Devices, systems, and methods are disclosed herein for modulating the levels of one or more target components in the blood and/or lymph of a vertebrate subject for treatment of a disease or condition in the vertebrate subject. An implantable device is provided which includes a body defining at least one lumen configured for fluid flow; at least one first reservoir in communication with at least one lumen; one or more energy sources configured to provide energy to elicit one or more signal responses associated with one or more labels that bind to one or more target components in one or more of blood fluid or lymph fluid of the vertebrate subject; one or more sensors configured to detect the one or more signal responses associated with one or more labeled target components; and one or more reactive components in communication with the at least one lumen for release responsive to the one or more sensors.