Method and apparatus for device controlled gene expression for cardiac protection
First Claim
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1. A method for cardiac protection, the method comprising:
- sensing one or more parameters indicative of an ischemic event in a mammal using an implantable medical device;
detecting the ischemic event from the one or more parameters, including detecting an end of the ischemic event, using the implantable medical device;
initiating one or more cardiac protection biologic therapies using the implantable medical device in response to the detection of the ischemic event, the one or more cardiac protection biologic therapies each including at least one signaling and non-signaling period, the at least one signaling period having a signaling duration during which at least one gene regulatory signal is delivered, the at least one non-signaling period having a non-signaling duration during which the at least one gene regulatory signal is not delivered, the at least one gene regulatory signal is capable of directly or indirectly regulating a regulatable transcriptional control element without inducing cardiac depolarization, the regulatable transcriptional control element is operably linked to an open reading frame forming an expression cassette, wherein the expression cassette is present in the mammal, and wherein expression of the open reading frame in an effective amount inhibits damage to tissue in the mammal resulting from ischemia; and
delivering the at least one gene regulatory signal from the implantable medical device during at least one of the signaling periods,wherein the one or more cardiac protection biologic therapies include at least one postconditioning cardiac biologic therapy, and initiating the one or more cardiac protection biologic therapies includes initiating the at least one postconditioning cardiac biologic therapy using the implantable medical device when a post-ischemia time interval expires, the post-ischemia time interval starting at the detected end of the ischemic event and ending after a predicted reperfusion period following the ischemic event has started.
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Abstract
A gene regulatory system detects ischemia events and is capable of delivering a biologic therapy in response to the detection of an ischemic event or the reception of a command. The biologic therapy protects the heart from ischemic damage by regulating the expression of an exogenously introduced gene product. In one embodiment, the gene regulatory system includes an implantable system that emits at least one gene regulatory signal in response to the detection of the ischemic event or the reception of the command. The gene regulatory signal directly or indirectly regulates gene expression of the gene product.
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Citations
20 Claims
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1. A method for cardiac protection, the method comprising:
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sensing one or more parameters indicative of an ischemic event in a mammal using an implantable medical device; detecting the ischemic event from the one or more parameters, including detecting an end of the ischemic event, using the implantable medical device; initiating one or more cardiac protection biologic therapies using the implantable medical device in response to the detection of the ischemic event, the one or more cardiac protection biologic therapies each including at least one signaling and non-signaling period, the at least one signaling period having a signaling duration during which at least one gene regulatory signal is delivered, the at least one non-signaling period having a non-signaling duration during which the at least one gene regulatory signal is not delivered, the at least one gene regulatory signal is capable of directly or indirectly regulating a regulatable transcriptional control element without inducing cardiac depolarization, the regulatable transcriptional control element is operably linked to an open reading frame forming an expression cassette, wherein the expression cassette is present in the mammal, and wherein expression of the open reading frame in an effective amount inhibits damage to tissue in the mammal resulting from ischemia; and delivering the at least one gene regulatory signal from the implantable medical device during at least one of the signaling periods, wherein the one or more cardiac protection biologic therapies include at least one postconditioning cardiac biologic therapy, and initiating the one or more cardiac protection biologic therapies includes initiating the at least one postconditioning cardiac biologic therapy using the implantable medical device when a post-ischemia time interval expires, the post-ischemia time interval starting at the detected end of the ischemic event and ending after a predicted reperfusion period following the ischemic event has started. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method for cardiac protection, the method comprising:
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receiving a command; sensing one or more parameters indicative of an ischemic event using an implantable medical device; detecting the ischemic event from the one or more parameters, including detecting an end of the ischemic event, using the implantable medical device; initiating one or more cardiac protection biologic therapies in response to one or more of the reception of the command and the detection of the ischemic event, the one or more cardiac protection biologic therapies each including at least one signaling and non-signaling period, the at least one signaling period having a signaling duration during which at least one gene regulatory signal is delivered, the at least one non-signaling period having a non-signaling duration during which the at least one gene regulatory signal is not delivered, the at least one gene regulatory signal is capable of directly or indirectly regulating a regulatable transcriptional control element without inducing cardiac depolarization, the regulatable transcriptional control element is operably linked to an open reading frame forming an expression cassette, wherein the expression cassette is present in the mammal, and wherein expression of the open reading frame in an effective amount inhibits damage to cardiac tissue resulting from ischemia; and delivering the at least one gene regulatory signal from the implantable medical device during at least one of the signaling periods, wherein initiating the one or more cardiac protection biologic therapies comprises initiating at least one postconditioning cardiac biologic therapy using the implantable medical device in response to one or more of the reception of the command and when a post-ischemia time interval expires, the post-ischemia time interval starting at the detected end of the ischemic event and ending after a predicted reperfusion period following the ischemic event has started. - View Dependent Claims (17, 18, 19, 20)
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Specification