single 7 ns laser pulse was applied and the number of VNBs were counted in the irradiated area (˜150 μm laser beam diameter) of the dark field images. Dark field images were recorded with an illumination time of 10 ms after firing the laser pulse so as to capture the short-lived VNBs. As the laser fluence (i.e. the energy density calculated as the energy of a single laser pulse divided by the laser beam area), increases, more AuNPs in the irradiated zone will form VNBs.
[0147] In water and in bovine vitreous, 10 nm HA-AuNPs (1.10.sup.12 particles/ml) were shown to induce fiber breakage at a laser intensity of 800 μJ (around 4.5 J/cm.sup.2) (see
[0148] Transmission electron microscopy (TEM) images were obtained at the VIB-UGent Transmission Electron Microscopy-Core facility using a JEM-JEOL 1120 EXII under an accelerating voltage of 80 kV. Samples were prepared by adding one drop (of about 50 μL) of the colloidal solutions onto a holey carbon-formvar coated copper TEM grid (100 mesh).
[0149] Observations of particles and collagen fibers by TEM reveals that all types of particles as discussed in the examples hereinabove can bind collagen structures, regardless their size and charge, see
[0150] Without being bound by theory, it is believed that the nanoparticles provided by aspects of the present invention can move through the vitreous but attach to vitreous opacity because of the differences in the structure of the opacity. More specifically, nanoparticle mobility in vitreous can be improved by applying a HA coating to the nanoparticles. In particular, coating Au nanoparticles with HA avoids their immobilization in vitreous. As shown in
[0151] Surprisingly, while the negatively charged HA-AuNPs do not seem to interact with the collagen strands of the biopolymer network in vitreous, they do bind to type I collagen fibers (see e.g.
[0152] For a concentration of 10.sup.10 particles/ml, no aggregation is observed on the collagen fiber with 10 nm HA-AuNPs, which may explain why no breaking or other effect was observed on the collagen fiber at this concentration in examples hereinabove for these particles. However, for larger particles, it was possible to break the fibers at this concentration due to a lower threshold to trigger VNBs.
[0153] Because the composition of human floater-causing opacities may be more complex than the models discussed hereinabove, the example hereinbelow was carried out in human vitreous containing floater-causing opacities. These vitreous were obtained by pars plana vitrectomy. Samples of vitreous containing floaters were collected at the VMR institute after vitrectomy of patients.
[0154] In traditional YAG laser vitreolysis, floaters are destroyed by plasma formation, requiring laser pulses at very high energy densities up to 5000 J/cm.sup.2. Since a single YAG laser pulse typically has an energy in the order of 10 mJ, it means that the laser beam needs to be tightly focused to less than 20 μm diameter onto the floaters to achieve local photo destruction. Considering that vitreous opacities can have much larger dimensions, up to 1000 shots may be needed to destroy a single opacity, amounting to a total light dose of 10.sup.4 mJ.
[0155] By comparison, the present invention provides a composition comprising particles as sensitizing agent to enhance light absorption so that much lower energy densities and total light doses are needed to achieve the same effect.
[0156] In particular embodiments, the laser beam may be larger than 20 μm, for example in the order of hundred microns, e.g. the laser beam may have a diameter of 150 μm and pulses had an energy of less than 10 mJ, e.g. 1 mJ or less, e.g. 0.8 mJ. This means that the light energy density can be as low as 4.5 J/cm.sup.2, which is approximately 1000 times less than what is used for YAG laser therapy. In addition, since consequently the laser beam can be much larger, fewer laser pulses are needed to completely destroy the fibers. In embodiments of the present invention, less than thousands, e.g. less than hundred pulses may be needed, for example only about 10 pulses can be used to destroy opacities, which corresponds to a total light dose of about 10 mJ, again approximately 1000 times less than YAG laser therapy. Thus, gold nanoparticle assisted photo-ablation of vitreous opacities might be less damaging for the posterior segment of the eye, as a significantly lower number of weaker laser pulses seem to be sufficient to break opacities. Another practical advantage of being able to use a larger laser beam is that the distance along the optical axis (direction of light propagation) over which a suitable energy density is achieved for photo-ablation is much larger. Indeed, assuming a Gaussian beam profile for simplicity, the depth of focus scales with the square of the beam spot size. This means that for a laser beam of 150 μm diameter, the depth of focus is at least 56 times (150 μm/20 μm).sup.2) more extended as compared to the lower than 20 μm beam for the YAG laser. In practice, this means that 3D focusing onto the floater is not such a stringent requirement, making the whole procedure much easier to perform.
[0157] Annex 1: Simulation of the Optical Properties of Gold Nanoparticles.
[0158] The optical responses (i.e. scattering, absorption and extinction) of AuNPs were computed using Mie theory, which constitutes an exact solution to the problem of absorption and scattering of light by an object composed by concentric spheres. In particular, the Generalized Multiparticle Mie Theory (GMM) formulation developed by Xu (Xu, Y.; Wang, R. T. Electromagnetic Scattering by an Aggregate of Spheres: Theoretical and Experimental Study of the Amplitude Scattering Matrix. Phys. Rev. E 1998, 58 (3), 3931-3948) was used. This method is able to exactly solve the complex problem of interaction between an electromagnetic field and an aggregate of spheres, and was used to simulate the extinction, scattering and absorption cross sections. In all the calculations presented in this work the dielectric function tabulated by Palik for Au was employed. In the calculations performed, the nanoparticles were excited by a plane wave with an incidence pointing vector (propagation direction) normal to the surface. As the GMM code is restricted to applications in homogeneous media, an effective medium approximation was used (Chettiar, U. K.; Engheta, N. Internal Homogenization: Effective Permittivity of a Coated Sphere. Opt. Express 2012, 20 (21), 22976-22986) to account for the interface between the particle surface and the aqueous environment. It was considered that particles were immersed in a dielectric environment with an effective refractive index (n.sub.eff) of 1.35, which was calculated as the weighted average of 20% of the refractive index of collagen (n.sub.r 1.41) and 80% of the refractive index of water (n.sub.r 1.33) (Leonard, D. W.; Meek, K. M. Refractive Indices of the Collagen Fibrils and Extrafibrillar Material of the Corneal Stroma. Biophys. J. 1997, 72 (3), 1382-1387).
[0159] Annex 2: Vitreous Samples
[0160] a) Bovine Vitreous Containing Collagen I Fibers
[0161] Bovine eyes were enucleated less than one hour after cows were slaughtered (slaughterhouse Zele, Belgium). Since vitreous has a very fragile structure, it was carefully removed from the globe. First, 200 to 400 μl was carefully cut and placed on a glass-bottomed culture dish. Subsequently 50 μl of a suspension of collagen fibers was injected in the vitreous sample using a 1 ml syringe equipped with a 21.5 G needle and let to equilibrate at room temperature for 30 min. AuNPs were then randomly injected in the sample (no more than 40 μl per injection) using a 1 ml syringe equipped with a 30 G needle (no more than 5 injection spots per vitreous sample to avoid extensive liquefaction). The sample was let to equilibrate for 30 min prior to applying (nanosecond) laser pulses (Opolette HE 355 LD laser, OPOTEK Inc.)
[0162] b) Human Vitreous Containing Opacities
[0163] Samples of vitreous containing opacities were collected at the VMR Institute for Vitreous Macula Retina (Huntington beach, CA, USA) from patients undergoing vitrectomy for the treatment of Vision Degrading Myodesopsia. The study protocol adhered to the Declaration of Helsinki. Prior to surgery, patients gave a written informed consent that has been reviewed and accepted by the ethical committee of Saint Joseph Health Center for clinical research (Irvine, Calif., USA). After vitrectomy the (undiluted) samples were frozen and stored at −80° C. until further use. After thawing the human vitreous samples, they were directly mixed with an equal volume of a dispersion of AuNPs (typically 10.sup.12 nanoparticles/ml in water). The samples were then allowed to equilibrate for 30 min at room temperature prior to applying (nanosecond) laser pulses.