# Patent

## Title
Method and apparatus for electromagnetic enhancement of biochemical signaling pathways for therapeutics and prophylaxis in plants, animals and humans

## Abstract

Apparatus and methods for delivering electromagnetic signals configured specifically to accelerate the asymmetrical kinetics of the binding of intracellular ions to their respective intracellular buffers, to enhance the biochemical signaling pathways plant animal and human molecules, cells, tissues, organs, portions of entire organisms and entire organisms employ for growth, repair and maintenance. Described herein are devices and methods that utilize repetitive bursts of waveforms configured to maximize the bound concentration of intracellular ions at their associated molecular buffers to enhance the biochemical signaling pathways living systems employ for growth, repair and maintenance. For example the systems and methods described herein may drive the binding of calcium to calmodulin (CaM), thereby enhancing the CaM-dependent nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway.

## Background
CROSS REFERENCE TO RELAYED APPLICATIONS
This application claims the benefit under 35 U.S.C. 119 of U.S. Patent Application No. 61/456,036, filed Oct. 29, 2010, entitled “METHOD AND APPARATUS FOR ELECTROMAGNETIC ENHANCEMENT OF BIOCHEMICAL SIGNALING PATHWAYS FOR THERAPEUTICS AND PROPHYLAXIS IN PLANTS, ANIMALS AND HUMANS”. This application is herein incorporated by reference in its entirety.
This patent application also claims priority as a continuation-in-part of U.S. patent application Ser. No. 12/819,956, filed Jun. 21, 2010, and titled “APPARATUS AND METHOD FOR ELECTROMAGNETIC TREATMENT”, which claims priority as a continuation-in-part to each of the following: U.S. patent application Ser. No. 12/772,002, filed Apr. 30, 2010, entitled “APPARATUS AND METHOD FOR ELECTROMAGNETIC TREATMENT OF PLANT, ANIMAL AND HUMAN TISSUE, ORGANS, CELLS AND MOLECULES”, which is a continuation of U.S. patent application Ser. No. 11/003,108, filed Dec. 3, 2004, entitled “APPARATUS AND METHOD FOR ELECTROMAGNETIC TREATMENT OF PLANT, ANIMAL, AND HUMAN TISSUE, ORGANS, CELLS, AND MOLECULES”, which claims the benefit under 35 U.S.C, §119 of U.S. Provisional Patent Application No. 60/527,327, filed Dec. 5, 2003, entitled “APPARATUS AND METHOD FOR ELECTROMAGNETIC TREATMENT OF PLANT, ANIMAL, AND HUMAN TISSUE, ORGANS, CELLS AND MOLECULES”; U.S. patent application Ser. No. 11/114,666, filed Apr. 25, 2005, entitled “ELECTROMAGNETIC TREATMENT INDUCTION APPARATUS AND METHOD FOR USING SAME”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/564,887, filed Apr. 26, 2004, entitled “INDUCTION MEANS FOR THERAPEUTICALLY TREATING HUMAN AND ANIMAL CELLS, TISSUES AND ORGANS WITH ELECTROMAGNETIC FIELDS”; U.S. patent application Ser. No. 11/110,000, filed Apr. 19, 2005, entitled “ELECTROMAGNETIC TREATMENT APPARATUS AND METHOD FOR ANGIOGENESIS MODULATION OF LIVING TISSUES AND CELLS”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/563,104, filed Apr. 29, 2004, entitled “APPARATUS AND METHOD FOR THERAPEUTICALLY TREATING HUMAN AND ANIMAL CELLS, TISSUES AND ORGANS WITH ELECTROMAGNETIC FIELDS”; U.S. patent application Ser. No. 11/369,308, filed Mar. 6, 2006, entitled “ELECTROMAGNETIC TREATMENT APPARATUS FOR AUGMENTING WOUND REPAIR AND METHOD FOR USING SAME”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/658,967, filed Mar. 7, 2005, entitled “APPARATUS AND METHOD FOR THERAPEUTICALLY TREATING HUMAN, ANIMAL, AND PLANT CELLS, TISSUES, ORGANS, AND MOLECULES WITH ELECTROMAGNETIC FIELDS FOR WOUND REPAIR”; U.S. patent application Ser. No. 11/369,309, filed Mar. 6, 2006, entitled “ELECTROMAGNETIC TREATMENT APPARATUS FOR ENHANCING PHARMACOLOGICAL, CHEMICAL AND TOPICAL AGENT EFFECTIVENESS AND METHOD FOR USING SAME”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/658,968, filed Mar. 7, 2005, entitled “APPARATUS AND METHOD FOR TREATING HUMAN, ANIMAL AND PLANT CELLS, TISSUES, ORGANS AND MOLECULES WITH ELECTROMAGNETIC FIELDS BY ENHANCINGHTE EFFECTS OF PHARMACOLOGICAL, CHEMICAL, COSMETIC AND TOPICAL AGENTS”; U.S. patent application Ser. No. 11/223,073, filed Sep. 10, 2005, entitled “INTEGRATED COIL APPARATUS FOR THERAPEUTICALLY TREATING HUMAN AND ANIMAL CELLS, TISSUES AND ORGANS WITH ELECTROMAGNETIC FIELDS AND METHOD FOR USING SAME”; U.S. patent application Ser. No. 11/339,204, filed Jan. 25, 2006, entitled “SELF-CONTAINED ELECTROMAGNETIC APPARATUS FOR TREATMENT OF MOLECULES, CELLS, TISSUES, AND ORGANS WITHIN A CEREBROFACIAL AREA AND METHOD FOR USING SAME”; U.S. patent application Ser. No. 11/818,065, filed Jun. 12, 2007, entitled “ELECTROMAGNETIC APPARATUS FOR PROPHYLAXIS AND REPAIR OF OPHTHALMIC TISSUE AND METHOD FOR USING SAME” which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/812,841, filed Jun. 12, 2006, entitled “APPARATUS AND METHOD FOR THERAPEUTICALLY TREATING HUMAN AND ANIMAL CELLS, TISSUES, ORGANS AND MOLECULES WITH ELECTROMAGNETIC FIELDS FOR TREATMENT OF DISEASES OF THE EYE AND PROPHYLACTIC TREATMENT OF THE EYE”; U.S. patent application Ser. No. 11/903,294, filed Sep. 20, 2007, entitled “ELECTROMAGNETIC APPARATUS FOR RESPIRATORY DISEASE AND METHOD FOR USING SAME”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/846,126, filed Sep. 20, 2006, entitled “APPARATUS AND METHOD FOR THE TREATMENT OF DISEASES OF THE LUNGS WITH ELECTROMAGNETIC FIELDS”; and U.S. patent application Ser. No. 11/977,043, filed Oct. 22, 2007, entitled “APPARATUS AND METHOD FOR THE TREATMENT OF EXCESSIVE FIBROUS CAPSULE FORMATION AND CAPSULAR CONTRACTURE WITH ELECTROMAGNETIC FIELDS”, which claims the benefit under 35 U.S.C. §119 of U.S. Provisional Patent Application No. 60/852,927, filed Oct. 20, 2006, entitled “APPARATUS AND METHOD FOR THE TREATMENT OF EXCESSIVE FIBROUS CAPSULE FORMATION AND CAPSULAR CONTRACTURE WITH ELECTROMAGNETIC FIELDS”.


INCORPORATION BY REFERENCE
All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
BACKGROUND
1. Field of the Invention
This invention pertains generally to a method and apparatus for in vitro and in vivo therapeutic and prophylactic treatment of plant, animal, and human molecules, cells, tissues, organs, portions of entire organisms and entire organisms. In particular, an embodiment according to the present invention pertains to use of non-thermal static and time-varying electromagnetic fields configured to accelerate the asymmetrical kinetics of the binding of intracellular ions to their respective buffers which regulate the biochemical signaling pathways living systems employ for growth, repair and maintenance. Another embodiment according to the present invention pertains to the non-thermal application of repetitive pulse bursts of sinusoidal, rectangular, chaotic or arbitrary waveform electromagnetic fields to instantaneously accelerate ion-buffer binding in signaling pathways in structures such as molecules, cells, tissues, organs, and entire organisms of plants, animals or humans using ultra lightweight portable coupling devices such as inductors and electrodes, driven by miniature signal generator circuitry that can be incorporated into an anatomical positioning device such as a dressing, bandage, compression bandage, compression dressing; knee, elbow, lumbar or cervical back, shoulder, foot, head, neck and other body portion wraps and supports; garments, footwear, gloves, and fashion accessories; mattress pads, seat cushions, beds, furniture; seats, beds, cushions and other body supports in cars, motorcycles, bicycles, buses, trains, airplanes, boats and ships.
Yet another embodiment according to the present invention pertains to application of sinusoidal, rectangular, chaotic or arbitrary waveform electromagnetic signals, having frequency components below about 100 GHz, configured to accelerate the binding of intracellular Ca2+ to a buffer, such as calmodulin (hereinafter known as CaM), to enhance biochemical signaling pathways in target structures such as plant, animal and human molecules, cells, tissues, organs, portions of entire organisms and entire organisms. Signals configured according to embodiments of the present invention produce a net increase in abound ion, such as Ca2+ at CaM binding sites because the asymmetrical kinetics of Ca/CaM binding allows such signals to accumulate voltage induced at the ion binding site, thereby accelerating voltage-dependent ion binding. Examples of therapeutic and prophylactic applications of the present invention are modulation of biochemical signaling in anti-inflammatory pathways, modulation of biochemical signaling in cytokine release pathways, modulation of biochemical signaling in growth factor release pathways; chronic and acute musculoskeletal pain relief; edema and lymph reduction, anti-inflammatory, post-surgical and post-operative pain and edema relief, nerve, bone and organ pain relief, angina pain relief, increased local blood flow, microvascular blood perfusion, treatment of tissue and organ ischemia, cardiac tissue ischemia, brain tissue ischemia from stroke or traumatic brain injury, treatment of neurological injury and neurodegenerative diseases such as Alzheimer's and Parkinson's; wound repair, bone repair, tissue repair; osteoporosis treatment and prevention; degenerative bone disease treatment and prevention; angiogenesis, neovascularization; enhanced immune response; treatment of diabetes Types I and II; enhanced effectiveness of pharmacological agents; nerve regeneration, skeletal muscle regeneration, cardiac muscle regeneration; cancer treatment; prevention of apoptosis; modulation of heat shock proteins for prophylaxis and response to injury or pathology. An embodiment according to the present invention can also be used in conjunction with other therapeutic and prophylactic procedures and modalities such as heat, cold, light, ultrasound, mechanical manipulation, massage, physical therapy, vacuum assisted wound closure, wound dressings, orthopedic and other surgical fixation devices, and surgical interventions. Yet another embodiment according to the present invention can also be used in conjunction with all pharmacological agents. Another embodiment of the present invention can be used with imaging or non-imaging diagnostic procedures.
2. Discussion of Related Art
Bone growth stimulator (hereinafter known as BGS) electromagnetic fields are now part of the standard armamentarium of orthopedic practice worldwide for the treatment of recalcitrant bone fractures. Radio frequency signals, originally developed for deep tissue heating (diathermy), were shown to produce biological effects when applied at non-thermal levels using pulse-modulation techniques to produce pulsed radio frequency (hereinafter known as PRF) signals. At the cellular level, numerous studies demonstrate that BGS, PRF and other electromagnetic field (hereinafter known as EMF) signals modulate the release of growth factors and cytokines.
Stimulation of transforming growth factor beta (“TGF-β”) messenger RNA (“mRNA”) with EMF in a bone induction model in a rat has been shown. Studies have also demonstrated up regulation of TGF-β mRNA by PEMF in human osteoblast-like cell line designated MG-63, wherein there were increases in TGF-β1, collagen, and osteocalcin synthesis. EMF stimulated an increase in TGF-β1 in both hypertrophic and atrophic cells from human non-union tissue. Further studies demonstrated an increase in both TGF-β1 mRNA and protein in osteoblast cultures resulting from a direct effect of EMF on a calcium/calmodulin-dependent pathway. Cartilage cell studies have shown similar increases in TGF-β1 mRNA and protein synthesis from EMF, demonstrating a therapeutic application to joint repair. U.S. Pat. No. 4,315,503 (1982) to Ryaby, U.S. Pat. No. 7,468,264 (2008) to Brighton and U.S. Pat. No. 5,723,001 (1998) and U.S. Pat. No. 7,744,524 (2010) to Pala typify the research conducted in this field.
However, prior art in this field has not produced electromagnetic signals configured specifically to accelerate the asymmetrical kinetics of the binding of intracellular ions to their associated buffers which regulate the biochemical signaling pathways living systems employ for growth, repair and maintenance. The result is that application of prior art devices, such as BGS devices and PRF devices, requires excessively long treatment times with associated prolonged patient morbidity, equivocal outcomes, and unnecessarily higher health care expenses.
Therefore, a need exists for an apparatus and a method that more effectively modulates the biochemical pathways that regulate tissue growth, repair and maintenance by configuring EMF signals specifically to accelerate the asymmetrical kinetics of ion binding to intracellular buffers which regulate the biochemical signaling pathways living systems employ for growth, repair and maintenance. A method based upon the current invention will be more effective by shortening treatment times, producing enhanced outcomes, reducing morbidity and reducing the cost of health care. An apparatus based upon the current invention incorporates miniaturized circuitry and light weight coil applicators or electrodes thus allowing the apparatus to be low cost, portable and, if desired, disposable. A further need exists for an apparatus and method that incorporates the asymmetrical kinetics of ion binding to intracellular buffers to configure electromagnetic waveforms to increase the rate of ion binding and enhance the biochemical signaling pathways living systems employ for growth, repair and maintenance. This shortens treatment times, produces enhanced outcomes, reduces morbidity and the cost of health care, and incorporates miniaturized circuitry and light weight applicators that can be constructed to be implantable.
SUMMARY OF THE DISCLOSURE
An apparatus and a method for delivering electromagnetic signals configured specifically to accelerate the asymmetrical kinetics of the binding of intracellular ions to their respective intracellular buffers, to enhance the biochemical signaling pathways plant animal and human molecules, cells, tissues, organs, portions of entire organisms and entire organisms employ for growth, repair and maintenance. A preferred embodiment according to the present invention utilizes a repetitive burst of arbitrary non-thermal waveforms configured to maximize the bound concentration of intracellular ions at their associated molecular buffers to enhance the biochemical signaling pathways living systems employ for growth, repair and maintenance. Non-thermal electromagnetic waveforms are selected first by choosing the ion and the intracellular buffer, for example Ca2+ and CaM, among the many ion-buffer combinations within the living cell, which determines the frequency range within which the signal must have non-thermal frequency components of sufficient, but non-thermal and non-destructive, amplitude to accelerate the kinetics of ion binding. Signals comprise a pulse duration, random signal duration or carrier period which is less than half of the ion bound time to increase the voltage in the target pathway so as to maximally accelerate ion binding to maximally modulate biochemical signaling pathways to enhance specific cellular and tissue responses to physical and chemical perturbations.
In preferred embodiments of the present invention, signals comprise bursts of at least one of sinusoidal, rectangular, chaotic or random wave shapes; have burst duration less than about 100 msec, with frequency content less than about 100 MHz, repeating at less than about 1000 bursts per second. Peak signal amplitude in the ion-buffer binding pathway is less than about 1000 V/m. One preferred embodiment according to the present invention comprises about a 10 to about a 50 millisecond burst of radio frequency sinusoidal waves in the range of about 1 to about 100 MHz, incorporating radio frequencies in the industrial, scientific and medical (hereinafter known as ISM) band, for example 27.12 MHz, but it may be 6.78 MHz, 13.56 MHz or 40.68 MHz in the short wave frequency band, repeating between about 0.1 and about 10 bursts/sec. Such waveforms can be delivered via inductive coupling with a coil applicator or via capacitive coupling with electrodes in electrochemical contact with the conductive outer surface of the target.
It is an object of the present invention to configure a waveform which accelerates the kinetics of Ca2− binding to CaM, consisting of about a 1 to about a 10 msec burst of between about 5 MHz to about 50 MHz in the ISM band, repeating between about 1 and about 10 bursts/sec and inducing a peak electric field between about 1 and about 100 V/m, then coupling the configured waveform using a generating device such as ultra-lightweight wire or printed circuit coils that are powered by a waveform configuration device such as miniaturized electronic circuitry.
It is another object of the present invention to configure a waveform which accelerates the kinetics of Ca2+ binding to CaM, consisting of about a 1 to about a 10 msec burst of 27.12 MHz radio frequency sinusoidal waves, repeating between about 1 and about 5 bursts/sec and inducing a peak electric field between about 1 and about 100 V/m, then coupling the configured waveform using a generating device such as ultra-lightweight wire, printed circuit coils or conductive garments that are powered by a waveform configuration device such as miniaturized electronic circuitry which is programmed to apply the aforementioned waveform at fixed or variable intervals, for example for 1 minute every 10 minutes, or for 10 minutes every hour, or for any other regimen found to be beneficial for a prescribed treatment.
It is another object of the present invention to apply electromagnetic waveforms to plants, animals and humans which accelerate the asymmetrical kinetics of the binding of intracellular ions to their associated intracellular buffers, by configuring the waveforms to contain repetitive frequency components of sufficient amplitude to increase the bound concentration of the intracellular ion to its associated intracellular buffer, thereby to enhance the biochemical signaling pathways of molecules, cells, tissues, organs, portions of entire organisms and entire organisms employ for growth, repair and maintenance.
It is yet another object of the present invention to apply electromagnetic waveforms to plants, animals and humans which match the asymmetrical kinetics of the binding of Sa2+ to CaM by configuring the waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway.
Another object of the present invention is to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway to accelerate blood and lymph vessel dilation for relief of post-operative and post traumatic pain and edema.
Another object of the present invention is to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to enhance angiogenesis and microvascularization for hard and soft tissue repair.
Another object of the present invention is to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to enhance bone repair.
It is another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway to enhance cartilage repair.
It is another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to reverse or prevent osteoporosis.
It is another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to accelerate deoxyribonucleic acid (hereinafter known as DNA) synthesis by living cells.
It is yet another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway to modulate growth factor release, such as basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VGEF), bone morphogenic protein (BMP), or any other growth factor production by living cells.
Another object of the present invention is to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to modulate cytokine, such as interleukin 1-beta (IL-1β), interleukin-6 (IL-6), or any other cytokine production by living cells.
Another object of the present invention is to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway, or any other signaling pathway, to accelerate the production of matrix proteins for tissue repair and maintenance.
It is another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cyclic adenosine monophosphate (cAMP) signaling pathway, or any other signaling pathway, to modulate cell and tissue differentiation.
It is yet another object of the present invention to configure electromagnetic waveforms to contain repetitive frequency components of sufficient amplitude to accelerate and increase the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cAMP signaling pathway, or any other signaling pathway, to prevent or reverse neurodegeneration.
Another object of the present invention is to configure electromagnetic waveforms to contain frequency components of sufficient amplitude to accelerate the binding of Ca2+ to CaM, thereby enhancing the CaM-dependent NO/cGMP signaling pathway to modulate heat shock protein release from living cells.
Another object of the present invention is to configure electromagnetic waveforms to contain frequency components of sufficient amplitude to accelerate the binding of any intracellular ion to its associated buffer in order to up regulate or down regulate the messenger ribonucleic acid (mRNA) or gene associated with any enzyme, cytokine or growth factor living tissue employs for repair, growth and maintenance.
For example, described specifically herein are electromagnetic treatment devices for accelerating cytosolic ion binding to a corresponding cytosolic buffer to modulate a biochemical signaling pathway employed for tissue growth, repair and maintenance. These devices may be configured to increase the voltage across a target ion binding pathway according to the asymmetrical binding kinetics of the target pathway, wherein the target ion binding pathway has an ion bound time. In some variations, these devices include: an applicator; and a signal generator configured to apply an electromagnetic signal to the applicator to induce, in the target pathway, a peak electric field less than about 100 V/m, wherein the signal generated by the signal generator has a pulse duration, random signal duration or carrier period which is less than twice the ion bound time, applied in a burst of waveforms having a burst duration of greater than 10 μsec and a signal repetition rate greater than 0.01 waveforms or bursts per second.
Any appropriate application may be used including a coil applicator and an electrode applicator.
The target ion binding pathway may comprise calcium binding to calmodulin, and the on bound time may be between about 10−2-10 sec.
As a consequence of the specific parameters for effectively modulating tissue as described herein, the devices may be made lightweight, portable, and/or disposable. In particular, these devices may be configured to be worn, and may be included as part of a garment, therapeutic device, anatomical support (e.g., brace), or the like. In general, these electromagnetic treatment devices may be configured to be compatible with a diagnostic or surgical device or method, and/or compatible with a pharmacological intervention or treatment.
These waveforms generated by the control circuit may have a carrier frequency within the ISM band. For example, in some variations, the waveforms generated by the control circuit have a carrier frequency of approximately 27.12 MHz.
Also described herein are methods for electromagnetic treatment of plants, animals, and humans by accelerating cytosolic ion binding to a corresponding cytosolic buffer in a target pathway to modulate a biochemical signaling pathways plants, animals and humans employ for tissue growth, repair and maintenance. In some variations, the methods include the steps of: activating an electromagnetic treatment device to treat the target pathway by inducing an electric field waveform having a pulse duration, random signal duration or carrier period which is less than twice the cytosolic ion bound time to increase the voltage in the target pathway so as to accelerate ion binding of the cytosolic ion to the buffer, thereby modulating the target pathway.
For example, the step of activating may comprise applying an electromagnetic signal to an applicator to induce, in the target pathway, a peak electric field less than about 100 V/m. The step of activating may comprise applying an electromagnetic signal to an applicator to apply a burst of waveforms having a burst duration of greater than 10 μsec and a signal repetition rate greater than 0.01 waveforms or bursts per second. Further, the step of activating comprises applying an electromagnetic signal to a coil applicator, and/or an electrode applicator.
In many of the variations described herein, the target ion binding pathway comprises calcium binding to calmodulin, and the on bound time may be between about 10−2-10 sec.
In one example, the step of activating comprises applying waveforms consisting of about 1 to about 10 msec burst of between about 5 MHz to about 50 MHz in the ISM band, repeating between about 1 and about 5 bursts/sec and inducing a peak electric field between about 1 and about 100 V/m.
In general, the step of activating may comprise applying EMF waveforms configured to modulate a particular pathway or achieve a particular desired result. For example, system may apply EMF waveforms configured to modulate the production of cytokines and growth factors that any living organism employs in response to any physical or chemical insult. Other examples include (but are not limited to): applying EMF waveforms configured to: up regulate or down regulate the mRNA or gene associated with each growth factor or cytokine any living organism employs in response to any physical or chemical insult; enhance the biochemical signaling pathways of molecules, cells, tissues, organs, portions of entire organisms and entire organisms employ for growth, repair and maintenance; modulate biochemical signaling in anti-inflammatory pathways, biochemical signaling in cytokine release pathways, biochemical signaling in growth factor release pathways; for chronic and acute musculoskeletal pain relief; edema and lymph reduction, anti-inflammatory, post-surgical and post-operative pain and edema relief, nerve, bone and organ pain relief, angina pain relief, increased local blood flow, microvascular blood perfusion, treatment of tissue and organ ischemia, cardiac tissue ischemia, brain tissue ischemia from stroke or traumatic brain injury, treatment of neurological injury and neurodegenerative diseases such as Alzheimer's and Parkinson's; wound repair, bone repair, tissue repair; osteoporosis treatment and prevention; degenerative bone disease treatment and prevention; angiogenesis, neovascularization; enhanced immune response; treatment of diabetes Types I and II; enhanced effectiveness of pharmacological agents; nerve regeneration, skeletal muscle regeneration, cardiac muscle regeneration; cancer treatment; prevention of apoptosis; modulation of heat shock proteins for prophylaxis and response to injury or pathology; modulate plasticity and cognition in humans and animals; modulate neurotransmitter release to modulate cognition and neuromuscular junction activity.
Other examples include applying EMF waveforms according to a regime defined to maximize the desired physiological outcome of tissue growth, repair and maintenance, or cognition.
In some variations the step of activating may include applying EMF waveforms configured to employ a carrier frequency within those employed by mobile communication and wireless devices.
Also described herein are methods of treating a region of a patient's body to enhance calmodulin-dependent signaling pathways, the method comprising: placing an electromagnetic treatment device on or over a region of the patent's body to be treated; activating an electromagnetic treatment device to generate an electric field having a pulse duration, random signal duration or carrier period which is less than twice the bound time of cytosolic calcium to calmodulin to accelerate calcium ion binding to calmodulin in the region of the patient's body. For example, the step of activating may comprise generating an electric field comprising an about 1 to about 10 msec burst of between about 5 MHz to about 50 MHz waves in the ISM band, repeating between about 1 and about 10 bursts/sec and inducing a peak electric field between about 1 and about 100 V/m. In some variations, the burst of waves has a carrier frequency of about 27.12 MHz.
In any of the variations described, the burst of waves comprises one of: sinusoidal, rectangular, chaotic, or random wave shapes.
An electromagnetic device may be placed on or against the patient in an appropriate position. For example, the step of placing may comprise placing a coil applicator of the electromagnetic treatment device on or over the region of the patient's body to be treated.
In general, the systems and methods described herein may be used to enhance CaM-dependent signaling, including NO/cGMP signaling, to achieve a variety of specific results, including, for example: to accelerate blood and lymph vessel dilation for relief of post-operative, post traumatic and musculoskeletal pain and edema; enhance angiogenesis and microvascularization for hard and/or soft tissue repair; enhance bone repair; enhance cartilage repair; to reverse or prevent osteoporosis; accelerate deoxyribonucleic acid synthesis; to modulate growth factor release; to modulate cytokine production; to accelerate the production of matrix proteins for tissue repair and maintenance; to modulate cell and tissue differentiation; to prevent or reverse neurodegeneration; to modulate heat shock protein release; to modulate neurotransmitter release to modulate cognition and neuromuscular junction activity; up regulate or down regulate the mRNA or gene expression associated with an enzyme, cytokine or growth factor employed for repair, growth and maintenance of tissue.
Also described herein are methods of applying a wearable electromagnetic treatment device to drive the binding of calcium to calmodulin in a target tissue by applying electromagnetic waveforms to a tissue that match the asymmetrical kinetics of binding of calcium to calmodulin, thereby enhancing calmodulin-dependent signaling, the method comprising: positioning a wearable applicator of an electromagnetic treatment device adjacent to the target tissue; and providing an electromagnetic signal to the applicator from the electromagnetic treatment device to induce an electric field of amplitude of less than about 100 V/m at the target tissue and wherein the signal comprises an about 1 to about 10 msec burst of between about 5 MHz to about 50 MHz carrier waves in the ISM band, repeating between about 1 and about 10 bursts/sec; whereby calmodulin-dependent signaling is enhanced in the target tissue.
As mentioned, the step of positioning may include placing a coil applicator of the electromagnetic treatment device on or over the region of the patient's body to be treated, which device is programmed to deliver an EMF waveform configured to enhance CaM-dependent signaling to do one or more of: accelerate blood and lymph vessel dilatation for relief of post-operative, post traumatic and musculoskeletal pain and edema; enhance angiogenesis and microvascularization tier hard and/or soft tissue repair; enhance bone repair; enhance cartilage repair; reverse or prevent osteoporosis; accelerate deoxyribonucleic acid synthesis; modulate growth factor release; modulate cytokine production; modulate the production of matrix proteins for tissue repair and maintenance; modulate cell and tissue differentiation; prevent or reverse neurodegeneration; modulate heat shock protein release; up regulate or down regulate the mRNA or gene expression associated with an enzyme, cytokine or growth factor employed for repair, growth and maintenance of tissue.
In some variations, positioning comprises placing a coil applicator of the electromagnetic treatment device on or over the region of the patient's body to be treated, which device is programmed to deliver an EMF waveform configured to enhance CaM-dependent signaling for chronic and acute musculoskeletal pain relief; edema and lymph reduction, anti-inflammatory, post-surgical and post-operative pain and edema relief, nerve, bone and organ pain relief, angina pain relief, increased local blood flow, microvascular blood perfusion, treatment of tissue and organ ischemia, cardiac tissue ischemia, brain tissue ischemia from stroke or traumatic brain injury, treatment of neurological injury and neurodegenerative diseases such as Alzheimer's and. Parkinson's; wound repair, bone repair, tissue repair; osteoporosis treatment and prevention; degenerative bone disease treatment and prevention; angiogenesis, neovascularization; enhanced immune response; treatment of diabetes Types I and II; enhanced effectiveness of pharmacological agents; nerve regeneration, skeletal muscle regeneration, cardiac muscle regeneration; cancer treatment; prevention of apoposis; modulation of heat shock proteins for prophylaxis and response to injury or pathology.
In addition, in any of these methods, the step of positioning may include placing a coil applicator of the electromagnetic treatment device on or over the region of the patient's body to be treated, which device is programmed to deliver an EMF waveform configured to enhance CaM-dependent signaling to modulate plasticity and cognition in humans and animals. In some variations, positioning comprises placing a coil applicator of the electromagnetic treatment device on or over the region of the patient's body to be treated, which device is programmed to deliver an EMF waveform configured to enhance CaM-dependent signaling to modulate neurotransmitter release to modulate cognition and neuromuscular junction activity.
The above and yet other objects and advantages of the present invention wilt become apparent from the hereinafter set forth Brief Description of the Drawings and Detailed Description.



BRIEF DESCRIPTION OF THE DRAWINGS
Preferred embodiments and applications of the present invention will be described below in more detail, with reference to the accompanying drawings:
FIG. 1 is a schematic representation of the biological EMF transduction pathway which is a representative target pathway of EMF signals configured as embodiments of the present invention. According to the present invention, an EMF signal can be configured to accelerate cytosolic ion binding to a cytosolic buffer, such as Ca2+ binding to CaM, because the rate constant for binding, kon is voltage-dependent and kon is much greater than the rate constant for unbinding, koff, imparting rectifier-like properties to ion-buffer binding, such as Ca2+ binding to CaM; cNOS* represents activated constitutive nitric oxide synthase (cNOS), catalyzes the production of NO from L-arginine; sGC* is activated guanylyl cyclase which catalyzes cyclic guanosine monophosphate (cGMP) formation when NO signaling modulates the tissue repair pathway; AC* is activated adenylyl cyclase, which catalyzes cyclic adenosine monophosphate (cAMP) when NO signaling modulates differentiation and survival;
FIG. 2 is a block diagram of miniaturized circuitry for use with a coil applicator according to a preferred embodiment of the present invention, wherein a CPU modulator, a preferred embodiment of which is an 8 bit 4 MHz micro-controller, but other bit-MHz combination micro-controllers may be used, is programmed, according to the present invention to deliver an EMF waveform to the target ion binding pathway, such as that illustrated in FIG. 4, via a coil applicator, or via electrodes (not shown). A BATTERY, which may be rechargeable, operated device with an ON/OFF switch, a POWER SUPPLY and output amplifier, AMP, is illustrated.
FIG. 3 is drawing of a portable and disposable coil/generator combination according to a preferred embodiment of the present invention. The coil applicator is flexible and circular, but may be conformable, for example oval or saddle shaped. The miniature signal generator, a block diagram of which is illustrated in FIG. 2, is an integral portion of the coil applicator. The EMF device illustrated in FIG. 3 is portable, and, if desired, disposable, and can be used alone or incorporated into an anatomical positioning device such as a dressing, bandage, compression bandage, compression dressing; knee, elbow, lower back, shoulder, foot, and other body portion wrap and support; garments, footwear, gloves, and fashion accessories; mattress pads, seat cushions, furniture, beds; in seats or beds within cars, motorcycles, bicycles, buses, trains, planes, boats and ships;
FIG. 4 depicts a waveform delivered to a target pathway structure of a plant, animal or human, such as a molecule, cell, tissue, organ, partial or entire organism, according to a preferred embodiment of the present invention. Burst duration and period are represented by T1 and T2, respectively. It is noted that the signal within the rectangular box designated as T1 can be rectangular, sinusoidal, chaotic or random, provided the waveform duration or carrier period is less than one-half of the target ion bound time. The peak induced electric field is related to the peak induced magnetic field, designated as B in this figure, via Faraday's Law of Induction;
FIG. 5 Effect of a waveform configured according to an embodiment of the present invention on human umbilical vascular endothelial cell (HUVEC) cultures. 15 min exposure to a signal consisting of a 3 msec burst of a 27.12 MHz carrier, repeating at 2 bursts/sec, and with a peak induced electric field of 40 V/m produced more than a 3-fold increase cGMP. Use of a CaM antagonist, trifluoroperazine, (TFP) abolished the EMF effect, providing evidence that Ca2+ binding was accelerated by an EMF signal configured according to an embodiment of the present invention in endothelial cells;
FIG. 6 Effect of a waveform configured according to an embodiment of the present invention on nitric oxide (NO) release from MN9D neuronal cell cultures. Cells were incubated to serum-free medium in presence or absence of the CaM antagonist, W-7. After 30 min exposure to a waveform, consisting of a 3 msec burst of a 27.12 MHz carrier, repeating at 2 bursts/sec, at 20 V/m peak induced electric field, NO was quantified in conditioned medium (Griess reaction) EMF increased NO several-fold over that from control cultures, which was blocked by W-7 (A, FIG. 6); cells were lysed and cGMP evaluated with ELISA. Results showed cGMP was increased significantly by EMF, which could be blocked by W-7 (B, FIG. 6). Both results are illustrated in FIGS. 6A and 6B, and indicate signals configured according to the present invention can modulate CaM-dependent signaling in neurons.
FIG. 7 Effect of an EMF signal, configured according to an embodiment of the present invention, consisting of a 2 msec burst of a 27.12 MHz sinusoidal wave at 20 V/m, on cutaneous full thickness wound (Left) and transected Achilles' tendon (Right) healing in the rat. The results show tensile strength of the treated wound and tendon is respectively 59% and 69% stronger at 21 days as a result of twice daily EMF treatment for 30 minutes.
FIG. 8 Effect of an electromagnetic signal, configured according to an embodiment of the present invention consisting of a 2 msec burst of a 27.12 MHz sinusoidal wave at 20 V/m, repeating at 2 bursts/sec, on angiogenesis in a thermal myocardial necrosis model in the rat. EMF increases angiogenesis by 60% at 7 days. L-NAME, a general cNOS inhibitor fed to rats in the drinking water, eliminated the PEMF effect on angiogenesis, indicating that an EMF signal, configured as an embodiment of the present invention, accelerates Ca2+ binding to CaM in the NO signaling cascade that regulates angiogenesis.
FIG. 9 Groups of rats were subjected to contusive traumatic brain injury (TBI) and treated with an EMF signal configured according to an embodiment of the present invention. Treated animals received a 3 msec burst of 27.12 MHz sinusoidal carrier waves, repeating at 2 bursts/sec and delivering 20 V/m peak induced electric field to the target tissue according to a 5 min every 20 min exposure regimen for 6 hours. Control animals received no signal. Brains were collected at 6 hours and IL-1β levels were measured. The results, illustrated in FIG. 9 show that IL-1β levels in control group brains increased rapidly after the onset of TBI, but were maintained at normal levels in the EMF group. Net EMF effect on IL-1β was more than 2-fold at 6 hours, closely following the EMF effect on IL-1β in the clinical study described in FIG. 10. These results show that an EMF signal, configured according to an embodiment of the present invention can rapidly prevent early tissue damage from TBI.
FIG. 10 Effect of a radio frequency PEMF signal configured according to an embodiment of the present invention in a randomized double-blind clinical study on breast reduction patients. Post-operative pain was approximately 2.5-fold lower in the active cohorts by 5 hrs post-op. A measure of the inflammatory cytokine, IL-1β in wound exudates showed nearly the same 2.5 fold decrease in the active cohort over the same time range, indicating that a signal configured according to the present invention modulates CaM-dependent NO/cGMP signaling which is known to down-regulate IL-1β, thereby accelerating the reduction of the master pro-inflammatory cytokine via the signaling pathway schematized in FIG. 1.
FIG. 11 Effect of a radio frequency EMF signal, configured according to the present invention, to modulate CaM/NO signaling, on pain from knee osteoarthritis in a randomized double-blind clinical study. Mean maximum pain (VAS) in the active cohort decreased by 2-fold compared with its baseline value within the first 24 hours, which persisted to day 42. There was no significant decrease in pain in the sham cohort at any time point.



DETAILED DESCRIPTION
Basal levels of intracellular Ca2+ are typically 50-100 nM, tightly maintained by a number of physiological calcium buffers. It is generally accepted that transient elevations in cytosolic Ca2+ from external stimuli as simple as changes in temperature and mechanical forces, or as complex as mechanical disruption of tissue, rapidly activate CaM, which equally rapidly activates the cNOS enzymes, i.e., endothelial and neuronal NOS, or eNOS and nNOS, respectively. Studies have shown that both isoforms are inactive at basal intracellular levels of Ca2+, however, their activity increases with elevated Ca2+, reaching half-maximal activity at about 300 nM. Thus, nNOS and eNOS are regulated by changes in intracellular Ca2+ concentrations within the physiological range. In contrast, a third, inducible isoform of NOS (iNOS), which is up regulated during inflammation by macrophages and/or neutrophils, contains CaM that is tightly bound, even at low resting levels of cytosolic Ca2+, and is not sensitive to intracellular Ca2+.
Once cNOS is activated by CaM it converts its substrate, L-arginine, to citrulline, releasing one molecule of NO. As a gaseous free radical with a half-life of about 5 sec. NO diffuses locally through membranes and organelles and acts on molecular targets at a distance up to about 200 μm. The low transient concentrations of NO from cNOS can activate soluble guanylyl cyclase (sGC), which catalyzes the synthesis of cyclic guanosine monophosphate (cGMP). The CaM/NO/cGMP signaling pathway is a rapid response cascade which can modulate peripheral and cardiac blood flow in response to normal physiologic demands, as well as to inflammation. This same pathway also modulates the release of cytokines, such as interleukin-1beta (IL-1β) and growth factors such as basic fibroblast growth factor (FGF-2) and vascular endothelial growth factor (VEGF) which have pleiotropic effects on cells involved in tissue repair and maintenance.
Following an injury, e.g., a bone fracture, torn rotator cuff, sprain, strain or surgical incision, repair commences with an inflammatory stage during which the pro-inflammatory cytokine IL-1β is rapidly released. This, in turn, up-regulates iNOS, resulting in the production of large amounts of NO in the wound bed. Continued exposure to NO leads to the induction of cyclooxygenase-2 and increased synthesis of prostaglandins which also play a role in the inflammatory phase. While this process is a natural component of healing, when protracted, it can lead to increased pain and delayed or abnormal healing. In contrast, CaM/eNOS/NO signaling has been shown to attenuate levels of IL-1β and down-regulate iNOS. As tissue further responds to injury, the CaM/NO/cGMP cascade is activated in endothelial cells to stimulate angiogenesis, without which new tissue growth cannot be sustained. Evidence that non-thermal EMF can modulate this cascade is provided by several studies. An early study showed that the original BGS signal promoted the creation of tubular, vessel-like, structures from endothelial cells in culture in the presence of growth factors. Another study using the same BGS signal confirmed a seven-fold increase in endothelial cell tubularization in vitro. Quantification of angiogenic proteins demonstrated a five-fold increase in FGF-2, suggesting that the same BGS signal stimulates angiogenesis by increasing FGF-2 production. This same study also reported increased vascular in-growth more than two-fold when applied to an implanted Matrigel plug in mice, with a concomitant increase in FGF-2, similar to that observed in vitro. The BGS signal significantly increased neovascularization and wound repair in normal mice, and particularly in diabetic mice, through an endogenous increase in FGF-2, which could be eliminated by using a FGF-2 inhibitor. Similarly, a pulse modulated radio frequency (PRF) signal of the type used clinically for wound repair was reported to significantly accelerate vascular sprouting from an arterial loop transferred from the hind limb to the groin in a rat model. This study was extended to examine free flap survival on the newly produced vascular bed. Results showed 95% survival of PRF-treated flaps compared to 11% survival in the sham-treated flaps, suggesting a significant clinical application for PRF signals in reconstructive surgery.
The proposed EMF transduction pathway relevant to tissue maintenance, repair and regeneration, begins with voltage-dependent Ca2+ binding to CaM, which is favored when cytosolic Ca2+ homeostasis is disrupted by chemical and/or physical insults at the cellular level. Ca/CaM binding produces activated CaM which binds to, and activates, cNOS, which catalyzes the synthesis of the signaling molecule NO from L-arginine. This pathway is shown in its simplest schematic from in FIG. 1. According to the present invention, EMF can accelerate the kinetics of Ca2+ binding to CaM, the first step of a well characterized cascade that responds to chemical or physical insults. Ca/CaM binding is kinetically asymmetrical, i.e., the rate of binding exceeds the rate of dissociation by several orders of magnitude (kon>>koff), driving the reaction in the forward direction. Ca/CaM binding has been well characterized, with the binding time constant reported to be in the range of 10−2-10−3 sec. in contrast, release of Ca2+ from CaM cannot occur until cNOS* has converted L-arginine to citrulline and NO, which takes the better part of a second. Subsequent reactions involving NO depend upon the cell/tissue state. For example, tissue repair requires a temporal sequence of inflammatory, anti-inflammatory, angiogenic and proliferative components. Endothelial cells orchestrate the production of FGF-2 and VEGF for angiogenesis. For each of these phases, early NO production by endothelial cells, leading to increased cGMP by these, as well as other NO targets, such as vascular smooth muscle, would be expected to be modulated by an EMF effect on sGC via Ca/CaM binding. In contrast, nerve or bone regeneration may require other pathways leading to differentiation during development and growth, and prevention of apoptosis, as in response to injury or neurodegenerative diseases. For these cases, early cyclic adenosine monophosphate (cAMP) formation would be modulated by an EMF effect on sAC via Ca/CaM binding.
The substantial asymmetry of Ca/CaM binding kinetics provides a unique opportunity to configure EMF signals that selectively modulate kon. In general, if kon>>koff, and kon is voltage-dependent, according to the present invention, ion binding could be increased with an exogenous electric field signal having a carrier period or pulse duration that is significantly shorter than the mean lifetime of the bound ion. This applies to the CaM signaling pathway, causing it to exhibit rectifier-like properties, i.e., to yield a net increase in the population of bound Ca2+ because the forward (binding) reaction is favored.
The change in surface concentration, ΔΓ, of Ca2+ at CaM is equal to the net increase in the number of ions that exit the outer Helmholtz plane, penetrate the water dipole layer at the aqueous interface of the binding site, and become bound in the inner Helmholtz plane. For the general case of ion binding, evaluation of Ca/CaM binding impedance, ZA(s), allows calculation of the efficacy of any given waveform in that pathway by evaluating the frequency range over which the forward binding reaction can be accelerated. Thus, binding current, IA(t), is proportional to the change in surface charge (bound ion concentration) via dq(t)/dt, or, in the frequency domain, via sqA(s). IA(s) is, thus, given by:

IA(s)=sqA(s)=sΓof(ΔΓ(s))  (1)

where s is the real-valued frequency variable of the Laplace transform. Taking the first term of the Taylor expansion of equation 1 gives:

IA(s)=qΓsΓoΔΓ(s)  (2)

where qΓ=∂q/∂Γ, a coefficient representing the dependence of surface charge on bound ion concentration. ΔΓ(s) is a function of the applied voltage waveform, E(s), and, referring to the reaction scheme in FIG. 1, of the change in concentration of eNOS*, defined as ΔΦ(s):

ΔΓ(s)=kon/Γos[−ΔΓ(s)+aE(s)+ΔΦ(s)]  (3)

where Γo is the initial surface concentration of Ca2+ (homeostasis), and a=∂Γ/∂E, representing the voltage dependence of Ca2+ binding. Referring to the reaction scheme in FIG. 1, it may also be seen that eNOS* depends only upon Ca2+ binding, i.e., ΔΓ(s). Thus:

ΔΦ(s)=νΦ/Φos[−ΔΦ(s)−ΔΓ(s)]  (4)

where νΦ is the rate constant for Ca/CaM binding to eNOS and Φo is the initial concentration of eNOS* (homeostasis).

Using equations 2, 3 and 4, and for kon>>νΦ, ZA(s) may be written:




  
    
      
        
          
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Equation 5 describes the overall frequency response of the first binding step in a multistep ion binding process at an electrified interface, wherein the second step requires that the bound ion remain bound fir a period of time significantly longer than the initial binding step. For this case, the first ion binding step is represented by an equivalent electrical impedance which is functionally equivalent to that of a series RA-CA electric circuit, embedded in the overall dielectric properties of the target. RA is inversely proportional to the binding rate constant (kon), and CA is directly proportional to bound ion concentration.
The present invention teaches that an electromagnetic field, for which pulse duration or carrier period is less than about half of the bound ion lifetime can be configured to maximize current flow into the capacitance CA, which will increase the voltage, Eb(s), where s is the LaPlace frequency, across CA. Eb(s) is a measure of the increase in the surface concentration of the binding ion in the binding sites of the buffer, above that which occurs naturally in response to a given physiological state. The result is an increase in the rate of biochemical signaling in plant, animal and human repair, growth and maintenance pathways which results in the acceleration of the normal physiological response to chemical or physical stimuli. The following equation demonstrates the relation between the configured electromagnetic waveform, E(s) and Eb(s).




  
    
      
        
          
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The present invention further teaches that a time-varying electromagnetic field for which pulse duration or carrier period is less than about half of the bound ion lifetime of Ca2+ binding to CaM will maximize the current flow into the Ca/CaM binding pathway to accelerate the CaM-dependent signaling which plants, animals and humans utilize for tissue growth, repair and maintenance. In particular, a time-varying electromagnetic field may be configured to modulate CaM-dependent NO/cGMP signaling which accelerates; pain and edema relief, angiogenesis, hard and soft tissue repair, repair of ischemic tissue, prevention and repair of neurodegenerative diseases, nerve repair and regeneration, skeletal and cardiac muscle repair and regeneration, relief of muscle pain, relief of nerve pain, relief of angina, relief of degenerative joint disease pain, healing of degenerative joint disease, immunological response to disease, including cancer.
A preferred embodiment according to the present invention is an electromagnetic signal which accelerates the kinetics of Ca2+ binding by maximizing non-thermal Eb(s) at its CaM binding sites, consisting of a 1-10 msec pulse burst of 27.12 MHz radio frequency sinusoidal waves, repeating between about 1 and about 5 bursts/sec and inducing a peak electric field between about 1 and about 100 V/m, then coupling the configured waveform using a generating device such as ultra lightweight wire coils that are powered by a waveform configuration device such as miniaturized electronic circuitry which is programmed to apply the waveform at fixed or variable intervals, for example 1 minute every 10 minutes, 10 minutes every hour, or any other regimen found to be beneficial for a prescribed treatment.
Referring to FIG. 1, examples of the biochemical signaling pathways which can be modulated by acceleration of Ca2+ binding to CaM with non-thermal electromagnetic fields (EMF) configured according to the present invention are illustrated. The application of non-thermal EMF, configured according to the present invention, instantaneously accelerates the kinetics of Ca2+ binding to CaM, the first step of a well characterized signaling cascade which a plant, animal or human organism utilizes to respond to chemical or physical insults. Ca/CaM binding is kinetically asymmetrical, i.e., the rate of binding exceeds the rate of dissociation by several orders of magnitude (kon>>koff), therefore the application of EMF will instantaneously drive the reaction in the forward direction. The Ca/CaM binding time constant is in the range of 1 to 10 milliseconds, in contrast, the release of Ca2+ from CaM cannot occur until cNOS* has converted L-arginine to citrulline and NO, which takes the better part of a second. Subsequent reactions involving NO depend upon the cell/tissue state. For example, tissue repair requires a temporal sequence of inflammatory, anti-inflammatory, angiogenic and proliferative components. Endothelial cells orchestrate the production of FGF-2 and VEGF for angiogenesis. For each of these phases, early NO production by endothelial cells, leading to increased cGMP by these, as well as other NO targets, such as vascular smooth muscle, are modulated by an EMF effect on GC via Ca/CaM binding. In contrast, nerve or bone regeneration require other pathways leading to differentiation during development and growth, and prevention of apoptosis, as in response to injury or neurodegenerative diseases. For these cases, early cAMP formation is modulated by an EMF effect on AC via Ca/CaM binding.
FIG. 2 illustrates a preferred embodiment of an apparatus according to the present invention. A CPU MODULATOR, a preferred embodiment of which is an 8 bit 4 MHz micro-controller, but other bit-MHz combination micro-controllers may be used, is programmed, according to the present invention, for a given carrier frequency or pulse duration, for example about 27.12 MHz sinusoidal wave; a given burst duration, for example about 3 msec; to provide a given in situ peak electric field, for example 20 V/m; a given treatment time, for example about 15 min.; and a given treatment regimen, for example about 10 min. every about hour. The BATTERY MODULE, in a preferred embodiment, has an output voltage of 3.3 V, but other voltages can be used, supplies DC voltage and current to a POWER SUPPLY which provides operating power to the CPU MODULATOR and the output amplifier, hereinafter referred to as AMP. The electromagnetic signal is applied inductively to the plant animal or human target with a COIL applicator, or capacitively with electrodes in electrochemical contact with the out conductive surface of the target structure (not shown). The COIL applicator is flexible and circular, but may also be anatomically conformable, such as oval or saddle shaped, with a diameter of between about 2 cm to about 50 cm. An electromagnetic treatment, or, if desired, an electromagnetic treatment regimen, is initiated with the ON/OFF switch, which may be mechanical or electronic.
A preferred embodiment according to the present invention combines signal generation and coil or electrode applicator in one portable or disposable unit, such as illustrated in FIG. 3 for the case of an inductively coupled signal. When electrical coils are used as the applicator, the electrical coils can be powered with a time varying magnetic field that induces a time varying electric field in a target pathway structure according to Faraday's law. An electromagnetic signal generated by a circuit such as shown in FIG. 2 can also be applied using electrochemical coupling, wherein electrodes are in direct contact with skin or another outer electrochemically conductive boundary of a target pathway structure. In yet another embodiment according to the present invention, the electromagnetic signal generated by the generating circuit of FIG. 2 can also be applied using electrostatic coupling wherein an air gap exists between a generating device such as an electrode and a target pathway structure such as a molecule, tissue, and organ of a plant animal or human. An advantage of the preferred embodiment according to the present invention is that its Ultra lightweight coils and miniaturized circuitry allow for use with common physical therapy treatment modalities and at any location on a plant, animal or human for which any therapeutic or prophylactic effect is desired. An advantageous result of application of the preferred embodiment according to the present invention is that a living organism's wellbeing can be maintained and enhanced.
The inductive device illustrated in FIG. 3 is flexible, portable and, if desired, disposable; and can be used alone or incorporated into an anatomical positioning device such as a dressing, bandage, compression bandage, compression dressing; knee, elbow, lower back, shoulder, foot, and other body portion wrap and support; garments, footware, gloves, and fashion accessories; mattress pads, seat cushions, furniture, beds; in seats or beds within cars, motorcycles, bicycles, buses, trains, planes, boats and ships.
Referring to FIG. 4 an embodiment according to the present invention of an induced electric field waveform is illustrated. A burst of duration between about 1 msec and about 20 msec, containing a repetitive rectangular pulse, a sinusoidal wave or a chaotic or random waveform, having, respectively, a period or frequency less than half of the bound time of the target ion binding pathway, repeats between about 1 and about 10 bursts/sec, and induces a peak electric field of 20 V/m which is proportional to a peak applied time varying magnetic field of 50 mG according to Faraday's Law of Induction. The induced electric field illustrated in FIG. 3 is configured according to the teaching of the present invention to modulate biochemical signaling pathways in plant, animal and human targets, such as those illustrated in FIG. 1.
Example 1
The biochemical signaling pathways illustrated in FIG. 1 show that the effect of EMF, configured according to embodiments of the present invention, on the synthesis of NO from eNOS, by increasing the rate of Ca2+ binding to CaM, will increase the rate of angiogenesis, which increases the rate of tissue repair. Angiogenesis requires the production of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF), which first require that eNOS be activated by CaM, as illustrated in FIG. 1, to synthesize NO by endothelial cells.
This study examined the effect of EMF, configured according to an embodiment of the current invention, on the CaM/NO/cGMP pathway to modulate cGMP production from human umbilical vascular endothelial cells (HUVECs) in culture. HUVEC cells in serum-free medium were removed from the incubator 15 min prior to EMF exposure. The temperature change from 37° C. to approximately 25° C. was a repeatable “injury” designed to increase intracellular Ca2+. Cultures were then exposed at room temperature for 15 min to EMF within the central portion of a single-turn 20 cm diameter coil (antenna). The EMF signal consisted of a 3 msec burst of 27.12 MHz sinusoidal waves repeating at 2 bursts/sec. The average induced electric field was 32±6 V/m. Cultures remained at room temperature for an additional 15 min after EMF exposure, after which cells were lysed for cGMP analysis with enzyme-linked immunosorbent assay (ELISA). In some cultures trifluoroperazine (TFP) a CaM antagonist was employed to test whether increased Ca/CaM binding via EMF led to the observed increased levels of cGMP. The results, summarized in FIG. 5, demonstrate that a single 15-minute exposure to an EMF configured according to the present invention, produced nearly a 3-fold increase in cGMP, and that this EMF effect was abolished by TFP.
These results provide mechanistic support for the reported acceleration of cutaneous wound repair by 59% and Achilles' tendon repair by 69% at 21 days in rat models as measured by tensile strength, and illustrated in FIG. 6, in randomized, blinded studies using an EMF signal identical to that employed for HUVEC cultures, as above. This study also provided additional mechanistic support for a randomized blinded animal study in which exposure for 20 min twice daily to the EMF waveform used in the HUVEC study significantly increased angiogenesis in vivo (+150%, P<0.001) 7 days following a thermal myocardial injury in the rat, as illustrated in FIG. 7. CD-31 antibody was employed to identify newly formed blood vessels in tissue sections throughout the penumbra surrounding the ischemic core of the cardiac lesion. The PRF effect was eliminated in rats that received L-nitrosoarginine methyl ester (L-NAME), a non-selective cNOS inhibitor, in the drinking water. The conclusion is that the EMF signal, configured according to the present invention, modulated angiogenesis through CaM-dependent NO/cGMP signaling in the cutaneous wound and cardiac ischemia animal models.
Example 2
According to an application of the present invention an EMF signal, configured according to an embodiment of the present invention to modulate CaM-dependent signaling, similar to that employed for HUVEC cultures of Example 1, and applied for 30 minutes to the MN9D dopaminergic neuronal cell line, increased NO production by several-fold in a serum depletion paradigm and produced a 45% increase in cGMP. The EMF effects on NO and cGMP were inhibited by the CaM antagonist N-(6-Aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (W-7), indicating the EMF signal acted in this neuronal culture according to the transduction mechanism illustrated in FIG. 1. These results are summarized in FIG. 6. The effect of the same EMF signal on cAMP production in MN9D cells was also studied, MN9D cells in serum free medium were removed from the incubator (repeatable temperature stress injury to transiently increase intracellular Ca2+) and exposed to EMF for 15 min, cAMP was evaluated in cell lysates by ELISA. Results demonstrate that an EMF signal, configured according to an embodiment of the present invention, increased cAMP production by several-fold. Notably, the c-NOS inhibitor L-NAME abolished the PEMF effect on cAMP. The results, summarized in FIG. 7, indicate EMF signals, configured according to an embodiment of the present invention, are also able to affect neuronal differentiation and survival.
Example 3
An EMF signal, configured according to an embodiment of the present invention was applied to an in vivo wound repair model. A rat wound model has been well characterized both biochemically and biochemically, and was used in this study. Healthy, young adult male Sprague Dawley rats weighing more than 300 grams were utilized. The animals were anesthetized with an intraperitoneal dose of Ketamine 75 mg/kg and Medetomidine 0.5 mg/kg. After adequate anesthesia had been achieved, the dorsum was shaved, prepped with a dilute betadine/alcohol solution, and draped using sterile technique. Using a #10 scalpel, an 8-cm linear incision was performed through the skin down to the fascia on the dorsum of each rat. The wound edges were bluntly dissected to break any remaining dermal fibers, leaving an open wound approximately 4 cm in diameter. Hemostasis was obtained with applied pressure to avoid any damage to the skin edges. The skin edges were then closed with a 4-0 Ethilon running suture. Post-operatively, the animals received Buprenorphine 0.1-0.5 mg/kg, intraperitoneal. They were placed in individual cages and received food and water ad libitum.
EMF exposure was non-thermal pulse modulated radio frequency configured according to an embodiment of the present invention. For this signal burst duration was 2000 μsec and the amplitude and repetition rate were 0.050 and 2 bursts/sec, respectively. EMF was applied for 30 minutes twice daily Tensile strength was performed immediately after wound excision. Two 1 cm width strips of skin were transected perpendicular to the scar from each sample and used to measure the tensile strength in kg/mm2. The strips were excised from the same area in each rat to assure consistency of measurement. The strips were then mounted on a tensiometer. The strips were loaded at 10 mm/min and the maximum force generated before the wound pulled apart was recorded. The final tensile strength for comparison was determined by taking the average of the maximum load in kilograms per mm2 of the two strips from the same wound.
The results, illustrated in FIG. 7. Left, demonstrate that an embodiment of the present invention significantly accelerated wound repair in this animal model, with application to wound repair in humans.
This example also included an experiment to test the effect of an embodiment of this invention on the rate of healing of a transected Achilles' tendon in a rat model. The Achilles tendon of male adult Sprague Dawley rats was transected and stabilized with a single suture. There was no additional mechanical stabilization. Animals were divided into sham exposed and active groups. Active animals were treated in individual plastic cages with an EMF signal configured as an embodiment of the present invention with a peak amplitude of 0.05 G. Sham exposed animals were treated identically. PEMF exposure was 30 min twice daily until sacrifice at 21 days. The tensile strength of the isolated tendon was determined using a standard laboratory tensiometer. Pull rate was 0.45 mm/sec. Treated tendons had 69% higher tensile strength than sham treated (P<0.001). The results are summarized in FIG. 7, Right.
Example 4
In this example a highly reproducible thermal myocardial injury was created in the region of the distal aspect of the Left Anterior Descending Artery at the base of the heart of adult male Sprague Dawley rats. The EMF waveform, configured as an embodiment of the present invention, was a 2 msec burst of 27.12 MHz sinusoidal waves repeating at 5 bursts/sec delivering 0.05 G at the tissue target. Five freely roaming animals in a standard rat plastic cage, with all metal portions removed, were placed within a single turn 14×21 inch coil. Exposure was 30 min twice daily for three weeks. Sham animals were identically exposed, but received no EMF signal. Upon sacrifice, myocardial tissue specimens were stained with CD-31 to evaluate the presence of newly forming blood vessels and capillaries in peri-ischemic tissue. Results at 21 days showed that number of vessels and capillaries in peri-ischemic myocardial tissue was increased by approximately 100% (p<0.001) in EMF vs sham exposed animals. That an EMF signal, configured as an embodiment of the present invention, modulated CaM-dependent NO release, as illustrated in FIG. 1, was verified by feeding animals L-NAME, a cNOS inhibitor, in their drinking water for 7 days. EMF, configured as an embodiment of the present invention, accelerated angiogenesis at 7 days by 60%. The EMF effect was abolished by L-NAME. This result is illustrated in FIG. 8.
Example 5
In this example, groups of rats were subjected to contusive traumatic brain injury (TBI) and treated with an EMF signal configured as an embodiment of the present invention. 300-350 g Sprague-Dawley were anesthetized with ketamine (75 mg/kg) and medetomidine (0.5 mg/kg). When anesthetic depth was reached, the scalp was reflected and a metal disk measuring 10 mm in diameter and 2 mm thickness was secured with epoxy symmetrically onto the skull at the midline equally between lambda and bregma, two anatomical landmarks defined by the intersections of the coronal and lambdoid sutures with the mid-sagittal suture, respectively, to minimize the risk of skull fracture upon impact. The animal was then secured to a firm (spring constant=4) foam pad. Injury was produced using a “weight-drop” type impact device, consisting of a clear plastic cylinder with internal diameter of 1-inch and a weight that fits just within the cylinder. After impact, the scalp was approximated using interrupted nylon sutures and anesthesia was reversed by 1 mg/kg atipamezole. This injury induces inflammation, edema, and neuronal death without a secondary impact (bounce) or deleterious side effects (skull fracture, death). Active animals were treated with an EMF signal configured as an embodiment of the present invention, applied in a 5 min on in every 20 min regimen for 6 hours. Animals were sacrificed and brains homogenized to determine the EMF effect on the master pro-inflammatory cytokine, IL-1β. The results, illustrated in FIG. 9, show that EMF reduced IL-1β by approximately 2-fold in treated vs control animals. This result indicates that EMF, configured according to an embodiment of the present invention, produced a very rapid drop in the inflammatory response to traumatic brain and cervical injury which no other pharmacological or physical modality has been able to achieve. An important factor is that these results were obtained with a portable disposable device which can be incorporated in kits for field response to brain trauma, stroke and other neurological injuries.
Example 6
In this example the effect of a pulse modulated radio frequency EMF signal, configured according to an embodiment of the present invention, on post-operative pain was studied in a randomized double-blind clinical study on breast reduction patients. Patients were treated with EMF, configured according to an embodiment of the present invention, delivered to the target tissue with a disposable device, similar to that illustrated in FIG. 3, which was incorporated in the post surgical dressing. Treatment regimen for active patients was 30 min every 4 hours for three days. Sham patients received the same EMF device which did not deliver a signal. Wound exudates were collected and pain was assessed by participants using a validated Visual Analog Scale (VAS). Concentrations of IL-1β, a major pro-inflammatory cytokine, were approximately 3-fold lower at 5 hours post-op (P<0.001) in wound exudates from EMF-treated patients compared to those of the control group. EMF also produced a concomitant 2-fold decrease in pain at 1 hour (P<0.01) and a 2.5-fold decrease at 5 hours post-op (P<0.001), persisting to 48 hours post-op. No significant changes in VAS scores were observed in the control group. Furthermore, the increased levels of analgesia were reflected in a 2.2-fold reduction in narcotic use in patients receiving active treatment over the first 24 hours post-op (P=0.002). Importantly, the time course for both pain and IL-1β reduction were concomitant, showing that EMF, configured to modulate CaM/NO signaling in an embodiment according to the present invention, produced endogenous changes in the dynamics of IL-1β availability, which impacts the many known subsequent inflammatory events that are mediated by this cytokine, including those leading to post-operative pain. These results, which are illustrated in FIG. 10, demonstrate that EMF, configured according to an embodiment of the present invention produced a rapid, non-pharmacological, non-invasive post-operative anti-inflammatory response which significantly reduced patient morbidity and the cost of health care, and enhanced healing.
Example 7
In this example, a randomized double-blind clinical study, which employed an EMF signal configured according to an embodiment of the present invention, produced a rapid decrease in pain from osteoarthritis (OA) of the knee. A total of 37 patients (19 active, 18 sham) entered the study. The EMF signal consisted of a 7 msec burst of 6.8 MHz sinusoidal waves repeating at 1/sec with 0.05 G peak amplitude, used for 15 minutes twice daily, or as needed for pain relief. Maximum VAS scores were obtained at baseline (day 0) and daily for the first 14 days and from day 29 to day 42. Results show that EMF caused an approximate 2-fold decrease in mean VAS with respect to baseline by the end of day 1 in the treated group, which persisted to day 42 (P<0.001). There was no significant decrease in mean maximum pain scores at any time point in the sham group. The results, illustrated in FIG. 11 show that pain from knee OA was very rapidly reduced and was maintained at a reduced level for 42 days, indicating OA progression was slowed or stopped.
CaM-dependent NO production rapidly mediates relief of pain from knee OA by increasing circulation, decreasing nerve irritation, and decreasing inflammation. This is similar to the kinetics of the rapid reduction of pain in the breast reduction study of Example 6, wherein EMF, configured as an embodiment of the present invention, also produced a rapid initial reduction in pain within 5 hours post-op. This shows that the mechanisms of action are similar in both studies. EMF activates the CaM/cNOS pathway producing an initial rapid and transient release of NO leading to vaso- and lymphatic dilation. This causes a rapid reduction of effusion (edema) with a concomitant rapid reduction of pain. This means the mechanism of the EMF effect involves the down-regulation of IL-1β with its consequent attenuation of inflammation in this patient population.
Having described embodiments and examples applications for an apparatus and a method for delivering electromagnetic treatment which accelerates cytosolic ion binding to respective cytosolic buffers, thereby modulating signaling cascades which humans, animals and plants utilize for growth, repair and maintenance, it is noted that modifications and variations can be made by persons skilled in the art in light of the above teachings. It is therefore to be understood that changes may be made in the particular embodiments of the invention disclosed which are within the scope and spirit of the invention.

## Claims

1. An electromagnetic treatment device for accelerating cytosolic ion binding to a corresponding cytosolic buffer to modulate a biochemical signaling pathway employed for tissue growth, repair and maintenance, the device configured to increase a voltage across a target ion binding pathway according to an asymmetrical binding kinetics of the target pathway, wherein the target ion binding pathway has an ion bound time, the device comprising:
a flexible and circular lightweight wire coil applicator; and
a signal generator configured to apply an electromagnetic signal to the applicator to induce, in the target pathway, a peak electric field between 1 to 100 V/m, wherein a signal generated by the signal generator has a pulse duration, random signal duration or carrier period which is less than twice the ion bound time, applied in a burst of waveforms having a pulse duration of between 1 μs and 100 μs, further wherein the signal generated has a burst duration between 1 to 10 msec of between 5 MHz to 50 MHz carrier waves, repeating between 1 and 10 bursts/sec.

2. The device of claim 1, wherein the applicator comprises an electrode applicator.

3. The device of claim 1, wherein the target ion binding pathway comprises calcium binding to calmodulin, and the ion bound time is between about 10−2-10 sec.

4. The device of claim 1, wherein the electromagnetic treatment device is lightweight.

5. The device of claim 1, wherein the electromagnetic treatment device is disposable.

6. The device of claim 1, wherein the electromagnetic treatment device is portable.

7. The device of claim 1, wherein the lightweight electromagnetic treatment device is configured to be worn.

8. The device of claim 1, wherein the waveforms generated by the control circuit have a carrier frequency of 27.12 MHz.

9. The device of claim 1, further comprising an anatomical support configured to hold the treatment device adjacent to a target tissue.