light treatment device

Possible light treatment device for Covid 19 and other lower respiratory diseases.

One of the known respiratory problems associated with COVID-19 is that their spikes attach to ACE2 enzymes of type 2 pneumocytes in alveolar epithelium. Type 2 pneumocytes are defenders of the alveolus and synthesize, secrete and recycle all components of the surfactant that regulates alveolar surface tension in the lungs. Binding of COVID-19 spike protein to ACE2 down-regulates the enzyme, which contributes to ARDS for unopposed, detrimental action of ACE on lung tissue, triggering vasoconstriction, inflammation, apoptosis and fibrosis.

Space limitations:
SARS-CoV-2 virion = (0.1 or 0.065) micron in diameter.

1 mm = 1,000 microns
1 micron = 1,000 nm
1 nm = 100 angstroms

The average trachea for women is about 20 mm in diameter.
Rt Bronchial between 4 and 7 mm in diameter.
Lt Bronchial between 4 and 6 mm in diameter.
Most small airways are 1 mm to 0.5 mm in diameter, for avg internal diameter of 0.76 mm. 
Lung with 5 liter volume contains about 30,000 small airways.
Bronchiole air passages < 1 mm in diameter.

General performance specs for UV thru near IR light treatment device for lower respiratory tract:

Device to be about 1 meter long, sealed, flexible, hollow carbon fiber, or possibly PET or PvB tapered tube of 0.4 mm inner diameter and 0.6 mm outer diameter (smaller if possible) at tip, and about 5 mm inner diameter and 5.2 mm outer diameter at base. Dimensions subject to fit within lungs and dimension needed for wiring of individual steering strands. Number of steering strands may be reduced if needed to fit conductors within device interior space. Outer membrane to be both flexible and slippery, that can be reused after thorough wash with soap and water, UV or ozone disinfection. Possibly coated with synthetic mucus. Length of tube as required to extend throughout lower respiratory tract. Outer membrane sealed against leaks, does not out-gas, does not stain, and can be lightly rubbed against the cilia, bronchial and lung membranes without damaging them.  Tube is mechanically (computer assisted and steered) reeled or otherwise projected into and out from patient's bronchial and perhaps tertiary bronchiole tubes to get as close as possible to individual alveolar sacs. Overall tube size has to be of the smallest diameter possible to reach these sacs. Adequate speed of device movement is required for minimizing duration of individual treatment.

Center of tube has two flexible 8.3-micron diameter fiber optic cables with minimized cladding and jacket thickness. One for emitting UV thru near-IR light wavelengths, and other for enlarged viewing of bronchial tissues beyond tip of probe. Flexible fiber optic rod used to project treatment light has to be of material that transmits full range of wavelengths intended for treatment of infected areas, or, if just one particular wavelength is determined most effective, then that particular wavelength. Other flexible fiber optic rod transmits video view of bronchial and lung spaces and tissues ahead of probe back to computer programs and monitor on mobile base of device. 

Rounded tip of probe is transparent hemispherical plastic. Tube tip has an adjustable lens for treatment fiber optic rod, to focus treatment light either into a spot or to spread light out over broad area as selected for best treatment. Unless acceptable image can be provided via other technology, such as simultaneous external MRI or CT scan, at probe tip viewing fiber optic cable has adjustable lens and f-stop to adjust depth of field for needed clarity of vision of treatment areas.

But both treatment and imaging lenses are kept clean of debris and mucus to maintain proper operation. Tube has two vessels, one 15-micron flexible vessel for warmed liquid transport, the other 15-micron vessel for air, with valves at probe tip. Nozzles sealed to probe tip outer wall. Vessels adjacent to two central flexible optical cables. First vessel contains one of: surface applied muscle relaxant or whatever is recommended for reducing irritation and distress to patients due to intubation; therapeutic alveolar replacement surfactant similar to that given to preemies; and liquefied ACE2 enzymes to cause SARS-CoV-2 virion spikes to attach to, to reduce odds of their attachment to the ACE2 enzymes of the type 2 pneumocytes. Second vessel is used to vacuum excessive fluid out of alveolar sacs, or to introduce drying gasses to dry those liquid filled alveolar sacs.

Surrounding the central fiber optic cables and liquid and gas vessels, near the exterior tube wall are nine equally spaced 2-micron diameter carbon nanotube steering strands that run parallel to the length of the tube. Steering strands are used to induce angles into the tube to allow the tube to be steered into different bronchial subdivisions, and to reduce tube contact pressure with bronchi. Steering strands are sequentially contracted to maintain equivalent angles to those of the bronchi structure through which the device passes. Strands are made from carbon nanotubes which are can be easily stretched, but can also be reduced in length or contracted via small electric currents. Watertight connections are made to the ends of the steering strands at perpendicular frames to which the nanotubes connect. Insulated electric current leads return to the outside start of the tube near the computer controller and mobile stand.

Steering strands connect to perpendicular frames spaced along length of tube. Frames attached to inner surface of tube wall. Spacing of frames determined by diameter of tube, at about 2 to 3 times diameter of tube at frame location, unless another spacing is found to be better suited for achieving appropriate angles necessary for the steering of the tube into patients' bronchi by alternative location testing.

One negative lead from one side of each perpendicular frame and the positive lead from each strand are connected to a switching center. This switching center is controlled by a computer program designed to keep the steering and angling of the tube synchronized with the depth of tube feed. In addition to that part of the software program, another part simultaneously controls the motion of the tube into and out from each individual bronchus. Another subroutine of the device’s software program controls therapeutic light frequencies, determined from invitro testing, and that the light is accurately applied to infecting virions without damaging substrate tissues and immune system cells and molecules. Another program subroutine controls application of muscle relaxant during intubation. Separate program subroutine controls deposition of liquefied enzymes. Yet another program subroutine controls vacuum or drying gas treatment. Opening of valves, control of focusing lenses and actuating of pumps within the reservoirs filled with therapeutic liquids and gasses, are controlled by the device’s software control programs.

Combined projection/retraction, steering and angling portion of the device’s computer control software program is similar to that used to autonomously drive cars. Prior or simultaneous X-ray, CT or MRI patient data is used in conjunction with views from the probe tip to steer the tube efficiently first to those areas in greatest need of the therapy provided by the device, and then as a preventative to the secondary nearby alveolar sacs. Prior investigative data is also used to program location of areas where prophylactic enzyme deposition is applied, and where alveolar vacuum or drying gas treatment is applied.

To help computer program better control location of tube, soft contact of tube wall with bronchial tissue might be used. Tube might use sinusoidal wave motion (like sidewinder snake motion) and light contact between tube device and bronchi during intubation to maintain centering of the tube within the bronchi yet only exert slight pressure on the surrounding tissues rather than to slide over and rub against or abrade them.

I would hope that such a device could be automatically controlled by computer software without a great deal of hospital staff oversight, as the feedback gained from the use of the device would gradually improve the therapeutic efficacy of the device.