Development of a lung ultrasound therapy system for acute respiratory distress syndrome

急性呼吸窘迫综合征肺部超声治疗系统的开发

• 批准号: 523598-2018
• 负责人: Lee, Warren
• 金额: $ 17.62万
• 依托单位: University of Toronto
• 依托单位国家: 加拿大
• 项目类别: Collaborative Health Research Projects
• 财政年份: 2019
• 资助国家: 加拿大
• 起止时间: 2019-01-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=694660
• 关键词: Development; lung; ultrasound; therapy; system

Treatment of acute respiratory distress syndrome (ARDS), a common disorder in intensivecare units with a mortality rate approaching 40%, is a considerable challenge. In ARDS, thelungs are filled with fluid resulting in patients drowning in their own fluids. ARDS is one of themost difficult conditions to treat because of its patchy distribution, where the fluid-filled regionsof the lung are interspersed within the normal lungs, causing conventional treatments topreferentially affect the normal lungs rather than the injured regions. For instance, mechanicalventilators, although life-saving, preferentially inflate the normal regions of the lung resultingin overdistension and injury of the normal lung itself. Similarly, medicines given by inhalationor injection preferentially affect the normal lungs or other organs in the body. Here wepropose a revolutionary form of personalized and targeted medicine to treat ARDS based onultrasound technology and microbubbles (tiny gas bubbles already used clinically fordiagnostic purposes). While the normal regions of lung scatter ultrasound waves (becauseultrasound is blocked by air), the ultrasound waves are able to penetrate the injured (fluidfilledor collapsed) regions, allowing enhanced delivery of drugs like antibiotics to thedamaged lung. This approach is a revolutionary form of personalized medicine, since it willallow the delivery of medicines and genes exactly where they are needed in each patient. Inthis project, we will develop a clinical prototype of an ultrasound therapy system specificallyfor the lungs and optimize treatment protocols using large animal models of ARDS. At the endof the project, we will translate the study to a Phase I clinical trial in humans.

急性呼吸窘迫综合征（ARDS）是重症监护病房的常见疾病，死亡率接近40%，其治疗是一个相当大的挑战。在急性呼吸窘迫综合征中，肺部充满液体，导致患者被自己的液体淹死。ARDS是最难治疗的疾病之一，因为它的斑片状分布，其中肺的充满液体的区域散布在正常肺内，导致常规治疗参考影响正常肺而不是损伤区域。例如，机械通气虽然可以挽救生命，但优先使肺的正常区域膨胀，导致过度膨胀和正常肺本身的损伤。同样，通过吸入或注射给予的药物优先影响正常的肺或身体的其他器官。在这里，我们提出了一种革命性的个性化和靶向药物，以治疗基于超声技术和微泡（微小的气泡已用于临床诊断目的）的ARDS。当肺的正常区域散射超声波（因为超声波被空气阻挡）时，超声波能够穿透受伤（充满液体或塌陷）的区域，从而增强药物（如抗生素）向受损肺的输送。这种方法是个性化医疗的一种革命性形式，因为它将允许药物和基因精确地输送到每个患者需要的地方。在这个项目中，我们将开发一个专门用于肺部的超声治疗系统的临床原型，并使用大型ARDS动物模型优化治疗方案。在项目结束时，我们将把这项研究转化为人体I期临床试验。