Respiratory flow phenomena and gravitational deposition in a three-dimensional space-filling model of the pulmonary acinar tree

Particle transport and deposition: basic physics of particle kinetics

The human body interacts with the environment in many different ways. The lungs interact with the external environment through breathing. The enormously large surface area of the lung with its extremely thin air-blood barrier is exposed to particles suspended in the inhaled air. The particle-lung interaction may cause deleterious effects on health if the inhaled pollutant aerosols are toxic. Conversely, this interaction can be beneficial for disease treatment if the inhaled particles are therapeutic aerosolized drugs. In either case, an accurate estimation of dose and sites of deposition in the respiratory tract is fundamental to understanding subsequent biological response, and the basic physics of particle motion and engineering knowledge needed to understand these subjects is the topic of this article. A large portion of this article deals with three fundamental areas necessary to the understanding of particle transport and deposition in the respiratory tract. These are: (i) the physical characteristics of particles, (ii) particle behavior in gas flow, and (iii) gas-flow patterns in the respiratory tract. Other areas, such as particle transport in the developing lung and in the diseased lung are also considered. The article concludes with a summary and a brief discussion of areas of future research.

Computational and bioengineered lungs as alternatives to whole animal, isolated organ, and cell-based lung models

Development of lung models for testing a drug substance or delivery system has been an intensive area of research. However, a model that mimics physiological and anatomical features of human lungs is yet to be established. Although in vitro lung models, developed and fine-tuned over the past few decades, were instrumental for the development of many commercially available drugs, they are suboptimal in reproducing the physiological microenvironment and complex anatomy of human lungs. Similarly, intersubject variability and high costs have been major limitations of using animals in the development and discovery of drugs used in the treatment of respiratory disorders. To address the complexity and limitations associated with in vivo and in vitro models, attempts have been made to develop in silico and tissue-engineered lung models that allow incorporation of various mechanical and biological factors that are otherwise difficult to reproduce in conventional cell or organ-based systems. The in silico models utilize the information obtained from in vitro and in vivo models and apply computational algorithms to incorporate multiple physiological parameters that can affect drug deposition, distribution, and disposition upon administration via the lungs. Bioengineered lungs, on the other hand, exhibit significant promise due to recent advances in stem or progenitor cell technologies. However, bioengineered approaches have met with limited success in terms of development of various components of the human respiratory system. In this review, we summarize the approaches used and advancements made toward the development of in silico and tissue-engineered lung models and discuss potential challenges associated with the development and efficacy of these models.

Performance of combination drug and hygroscopic excipient submicrometer particles from a softmist inhaler in a characteristic model of the airways

Excipient enhanced growth (EEG) of inhaled submicrometer pharmaceutical aerosols is a recently proposed method intended to significantly reduce extrathoracic deposition and improve lung delivery. The objective of this study was to evaluate the size increase of combination drug and hygroscopic excipient particles in a characteristic model of the airways during inhalation using both in vitro experiments and computational fluid dynamic (CFD) simulations. The airway model included a characteristic mouth-throat (MT) and upper tracheobronchial (TB) region through the third bifurcation and was enclosed in a chamber geometry used to simulate the thermodynamic conditions of the lungs. Both in vitro results and CFD simulations were in close agreement and indicated that EEG delivery of combination submicrometer particles could nearly eliminate MT deposition for inhaled pharmaceutical aerosols. Compared with current inhalers, the proposed delivery approach represents a 1-2 order of magnitude reduction in MT deposition. Transient inhalation was found to influence the final size of the aerosol based on changes in residence times and relative humidity values. Aerosol sizes following EEG when exiting the chamber (2.75-4.61 μm) for all cases of initial submicrometer combination particles were equivalent to or larger than many conventional pharmaceutical aerosols that frequently have MMADs in the range of 2-3 μm.

In silico models of aerosol delivery to the respiratory tract - development and applications

This review discusses the application of computational models to simulate the transport and deposition of inhaled pharmaceutical aerosols from the site of particle or droplet formation to deposition within the respiratory tract. Traditional one-dimensional (1-D) whole-lung models are discussed briefly followed by a more in-depth review of three-dimensional (3-D) computational fluid dynamics (CFD) simulations. The review of CFD models is organized into sections covering transport and deposition within the inhaler device, the extrathoracic (oral and nasal) region, conducting airways, and alveolar space. For each section, a general review of significant contributions and advancements in the area of simulating pharmaceutical aerosols is provided followed by a more in-depth application or case study that highlights the challenges, utility, and benefits of in silico models. Specific applications presented include the optimization of an existing spray inhaler, development of charge-targeted delivery, specification of conditions for optimal nasal delivery, analysis of a new condensational delivery approach, and an evaluation of targeted delivery using magnetic aerosols. The review concludes with recommendations on the need for more refined model validations, use of a concurrent experimental and CFD approach for developing aerosol delivery systems, and development of a stochastic individual path (SIP) model of aerosol transport and deposition throughout the respiratory tract.

Spatial dependence of alveolar angiogenesis in post-pneumonectomy lung growth

Growth of the remaining lung after pneumonectomy has been observed in many mammalian species; nonetheless, the pattern and morphology of alveolar angiogenesis during compensatory growth is unknown. Here, we investigated alveolar angiogenesis in a murine model of post-pneumonectomy lung growth. As expected, the volume and weight of the remaining lung returned to near-baseline levels within 21 days of pneumonectomy. The percentage increase in lobar weight was greatest in the cardiac lobe (P < 0.001). Cell cycle flow cytometry demonstrated a peak of lung cell proliferation (12.02 ± 1.48%) 6 days after pneumonectomy. Spatial autocorrelation analysis of the cardiac lobe demonstrated clustering of similar vascular densities (positive autocorrelation) that consistently mapped to subpleural regions of the cardiac lobe. Immunohistochemical staining demonstrated increased cell density and enhanced expression of angiogenesis-related factors VEGFA, and GLUT1 in these subpleural regions. Corrosion casting and scanning electron microscopy 3-6 days after pneumonectomy demonstrated subpleural vessels with angiogenic sprouts. The monopodial sprouts appeared to be randomly oriented along the vessel axis with interbranch distances of 11.4 ± 4.8 μm in the regions of active angiogenesis. Also present within the regions of increased vascular density were frequent "holes" or "pillars" consistent with active intussusceptive angiogenesis. The mean pillar diameter was 4.2 ± 3.8 μm, and the pillars were observed in all regions of active angiogenesis. These findings indicate that the process of alveolar construction involves discrete regions of regenerative growth, particularly in the subpleural regions of the cardiac lobe, characterized by both sprouting and intussusceptive angiogenesis.

Stereoscopic particle image velocimetry analysis of healthy and emphysemic alveolar sac models

Emphysema is a progressive lung disease that involves permanent destruction of the alveolar walls. Fluid mechanics in the pulmonary region and how they are altered with the presence of emphysema are not well understood. Much of our understanding of the flow fields occurring in the healthy pulmonary region is based on idealized geometries, and little attention has been paid to emphysemic geometries. The goal of this research was to utilize actual replica lung geometries to gain a better understanding of the mechanisms that govern fluid motion and particle transport in the most distal regions of the lung and to compare the differences that exist between healthy and emphysematous lungs. Excised human healthy and emphysemic lungs were cast, scanned, graphically reconstructed, and used to fabricate clear, hollow, compliant models. Three dimensional flow fields were obtained experimentally using stereoscopic particle image velocimetry techniques for healthy and emphysematic breathing conditions. Measured alveolar velocities ranged over two orders of magnitude from the duct entrance to the wall in both models. Recirculating flow was not found in either the healthy or the emphysematic model, while the average flow rate was three times larger in emphysema as compared to healthy. Diffusion dominated particle flow, which is characteristic in the pulmonary region of the healthy lung, was not seen for emphysema, except for very small particle sizes. Flow speeds dissipated quickly in the healthy lung (60% reduction in 0.25 mm) but not in the emphysematic lung (only 8% reduction 0.25 mm). Alveolar ventilation per unit volume was 30% smaller in emphysema compared to healthy. Destruction of the alveolar walls in emphysema leads to significant differences in flow fields between the healthy and emphysemic lung. Models based on replica geometry provide a useful means to quantify these differences and could ultimately improve our understanding of disease progression.

Flow and Particle Dispersion in Lung Acini: Effect of Geometric and Dynamic Parameters During Synchronous Ventilation

The human lung comprises about 300 million alveoli which are located on bronchioles between the 17th to 24th generations of the acinar tree, with a progressively higher population density in the deeper branches (lower acini). The alveolar size and aspect ratio change with generation number. Due to successive bifurcation, the flow velocity magnitude also decreases as the bronchiole diameter decreases from the upper to lower acini. As a result, fluid dynamic parameters such as Reynolds (Re) and Womersley (α) numbers progressively decrease with increasing generation number. In order to characterize alveolar flow patterns and inhaled particle transport during synchronous ventilation, we have conducted measurements for a range of dimensionless parameters physiologically relevant to the upper acini. Acinar airflow patterns were measured using a simplified in vitro alveolar model consisting of a single transparent elastic truncated sphere (representing the alveolus) mounted over a circular hole on the side of a rigid circular tube (representing the bronchiole). The model alveolus was capable of expanding and contracting in-phase with the oscillatory flow through the bronchiole thereby simulating synchronous ventilation. Realistic breathing conditions were achieved by exercising the model over a range of progressively varying geometric and dynamic parameters to simulate the environment within several generations of the acinar tree. Particle image velocimetry was used to measure the resulting flow patterns. Next, we used the measured flow fields to calculate particle trajectories to obtain particle transport and deposition statistics for massless and finite-size particles under the influence of flow advection and gravity. Our study shows that the geometric parameters (β and ΔV/V) primarily affect the velocity magnitudes, whereas the dynamic parameters (Re and α) distort the flow symmetry while also altering the velocity magnitudes. Consequently, the dynamic parameters have a greater influence on the particle trajectories and deposition statistics compared to the geometric parameters. The results from this study can benefit pulmonary research into the risk assessment of toxicological inhaled aerosols, and the pharmaceutical industry by providing better insight into the flow patterns and particle transport of inhalable therapeutics in the acini.

Steady streaming: A key mixing mechanism in low-Reynolds-number acinar flows

Study of mixing is important in understanding transport of submicron sized particles in the acinar region of the lung. In this article, we investigate transport in view of advective mixing utilizing Lagrangian particle tracking techniques: tracer advection, stretch rate and dispersion analysis. The phenomenon of steady streaming in an oscillatory flow is found to hold the key to the origin of kinematic mixing in the alveolus, the alveolar mouth and the alveolated duct. This mechanism provides the common route to folding of material lines and surfaces in any region of the acinar flow, and has no bearing on whether the geometry is expanding or if flow separates within the cavity or not. All analyses consistently indicate a significant decrease in mixing with decreasing Reynolds number (Re). For a given Re, dispersion is found to increase with degree of alveolation, indicating that geometry effects are important. These effects of Re and geometry can also be explained by the streaming mechanism. Based on flow conditions and resultant convective mixing measures, we conclude that significant convective mixing in the duct and within an alveolus could originate only in the first few generations of the acinar tree as a result of nonzero inertia, flow asymmetry, and large Keulegan-Carpenter (K(C)) number.

Image-based modeling of lung structure and function

The current state-of-the-art in image-based modeling allows derivation of patient-specific models of the lung, lobes, airways, and pulmonary vascular trees. The application of traditional engineering analyses of fluid and structural mechanics to image-based subject-specific models has the potential to provide new insight into structure-function relationships in the individual via functional interpretation that complements imaging and experimental studies. Three major issues that are encountered in studies of airflow through the bronchial airways are the representation of airway geometry, the imposition of physiological boundary conditions, and the treatment of turbulence. Here we review some efforts to resolve each of these issues, with particular focus on image-based models that have been developed to simulate airflow from the mouth to the terminal bronchiole, and subjected to physiologically meaningful boundary conditions via image registration and soft-tissue mechanics models.

Aerosol deposition characteristics in distal acinar airways under cyclic breathing conditions

Although the major mechanisms of aerosol deposition in the lung are known, detailed quantitative data in anatomically realistic models are still lacking, especially in the acinar airways. In this study, an algorithm was developed to build multigenerational three-dimensional models of alveolated airways with arbitrary bifurcation angles and spherical alveolar shape. Using computational fluid dynamics, the deposition of 1- and 3-μm aerosol particles was predicted in models of human alveolar sac and terminal acinar bifurcation under rhythmic wall motion for two breathing conditions (functional residual capacity = 3 liter, tidal volume = 0.5 and 0.9 liter, breathing period = 4 s). Particles entering the model during one inspiration period were tracked for multiple breathing cycles until all particles deposited or escaped from the model. Flow recirculation inside alveoli occurred only during transition between inspiration and expiration and accounted for no more than 1% of the whole cycle. Weak flow irreversibility and convective transport were observed in both models. The average deposition efficiency was similar for both breathing conditions and for both models. Under normal gravity, total deposition was ~33 and 75%, of which ~67 and 96% occurred during the first cycle, for 1- and 3-μm particles, respectively. Under zero gravity, total deposition was ~2-5% for both particle sizes. These results support previous findings that gravitational sedimentation is the dominant deposition mechanism for micrometer-sized aerosols in acinar airways. The results also showed that moving walls and multiple breathing cycles are needed for accurate estimation of aerosol deposition in acinar airways.

Flow and particle dispersion in a pulmonary alveolus--part II: effect of gravity on particle transport

The acinar region of the human lung comprises about 300x10(6) alveoli, which are responsible for gas exchange between the lung and the blood. As discussed in Part I (Chhabra and Prasad, "Flow and Particle Dispersion in a Pulmonary Alveolus-Part I: Velocity Measurements and Convective Particle Transport," ASME J. Biomech. Eng., 132, p. 051009), the deposition of aerosols in the acinar region can either be detrimental to gas exchange (as in the case of harmful particulate matter) or beneficial (as in the case of inhalable pharmaceuticals). We measured the flow field inside an in-vitro model of a single alveolus mounted on a bronchiole and calculated the transport and deposition of massless particles in Part I. This paper focuses on the transport and deposition of finite-sized particles ranging from 0.25 microm to 4 microm under the combined influence of flow-induced advection (computed from velocity maps obtained by particle image velocimetry) and gravitational settling. Particles were introduced during the first inhalation cycle and their trajectories and deposition statistics were calculated for subsequent cycles for three different particle sizes (0.25 microm, 1 microm, and 4 microm) and three alveolar orientations. The key outcome of the study is that particles <or=0.25 microm follow the fluid streamlines quite closely, whereas midsize particles (d(p)=1 microm) deviate to some extent from streamlines and exhibit complex trajectories. The motion of large particles >or=4 microm is dominated by gravitational settling and shows little effect of fluid advection. Additionally, small and midsize particles deposit at about two-thirds height in the alveolus irrespective of the gravitational orientation whereas the deposition of large particles is governed primarily by the orientation of the gravity vector.

Flow and particle dispersion in a pulmonary alveolus--part I: velocity measurements and convective particle transport

The alveoli are the smallest units of the lung that participate in gas exchange. Although gas transport is governed primarily by diffusion due to the small length scales associated with the acinar region (approximately 500 microm), the transport and deposition of inhaled aerosol particles are influenced by convective airflow patterns. Therefore, understanding alveolar fluid flow and mixing is a necessary first step toward predicting aerosol transport and deposition in the human acinar region. In this study, flow patterns and particle transport have been measured using a simplified in-vitro alveolar model consisting of a single alveolus located on a bronchiole. The model comprises a transparent elastic 5/6 spherical cap (representing the alveolus) mounted over a circular hole on the side of a rigid circular tube (representing the bronchiole). The alveolus is capable of expanding and contracting in phase with the oscillatory flow through the tube. Realistic breathing conditions were achieved by exercising the model at physiologically relevant Reynolds and Womersley numbers. Particle image velocimetry was used to measure the resulting flow patterns in the alveolus. Data were acquired for five cases obtained as combinations of the alveolar-wall motion (nondeforming/oscillating) and the bronchiole flow (none/steady/oscillating). Detailed vector maps at discrete points within a given cycle revealed flow patterns, and transport and mixing of bronchiole fluid into the alveolar cavity. The time-dependent velocity vector fields were integrated over multiple cycles to estimate particle transport into the alveolar cavity and deposition on the alveolar wall. The key outcome of the study is that alveolar-wall motion enhances mixing between the bronchiole and the alveolar fluid. Particle transport and deposition into the alveolar cavity are maximized when the alveolar wall oscillates in tandem with the bronchiole fluid, which is the operating case in the human lung.

Flow Field Analysis in Expanding Healthy and Emphysematous Alveolar Models Using Particle Image Velocimetry

Particulates that deposit in the acinus region of the lung have the potential to migrate through the alveolar wall and into the blood stream. However, the fluid mechanics governing particle transport to the alveolar wall are not well understood. Many physiological conditions are suspected to influence particle deposition including morphometry of the acinus, expansion and contraction of the alveolar walls, lung heterogeneities, and breathing patterns. Some studies suggest that the recirculation zones trap aerosol particles and enhance particle deposition by increasing their residence time in the region. However, particle trapping could also hinder aerosol particle deposition by moving the aerosol particle further from the wall. Studies that suggest such flow behavior have not been completed on realistic, nonsymmetric, three-dimensional, expanding alveolated geometry using realistic breathing curves. Furthermore, little attention has been paid to emphysemic geometries and how pathophysiological alterations effect deposition. In this study, fluid flow was examined in three-dimensional, expanding, healthy, and emphysemic alveolar sac model geometries using particle image velocimetry under realistic breathing conditions. Penetration depth of the tidal air was determined from the experimental fluid pathlines. Aerosol particle deposition was estimated by simple superposition of Brownian diffusion and sedimentation on the convected particle displacement for particles diameters of 100–750 nm. This study (1) confirmed that recirculation does not exist in the most distal alveolar regions of the lung under normal breathing conditions, (2) concluded that air entering the alveolar sac is convected closer to the alveolar wall in healthy compared with emphysematous lungs, and (3) demonstrated that particle deposition is smaller in emphysematous compared with healthy lungs.

Theoretical modeling of the interaction between alveoli during inflation and deflation in normal and diseased lungs

Alveolar recruitment is a central strategy in the ventilation of patients with acute lung injury and other lung diseases associated with alveolar collapse and atelectasis. However, biomechanical insights into the opening and collapse of individual alveoli are still limited. A better understanding of alveolar recruitment and the interaction between alveoli in intact and injured lungs is of crucial relevance for the evaluation of the potential efficacy of ventilation strategies. We simulated human alveolar biomechanics in normal and injured lungs. We used a basic simulation model for the biomechanical behavior of virtual single alveoli to compute parameterized pressure-volume curves. Based on these curves, we analyzed the interaction and stability in a system composed of two alveoli. We introduced different values for surface tension and tissue properties to simulate different forms of lung injury. The data obtained predict that alveoli with identical properties can coexist with both different volumes and with equal volumes depending on the pressure. Alveoli in injured lungs with increased surface tension will collapse at normal breathing pressures. However, recruitment maneuvers and positive endexpiratory pressure can stabilize those alveoli, but coexisting unaffected alveoli might be overdistended. In injured alveoli with reduced compliance collapse is less likely, alveoli are expected to remain open, but with a smaller volume. Expanding them to normal size would overdistend coexisting unaffected alveoli. The present simulation model yields novel insights into the interaction between alveoli and may thus increase our understanding of the prospects of recruitment maneuvers in different forms of lung injury.

Improved three-dimensional Fourier domain optical coherence tomography by index matching in alveolar structures

Three-dimensional Fourier domain optical coherence tomography (3-D FDOCT) is used to demonstrate that perfusion fixation with a mixture of glutaraldehyde and paraformaldehyde does not alter the geometry of subpleural lung parenchyma in isolated and perfused rabbit lungs. This is confirmed by simultaneous imaging of lung parenchyma with intravital microscopy. To eliminate the diffraction index interfaces between alveolar pockets and walls, we fill the fixed lungs with ethanol by perfusing with gradually increasing concentrations. This bottom-up filling process leaves no remaining air bubbles in the alveolar structures, thus drastically improving the resolution and penetration depth of 3-D FDOCT imaging. We observe an approximately 18% increase in alveolar area after ethanol filling, likely due in large part to elimination of the air/tissue interfaces. 3-D OCT datasets acquired from ethanol-filled lungs allow segmentation of the ethanol-filled structures, which were formerly air-filled, and 3-D reconstruction of larger areas of subpleural alveolar structures. Our innovative process of filling the lungs with ethanol postperfusion fixation thus enables more accurate quantification of alveolar geometries, a critical component of modeling lung function.

The effects of geometry on airflow in the acinar region of the human lung

Understanding flow phenomena in the pulmonary acinus is important for predicting particle transport and deposition and hence, in designing effective drug delivery strategies for the lung. In the current study, a three-dimensional honeycomb-like geometry involving a central airspace and surrounding alveoli is used to represent an alveolar duct and sacs. Numerical results predict that flow in the presence of wall motion is characterized by the presence of a developing recirculation region within the cavity and by a flow entrainment region indicative of the weak nature of interaction between duct and cavity. Under the normal breathing condition (2.5 s) and volumetric expansion (approximately 25%) considered here, recirculation disappears for Re<0.6. Alveolar flow in higher generations (at lower Reynolds number) results from significantly higher entrainment of the ductal flow, and does not exhibit any recirculation. In an asymmetric arrangement of the alveolar cluster, topological differences in cavity result in significant differences in the size of recirculation and the size of entrainment region within the alveoli of the same acinar generation, indicative of a non-uniform alveolar ventilation. The flow in the terminal alveolar sac is non-recirculating and not affected by variation in geometrical features.