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Reeder JT, Xie Z, Yang Q, Seo MH, Yan Y, Deng Y, Jinkins KR, Krishnan SR, Liu C, McKay S, Patnaude E, Johnson A, Zhao Z, Kim MJ, Xu Y, Huang I, Avila R, Felicelli C, Ray E, Guo X, Ray WZ, Huang Y, MacEwan MR, Rogers JA. Soft, bioresorbable coolers for reversible conduction block of peripheral nerves. Science 2022; 377:109-115. [PMID: 35771907 DOI: 10.1126/science.abl8532] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Implantable devices capable of targeted and reversible blocking of peripheral nerve activity may provide alternatives to opioids for treating pain. Local cooling represents an attractive means for on-demand elimination of pain signals, but traditional technologies are limited by rigid, bulky form factors; imprecise cooling; and requirements for extraction surgeries. Here, we introduce soft, bioresorbable, microfluidic devices that enable delivery of focused, minimally invasive cooling power at arbitrary depths in living tissues with real-time temperature feedback control. Construction with water-soluble, biocompatible materials leads to dissolution and bioresorption as a mechanism to eliminate unnecessary device load and risk to the patient without additional surgeries. Multiweek in vivo trials demonstrate the ability to rapidly and precisely cool peripheral nerves to provide local, on-demand analgesia in rat models for neuropathic pain.
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Affiliation(s)
- Jonathan T Reeder
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Zhaoqian Xie
- State Key Laboratory of Structural Analysis for Industrial Equipment, Department of Engineering Mechanics, Dalian University of Technology, Dalian, China.,Ningbo Institute of Dalian University of Technology, Ningbo, China
| | - Quansan Yang
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA
| | - Min-Ho Seo
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.,School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Busan, Republic of Korea
| | - Ying Yan
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Yujun Deng
- State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Katherine R Jinkins
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Siddharth R Krishnan
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Claire Liu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Shannon McKay
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Emily Patnaude
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Alexandra Johnson
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Zichen Zhao
- State Key Laboratory of Structural Analysis for Industrial Equipment, Department of Engineering Mechanics, Dalian University of Technology, Dalian, China.,Ningbo Institute of Dalian University of Technology, Ningbo, China
| | - Moon Joo Kim
- Department of Chemical Engineering, Northwestern University, Evanston, IL, USA
| | - Yameng Xu
- The Institute of Materials Science and Engineering, Washington University, St. Louis, MO, USA
| | - Ivy Huang
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Raudel Avila
- Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA
| | | | - Emily Ray
- Department of Biomedical Engineering, Washington University, St. Louis, MO, USA
| | - Xu Guo
- State Key Laboratory of Structural Analysis for Industrial Equipment, Department of Engineering Mechanics, Dalian University of Technology, Dalian, China.,Ningbo Institute of Dalian University of Technology, Ningbo, China
| | - Wilson Z Ray
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Department of Biomedical Engineering, Washington University, St. Louis, MO, USA
| | - Yonggang Huang
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.,Departments of Civil and Environmental Engineering, Northwestern University, Evanston, IL, USA
| | - Matthew R MacEwan
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Department of Biomedical Engineering, Washington University, St. Louis, MO, USA
| | - John A Rogers
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.,Department of Chemistry, Northwestern University, Evanston, IL, USA.,Department of Electrical Engineering and Computer Science, Northwestern University, Evanston, IL, USA.,Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
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5
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Garibyan L, Cornelissen L, Sipprell W, Pruessner J, Elmariah S, Luo T, Lerner EA, Jung Y, Evans C, Zurakowski D, Berde CB, Rox Anderson R. Transient Alterations of Cutaneous Sensory Nerve Function by Noninvasive Cryolipolysis. J Invest Dermatol 2015; 135:2623-2631. [PMID: 26099028 PMCID: PMC4640987 DOI: 10.1038/jid.2015.233] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 05/09/2015] [Accepted: 06/09/2015] [Indexed: 12/27/2022]
Abstract
Cryolipolysis is a noninvasive, skin cooling treatment for local fat reduction that causes prolonged hypoesthesia over the treated area. We tested the hypothesis that cryolipolysis can attenuate nociception of a range of sensory stimuli, including stimuli that evoke itch. The effects of cryolipolysis on sensory phenomena were evaluated by quantitative sensory testing (QST) in 11 healthy subjects over a period of 56 days. Mechanical and thermal pain thresholds were measured on treated and contralateral untreated (control) flanks. Itch duration was evaluated following histamine iontophoresis. Unmyelinated epidermal nerve fiber and myelinated dermal nerve fiber densities were quantified in skin biopsies from six subjects. Cryolipolysis produced a marked decrease in mechanical and thermal pain sensitivity. Hyposensitivity started between two to seven days after cryolipolysis and persisted for at least thirty-five days post treatment. Skin biopsies revealed that cryolipolysis decreased epidermal nerve fiber density, as well as dermal myelinated nerve fiber density, which persisted throughout the study. In conclusion, cryolipolysis causes significant and prolonged decreases in cutaneous sensitivity. Our data suggest that controlled skin cooling to specifically target cutaneous nerve fibers has the potential to be useful for prolonged relief of cutaneous pain and might have a use as a research tool to isolate and study cutaneous itch-sensing nerves in human skin.
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Affiliation(s)
- Lilit Garibyan
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
| | - Laura Cornelissen
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA
| | - William Sipprell
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Joachim Pruessner
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Sarina Elmariah
- Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Tuan Luo
- Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Ethan A Lerner
- Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Yookyung Jung
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - Conor Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
| | - David Zurakowski
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA
| | - Charles B Berde
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA
| | - R Rox Anderson
- Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA
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7
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Li H, Jia JP, Xu M, Zhang L. Changes in the blood-nerve barrier after sciatic nerve cold injury: indications supporting early treatment. Neural Regen Res 2015; 10:419-24. [PMID: 25878590 PMCID: PMC4396104 DOI: 10.4103/1673-5374.153690] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 11/04/2022] Open
Abstract
Severe edema in the endoneurium can occur after non-freezing cold injury to the peripheral nerve, which suggests damage to the blood-nerve barrier. To determine the effects of cold injury on the blood-nerve barrier, the sciatic nerve on one side of Wistar rats was treated with low temperatures (3-5°C) for 2 hours. The contralateral sciatic nerve was used as a control. We assessed changes in the nerves using Evans blue as a fluid tracer and morphological methods. Excess fluid was found in the endoneurium 1 day after cold injury, though the tight junctions between cells remained closed. From 3 to 5 days after the cold injury, the fluid was still present, but the tight junctions were open. Less tracer leakage was found from 3 to 5 days after the cold injury compared with 1 day after injury. The cold injury resulted in a breakdown of the blood-nerve barrier function, which caused endoneurial edema. However, during the early period, the breakdown of the blood-nerve barrier did not include the opening of tight junctions, but was due to other factors. Excessive fluid volume produced a large increase in the endoneurial fluid pressure, prevented liquid penetration into the endoneurium from the microvasculature. These results suggest that drug treatment to patients with cold injuries should be administered during the early period after injury because it may be more difficult for the drug to reach the injury site through the microcirculation after the tissue fluid pressure becomes elevated.
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Affiliation(s)
- Hao Li
- Department of Neurology, the First People's Hospital of Yibin, Yibin, Sichuan Province, China
| | - Jian-ping Jia
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Min Xu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Lei Zhang
- Department of Pharmacy, the First People's Hospital of Yibin, Yibin, Sichuan Province, China
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