Airflow and nanoparticle deposition in a 16-generation tracheobronchial airway model

Particle Deposition in Large-Scale Human Tracheobronchial Airways Predicted by Single-Path Modelling

The health effects of particles are directly related to their deposition patterns (deposition site and amount) in human airways. However, estimating the particle trajectory in a large-scale human lung airway model is still a challenge. In this work, a truncated single-path, large-scale human airway model (G3-G10) with a stochastically coupled boundary method were employed to investigate the particle trajectory and the roles of their deposition mechanisms. The deposition patterns of particles with diameters (dp) of 1-10 μm are investigated under various inlet Reynolds numbers (Re = 100-2000). Inertial impaction, gravitational sedimentation, and combined mechanism were considered. With the increasing airway generations, the deposition of smaller particles (dp < 4 μm) increased due to gravitational sedimentation, while that of larger particles decreased due to inertial impaction. The obtained formulas of Stokes number and Re can predict the deposition efficiency due to the combined mechanism in the present model, and the prediction can be used to assess the dose-effect of atmospheric aerosols on the human body. Diseases in deeper generations are mainly attributed to the deposition of smaller particles under lower inhalation rates, while diseases at the proximal generations mainly result from the deposition of larger particles under higher inhalation rates.

Targeted drug delivery with polydisperse particle transport and deposition in patient-specific upper airway during inhalation and exhalation

Identifying the deposition pattern of inhaled pharmaceutical aerosols in the human respiratory system and understanding the effective parameters in this process is vital for more efficient drug delivery to this region. This study investigated aerosol deposition in a patient-specific upper respiratory airway and determined the deposition fraction (DF) and pressure drop across the airway. An experimental setup was developed to measure the pressure drop in the same realistic geometry printed from the patient-specific geometry. The unsteady simulations were performed with a flow rate of 15 L/min and different particle diameters ranging from 2 to 30 µm. The results revealed significant flow circulation after the nasal valve in the upper and oropharynx regions, and a maximum local velocity observed in the nasopharynx. Transient cumulative deposition fraction showed that after 2 s of the simulation, all particles deposit or escape the computational domain. About 30 % of the injected large particles (d_p ≥ 20 µm) deposited in the first 1 cm away from the nostril and more than 95 % deposited in the nasal airway before entering the oropharynx region. While almost 94 % deposition in trachea was composed of particles smaller than 5 µm. Approximately 20 % of inhaled fine particles (2-5 µm) deposited in the upper airway and the rest deposited in oropharynx, larynx and trachea.

Nanoparticle transport and deposition in a heterogeneous human lung airway tree: An efficient one path model for CFD simulations

Understanding nano-particle inhalation in human lung airways helps targeted drug delivery for treating lung diseases. A wide range of numerical models have been developed to analyse nano-particle transport and deposition (TD) in different parts of airways. However, a precise understanding of nano-particle TD in large-scale airways is still unavailable in the literature. This study developed an efficient one-path numerical model for simulating nano-particle TD in large-scale lung airway models. This first-ever one-path numerical approach simulates airflow and nano-particle TD in generations 0-11 of the human lung, accounting for 93% of the whole airway length. The one-path model enables the simulation of particle TD in many generations of airways with an affordable time. The particle TD of 5 nm, 10 nm and 20 nm particles is simulated at inhalation flow rates for two different physical activities: resting and moderate activity. It is found that particle deposition efficiency of 5 nm particles is 28.94% higher than 20 nm particles because of the higher dispersion capacity. It is further proved that the diffusion mechanism dominates the particle TD in generations 0-11. The deposition efficiency decreases with the increase of generation number irrespective of the flow rate and particle size. The effects of the particle size and flow rate on the escaping rate of each generation are opposite to the corresponding effects on the deposition rate. The quantified deposition and escaping rates at generations 0-11 provide valuable guidelines for drug delivery in human lungs.

A Novel Machine Learning Prediction Model for Aerosol Transport in Upper 17-Generations of the Human Respiratory Tract

The main challenge of the health risk assessment of the aerosol transport and deposition to the lower airways is the high computational cost. A standard large-scale airway model needs a week to a month of computational time in a high-performance computing system. Therefore, developing an innovative tool that accurately predicts transport behaviour and reduces computational time is essential. This study aims to develop a novel and innovative machine learning (ML) model to predict particle deposition to the lower airways. The first-ever study uses ML techniques to explore the pulmonary aerosol TD in a digital 17-generation airway model. The ML model uses the computational data for a 17-generation airway model and four standard ML regression models are used to save the computational cost. Random forest (RF), k-nearest neighbour (k-NN), multi-layer perceptron (MLP) and Gaussian process regression (GPR) techniques are used to develop the ML models. The MLP regression model displays more accurate estimates than other ML models. Finally, a prediction model is developed, and the results are significantly closer to the measured values. The prediction model predicts the deposition efficiency (DE) for different particle sizes and flow rates. A comprehensive lobe-specific DE is also predicted for various flow rates. This first-ever aerosol transport prediction model can accurately predict the DE in different regions of the airways in a couple of minutes. This innovative approach and accurate prediction will improve the literature and knowledge of the field.

Inhalation delivery of repurposed drugs for lung cancer: Approaches, benefits and challenges

Lung cancer (LC) is one of the leading causes of mortality accounting for almost 25% of cancer deaths throughout the world. The shortfall of affordable and effective first-line chemotherapeutics, the existence of resistant tumors, and the non-optimal route of administration contribute to poor prognosis and high mortality in LC. Administration of repurposed non-oncology drugs (RNODs) loaded in nanocarriers (NCs) via inhalation may prove as an effective alternative strategy to treat LC. Furthermore, their site-specific release through inhalation route using an appropriate inhalation device would offer improved therapeutic efficacy, thereby reducing mortality and improving patients' quality of life. The current manuscript offers a comprehensive overview on use of RNODs in LC treatment with an emphasis on their inhalation delivery and the associated challenges. The role of NCs to improve lung deposition and targeting of RNODs via inhalation are also elaborated. In addition, information about various RNODs in clinical trials for the treatment of LC, possibility for repurposing phytoceuticals against LC via inhalation and the bottlenecks associated with repurposing RNODs against cancer are also highlighted. Based on the reported studies covered in this manuscript, it was understood that delivery of RNODs via inhalation has emerged as a propitious approach. Hence, it is anticipated to provide effective first-line treatment at an affordable cost in debilitating LC from low and middle-income countries (LMIC).

A dynamical overview of droplets in the transmission of respiratory infectious diseases

The outbreak of the coronavirus disease has drawn public attention to the transmission of infectious pathogens, and as major carriers of those pathogens, respiratory droplets play an important role in the process of transmission. This Review describes respiratory droplets from a physical and mechanical perspective, especially their correlation with the transmission of infectious pathogens. It covers the important aspects of (i) the generation and expulsion of droplets during respiratory activities, (ii) the transport and evolution of respiratory droplets in the ambient environment, and (iii) the inhalation and deposition of droplets in the human respiratory tract. State-of-the-art experimental, computational, and theoretical models and results are presented, and the corresponding knowledge gaps are identified. This Review stresses the multidisciplinary nature of its subject and appeals for collaboration among different fields to fight the present pandemic.

Fine and coarse particulate matter, trace element content, and associated health risks considering respiratory deposition for Ergene Basin, Thrace

Ergene Basin is located in Thrace, Turkey, where industries are densely populated. This study aimed to determine exposure of people living in Ergene Basin (Çorlu and Çerkezköy) to fine and coarse PM, and its potentially toxic element (PTE) content by considering variation in respiratory airway deposition rates with daily activities and PM particle size by employing deposition models of International Commission on Radiological Protection and Multiple Path Particle Dosimetry. Fine and coarse PM samples were collected daily for a year at points in Çorlu and Çerkezköy representing urban and industrial settings, respectively. A questionnaire survey was conducted in the study area to obtain time-activity budgets, and associated variation was included in the health risk assessment by considering time-activity-dependent inhalation rates. The studied PTEs were Al, As, Ba, Cd, Cr, Co, Mn, Ni, Pb, and Se. The mean fine and coarse PM concentrations were measured as 23 and 14 μg/m³ in Çorlu, and 22 and 12 μg/m³ in Çerkezköy, respectively. The only PTE that exceeded acceptable risk in terms of total carcinogenic risk was Cr. Non-carcinogenic risks of all the PTEs including Cr were below the threshold. The use of deposition fractions in the health risk assessment (HRA) calculations was found to prevent overestimation of health risks by at least 91% and 87% for fine and coarse PM, respectively, compared to the regular HRA. Minor differences in risk between Çorlu and Çerkezköy suggest that urban pollution sources could be at least as influential on human health as industrial sources.

Computational fluid dynamic models as tools to predict aerosol distribution in tracheobronchial airways

Aerosol and pollutants, in form of particulates 5-8 μm in main size face every day our respiratory system as natural suspension in air or forced to be inhaled as a coadjutant in a medical therapy for respiratory diseases. This inhalation happens in children to elderly, women and men, healthy or sick and disable people. In this paper we analyzed the inhalation of aerosol in conditions assimilable to the thermal therapy. We use a computational fluid dynamic 3D model to compute and visualize the trajectories of aerosol (3-7-10-25 µm) down to the sixth generation of bronchi, in a steady and dynamic condition (7 µm) set as breath cycle at rest. Results, compared to a set of milestone experimental studies published in literature, allow the comprehension of particles behavior during the inhalation from mouth to bronchi sixth generation, the visualization of jet at larynx constriction and vortices, in an averaged characteristic rigorous geometrical model including tracheal rings. Results on trajectories and deposition show the importance of the including transient physiological breath cycle on aerosol deposition analyses. Numerical and graphical results, may enable the design of medical devices and protocols to make the inhalations more effective in all the users' population.

Ultrafine urban particle measurements in Budapest and their airway deposition distribution calculation

OBJECTIVES

The aim of this study was to provide particle number and mass deposition rates of submicron particles in the human airways as inputs for toxicology and other areas of aerosol science.

METHODS

Scanning Mobility Particle Spectrometer was used to measure the number concentrations and size distributions of the ultrafine urban particles during summer and winter in Budapest. The Stochastic Lung Model (SLM) was applied to calculate number and mass deposition rates of the inhaled particles in different anatomical regions of the airways.

RESULTS

Our calculations revealed that for the selected days in summer and winter with PM10 values below the health limit 4.7 and 18.4 billion particles deposited in the bronchial region of the lungs. The deposition in the acinar region of the lung was even higher, 8.3 billion particles for the summer day, and 33.8 billion particles for winter day.

CONCLUSIONS

Our results clearly demonstrate that large daily numbers of urban UFPs are deposited in the respiratory tract, which may play a key role in the health effects of particulate matter (PM) inhalation. Present results, connecting the ambient exposure parameters with the local burden of the airway epithelium, can be useful inputs of in vitro cell culture experiments. By the combination of urban UFP monitoring and numerical modeling of particle deposition with toxicological studies, the health risks of urban aerosols could be better assessed. The use of UFP data in addition to PM10 and PM2.5 in the epidemiological studies would also be indicated.

A voxel image-based pulmonary airflow simulation method with an automatic detection algorithm for airway outlets

Investigations of pulmonary airflows in respiratory systems are important for the diagnostics and treatment of pulmonary diseases. For accurate prediction of the flow field in an airway, a numerical simulation must be conducted using the true geometry from computed tomography (CT) data. Flow simulation is still a difficult task because of the mesh generation process and preprocessing setup procedures. In this study, we developed a voxel image-based simulation method using an automatic detection algorithm for airway outlets to simplify the simulation process and improve its applicability in the medical field. Our approach is based on the lattice Boltzmann method with a topology analysis algorithm, which can preserve all raw information from the original CT images and give an accurate flow field inside the airways. Our method can reproduce the essential flow features inside airways, is highly efficient, and decreases the overall processing time. Thus, it has a great potential for future real-time airflow analyses to provide airflow information to medical experts. HIGHLIGHTS: This paper proposed a voxel image-based simulation method with a novel automatic outlet-selecting algorithm to calculate the velocity and pressure of physiological flows in multi-generation-branched airways. Our approach simplifies the simulation process by automatically applying the boundary conditions to large numbers of outlets and minimizes the time-consuming mesh generation process. Our proposed method has considerable potential for real-time simulations improving the applicability to patient-specific medical diagnostics and treatments.

A Review of Respiratory Anatomical Development, Air Flow Characterization and Particle Deposition

The understanding of complex inhalation and transport processes of pollutant particles through the human respiratory system is important for investigations into dosimetry and respiratory health effects in various settings, such as environmental or occupational health. The studies over the last few decades for micro- and nanoparticle transport and deposition have advanced the understanding of drug-aerosol impacts in the mouth-throat and the upper airways. However, most of the Lagrangian and Eulerian studies have utilized the non-realistic symmetric anatomical model for airflow and particle deposition predictions. Recent improvements to visualization techniques using high-resolution computed tomography (CT) data and the resultant development of three dimensional (3-D) anatomical models support the realistic representation of lung geometry. Yet, the selection of different modelling approaches to analyze the transitional flow behavior and the use of different inlet and outlet conditions provide a dissimilar prediction of particle deposition in the human lung. Moreover, incorporation of relevant physical and appropriate boundary conditions are important factors to consider for the more accurate prediction of transitional flow and particle transport in human lung. This review critically appraises currently available literature on airflow and particle transport mechanism in the lungs, as well as numerical simulations with the aim to explore processes involved. Numerical studies found that both the Euler–Lagrange (E-L) and Euler–Euler methods do not influence nanoparticle (particle diameter ≤50 nm) deposition patterns at a flow rate ≤25 L/min. Furthermore, numerical studies demonstrated that turbulence dispersion does not significantly affect nanoparticle deposition patterns. This critical review aims to develop the field and increase the state-of-the-art in human lung modelling.

Radiation Dosimetry of Inhaled Radioactive Aerosols: CFPD and MCNP Transport Simulations of Radionuclides in the Lung

Despite extensive efforts in studying radioactive aerosols, including the transmission of radionuclides in different chemical matrices throughout the body, the internal organ-specific radiation dose due to inhaled radioactive aerosols has largely relied on experimental deposition data and simplified human phantoms. Computational fluid-particle dynamics (CFPD) has proven to be a reliable tool in characterizing aerosol transport in the upper airways, while Monte Carlo based radiation codes allow accurate simulation of radiation transport. The objective of this study is to numerically assess the radiation dosimetry due to particles decaying in the respiratory tract from environmental radioactive exposures by coupling CFPD with Monte Carlo N-Particle code, version 6 (MCNP6). A physiologically realistic mouth-lung model extending to the bifurcation generation G9 was used to simulate airflow and particle transport within the respiratory tract. Polydisperse aerosols with different distributions were considered, and deposition distribution of the inhaled aerosols on the internal airway walls was quantified. The deposition mapping of radioactive aerosols was then registered to the respiratory tract of an image-based whole-body adult male model (VIP-Man) to simulate radiation transport and energy deposition. Computer codes were developed for geometry visualization, spatial normalization, and source card definition in MCNP6. Spatial distributions of internal radiation dosimetry were compared for different radionuclides (¹³¹I, ^134,137Cs, ⁹⁰Sr-⁹⁰Y, ¹⁰³Ru and ^239,240Pu) in terms of the radiation fluence, energy deposition density, and dose per decay.

Implementation of a specific boundary condition for a simplified symmetric single-path CFD lung model with OpenFOAM

CFD modeling research about the lung airflow with a complete resolution and an adequate accuracy at all scales requires a great amount of computational resources due to the vast number of necessary grid elements. As a result, a common practice is to conduct simplifications that allows to manage it with ordinary computational power. In this study, the implementation of a special boundary condition in order to develop a simplified single conductive lung airway model, which exactly represents the effect of the removed airways, is presented. The boundary condition is programmed in the open-source software OpenFOAM®, and the developed source code is presented in the proper syntax. After this description, modeling accuracy is evaluated under different flow rate conditions typical of human breathing processes, including both inspiration and expiration movements. Afterward, a validation process is conducted using results of a Weibel's model (0-4 generations) simulation for a medium flow rate of 50 L/min. Finally, a comparison against the proposed boundary condition implemented in the commercial code ANSYS Fluent is made, which highlights the benefits of using the free code toolbox. The specific contribution of this paper will be to show that OpenFOAM® developed model can perform even better than other commercial codes due to a precise implementation and coupling of the default solver with the in-house functions by virtue of the open-source nature of the code.

Use of computational fluid dynamics deposition modeling in respiratory drug delivery

INTRODUCTION

Respiratory drug delivery is a surprisingly complex process with a number of physical and biological challenges. Computational fluid dynamics (CFD) is a scientific simulation technique that is capable of providing spatially and temporally resolved predictions of many aspects related to respiratory drug delivery from initial aerosol formation through respiratory cellular drug absorption.

AREAS COVERED

This review article focuses on CFD-based deposition modeling applied to pharmaceutical aerosols. Areas covered include the development of new complete-airway CFD deposition models and the application of these models to develop a next-generation of respiratory drug delivery strategies.

EXPERT OPINION

Complete-airway deposition modeling is a valuable research tool that can improve our understanding of pharmaceutical aerosol delivery and is already supporting medical hypotheses, such as the expected under-treatment of the small airways in asthma. These complete-airway models are also being used to advance next-generation aerosol delivery strategies, like controlled condensational growth. We envision future applications of CFD deposition modeling to reduce the need for human subject testing in developing new devices and formulations, to help establish bioequivalence for the accelerated approval of generic inhalers, and to provide valuable new insights related to drug dissolution and clearance leading to microdosimetry maps of drug absorption.

Mice-to-men comparison of inhaled drug-aerosol deposition and clearance

Part of the effective prediction of the pharmacokinetics of drugs (or toxic particles) requires extrapolation of experimental data sets from animal studies to humans. As the respiratory tracts of rodents and humans are anatomically very different, there is a need to study airflow and drug-aerosol deposition patterns in lung airways of these laboratory animals and compare them to those of human lungs. As a first step, interspecies computational comparison modeling of inhaled nano-to-micron size drugs (50 nm < d<15μm) was performed using mouse and human upper airway models under realistic breathing conditions. Critical species-specific differences in lung physiology of the upper airways and subsequently in local drug deposition were simulated and analyzed. In addition, a hybrid modeling methodology, combining Computational Fluid-Particle Dynamics (CF-PD) simulations with deterministic lung deposition models, was developed and predicted total and regional drug-aerosol depositions in lung airways of both mouse and man were compared, accounting for the geometric, kinematic and dynamic differences. Interestingly, our results indicate that the total particle deposition fractions, especially for submicron particles, are comparable in rodent and human respiratory models for corresponding breathing conditions. However, care must be taken when extrapolating a given dosage as considerable differences were noted in the regional particle deposition pattern. Combined with the deposition model, the particle retention and clearance kinetics of deposited nanoparticles indicates that the clearance rate from the mouse lung is higher than that in the human lung. In summary, the presented computer simulation models provide detailed fluid-particle dynamics results for upper lung airways of representative human and mouse models with a comparative analysis of particle lung deposition data, including a novel mice-to-men correlation as well as a particle-clearance analysis both useful for pharmacokinetic and toxicokinetic studies.

Particulate emission from the gasification and pyrolysis of biomass: Concentration, size distributions, respiratory deposition-based control measure evaluation

Gasification and pyrolysis technologies have been widely employed to produce fuels and chemicals from solid wastes. Rare studies have been conducted to compare the particulate emissions from gasification and pyrolysis, and relevant inhalation exposure assessment is still lacking. In this work, we characterized the particles emitted from the gasification and pyrolysis experiments under different temperatures (500, 600, and 700 °C). The collection efficiencies of existing cyclones were compared based on particle respiratory deposition. Sensitivity analysis was conducted to identify the most effective design parameters. The particles emitted from both gasification and pyrolysis process are mainly in the size range 0.25-1.0 μm and 1.0-2.5 μm. Particle respiratory deposition modelling showed that most particles penetrate deeply into the last stage of the respiratory system. At the nasal breathing mode, particles with sizes ranging from 0.25 to 1.0 μm account for around 91%, 74%, 76%, 90%, 84%, and 79% of the total number of particles that deposit onto the last stage in the cases of 500 °C gasification, 600 °C gasification, 700 °C gasification, 500 °C pyrolysis, 600 °C pyrolysis, and 700 °C pyrolysis, respectively. At the oral breathing mode, particles with sizes ranging from 0.25 to 1.0 μm account for around 92%, 77%, 79%, 91%, 86%, and 81% of the total number of particles that deposit onto the last stage in the six cases, respectively. Sensitivity analysis showed that the particle removal efficiency was found to be most sensitive to the cyclone vortex finder diameter (D₀). This work could potentially serve as the basis for proposing health protective measures against the particulate pollution from gasification and pyrolysis technologies.

Transient Dynamics Simulation of Airflow in a CT-Scanned Human Airway Tree: More or Fewer Terminal Bronchi?

Using computational fluid dynamics (CFD) method, the feasibility of simulating transient airflow in a CT-based airway tree with more than 100 outlets for a whole respiratory period is studied, and the influence of truncations of terminal bronchi on CFD characteristics is investigated. After an airway model with 122 outlets is extracted from CT images, the transient airflow is simulated. Spatial and temporal variations of flow velocity, wall pressure, and wall shear stress are presented; the flow pattern and lobar distribution of air are gotten as well. All results are compared with those of a truncated model with 22 outlets. It is found that the flow pattern shows lobar heterogeneity that the near-wall air in the trachea is inhaled into the upper lobe while the center flow enters the other lobes, and the lobar distribution of air is significantly correlated with the outlet area ratio. The truncation decreases airflow to right and left upper lobes and increases the deviation of airflow distributions between inspiration and expiration. Simulating the transient airflow in an airway tree model with 122 bronchi using CFD is feasible. The model with more terminal bronchi decreases the difference between the lobar distributions at inspiration and at expiration.

A comparison of PM exposure related to emission hotspots in a hot and humid urban environment: Concentrations, compositions, respiratory deposition, and potential health risks

Particle number concentration, particle size distribution, and size-dependent chemical compositions were measured at a bus stop, alongside a high way, and at an industrial site in a tropical city. It was found that the industry case had 4.93×10⁷-7.23×10⁷ and 3.44×10⁴-3.69×10⁴#/m³ higher concentration of particles than the bus stop and highway cases in the range of 0.25-0.65μm and 2.5-32μm, respectively, while the highway case had 6.01×10⁵ and 1.86×10³#/m³ higher concentration of particles than the bus stop case in the range of 0.5-1.0μm and 5.0-32μm, respectively. Al, Fe, Na, and Zn were the most abundant particulate inorganic elements for the traffic-related cases, while Zn, Mn, Fe, and Pb were abundant for the industry case. Existing respiratory deposition models were employed to analyze particle and element deposition distributions in the human respiratory system with respect to some potential exposure scenarios related to bus stop, highway, and industry, respectively. It was shown that particles of 0-0.25μm and 2.5-10.0μm accounted for around 74%, 74%, and 70% of the particles penetrating into the lung region, respectively. The respiratory deposition rates of Cr and Ni were 170 and 220 ng/day, and 55 and 140ng/day for the highway and industry scenarios, respectively. Health risk assessment was conducted following the US EPA supplemented guidance to estimate the risk of inhalation exposure to the selected elements (i.e. Cr, Mn, Ni, Pb, Se, and Zn) for the three scenarios. It was suggested that Cr poses a potential carcinogenic risk with the excess lifetime cancer risk (ELCR) of 2.1-98×10^-5 for the scenarios. Mn poses a potential non-carcinogenic risk in the industry scenario with the hazard quotient (HQ) of 0.98. Both Ni and Mn may pose potential non-carcinogenic risk for people who are involved with all the three exposure scenarios.

Small Airway Absorption and Microdosimetry of Inhaled Corticosteroid Particles after Deposition

PURPOSE

To predict the cellular-level epithelial absorbed dose from deposited inhaled corticosteroid (ICS) particles in a model of an expanding and contracting small airway segment for different particle forms.

METHODS

A computational fluid dynamics (CFD)-based model of drug dissolution, absorption and clearance occurring in the surface liquid of a representative small airway generation (G13) was developed and used to evaluate epithelial dose for the same deposited drug mass of conventional microparticles, nanoaggregates and a true nanoaerosol. The ICS medications considered were budesonide (BD) and fluticasone propionate (FP). Within G13, total epithelial absorption efficiency (AE) and dose uniformity (microdosimetry) were evaluated.

RESULTS

Conventional microparticles resulted in very poor AE of FP (0.37%) and highly nonuniform epithelial absorption, such that <5% of cells received drug. Nanoaggregates improved AE of FP by a factor of 57-fold and improved dose delivery to reach approximately 40% of epithelial cells. True nanoaerosol resulted in near 100% AE for both drugs and more uniform drug delivery to all cells.

CONCLUSIONS

Current ICS therapies are absorbed by respiratory epithelial cells in a highly nonuniform manner that may partially explain poor clinical performance in the small airways. Both nanoaggregates and nanoaerosols can significantly improve ICS absorption efficiency and uniformity.

Ultrafine particle transport and deposition in a large scale 17-generation lung model

To understand how to assess optimally the risks of inhaled particles on respiratory health, it is necessary to comprehend the uptake of ultrafine particulate matter by inhalation during the complex transport process through a non-dichotomously bifurcating network of conduit airways. It is evident that the highly toxic ultrafine particles damage the respiratory epithelium in the terminal bronchioles. The wide range of in silico available and the limited realistic model for the extrathoracic region of the lung have improved understanding of the ultrafine particle transport and deposition (TD) in the upper airways. However, comprehensive ultrafine particle TD data for the real and entire lung model are still unavailable in the literature. Therefore, this study is aimed to provide an understanding of the ultrafine particle TD in the terminal bronchioles for the development of future therapeutics. The Euler-Lagrange (E-L) approach and ANSYS fluent (17.2) solver were used to investigate ultrafine particle TD. The physical conditions of sleeping, resting, and light activity were considered in this modelling study. A comprehensive pressure-drop along five selected path lines in different lobes was calculated. The non-linear behaviour of pressure-drops is observed, which could aid the health risk assessment system for patients with respiratory diseases. Numerical results also showed that ultrafine particle-deposition efficiency (DE) in different lobes is different for various physical activities. Moreover, the numerical results showed hot spots in various locations among the different lobes for different flow rates, which could be helpful for targeted therapeutical aerosol transport to terminal bronchioles and the alveolar region.

Design of a numerical model of lung by means of a special boundary condition in the truncated branches

BACKGROUND

The need for a better understanding of pulmonary diseases has led to increased interest in the development of realistic computational models of the human lung.

METHODS

To minimize computational cost, a reduced geometry model is used for a model lung airway geometry up to generation 16. Truncated airway branches require physiologically realistic boundary conditions to accurately represent the effect of the removed airway sections. A user-defined function has been developed, which applies velocities mapped from similar locations in fully resolved airway sections. The methodology can be applied in any general purpose computational fluid dynamics code, with the only limitation that the lung model must be symmetrical in each truncated branch.

RESULTS

Unsteady simulations have been performed to verify the operation of the model. The test case simulates a spirometry because the lung is obliged to rapidly perform both inspiration and expiration. Once the simulation was completed, the obtained pressure in the lower level of the lung was used as a boundary condition. The output velocity, which is a numerical spirometry, was compared with the experimental spirometry for validation purposes.

CONCLUSIONS

This model can be applied for a wide range of patient-specific resolution levels. If the upper airway generations have been constructed from a computed tomography scan, it would be possible to quickly obtain a complete reconstruction of the lung specific to a specific person, which would allow individualized therapies.

Nanoparticle transport and delivery in a heterogeneous pulmonary vasculature

Quantitative understanding of nanoparticles delivery in a complex vascular networks is very challenging because it involves interplay of transport, hydrodynamic force, and multivalent interactions across different scales. Heterogeneous pulmonary network includes up to 16 generations of vessels in its arterial tree. Modeling the complete pulmonary vascular system in 3D is computationally unrealistic. To save computational cost, a model reconstructed from MRI scanned images is cut into an arbitrary pathway consisting of the upper 4-generations. The remaining generations are represented by an artificially rebuilt pathway. Physiological data such as branch information and connectivity matrix are used for geometry reconstruction. A lumped model is used to model the flow resistance of the branches that are cut off from the truncated pathway. Moreover, since the nanoparticle binding process is stochastic in nature, a binding probability function is used to simplify the carrier attachment and detachment processes. The stitched realistic and artificial geometries coupled with the lumped model at the unresolved outlets are used to resolve the flow field within the truncated arterial tree. Then, the biodistribution of 200nm, 700nm and 2µm particles at different vessel generations is studied. At the end, 0.2-0.5% nanocarrier deposition is predicted during one time passage of drug carriers through pulmonary vascular tree. Our truncated approach enabled us to efficiently model hemodynamics and accordingly particle distribution in a complex 3D vasculature providing a simple, yet efficient predictive tool to study drug delivery at organ level.

The movement and deposition of PM2.5 in the upper respiratory tract for the patients with heart failure: an elementary CFD study

BACKGROUND

PM2.5 is an important factor to affect the patients with respiratory and cardiovascular diseases. Clinical studies have found that the morbidity and mortality of patients with heart failure (HF) have a close relationship with the movement and deposition state of PM2.5. One reason is that the breathing pattern of patients with HF has obvious difference with healthy people, however the effect caused by these differences on the distribution regularity of PM2.5 in the respiratory tract is still unclear. Hence, a computational fluid dynamics simulation was conducted to clarify the aerodynamic effect of breathing pattern of patients with HF on respiratory system.

METHODS

Ideal upper respiratory tract geometric model was established based on standardized aerosol research laboratory of Alberta and Weibel A dimension. The discrete phase method is used to calculate the movement of the airflow and particles. The flow rate were chosen as the inlet boundary conditions, and the outlets are set at a constant pressure. The rate of particle deposition, distribution location, wall pressure, flow velocity and wall shear stress are obtained, and compared to the normal control.

RESULTS

The results demonstrated that the rate of escaped particles in every bronchial outlet of the patients with HF was more than the normal controls, meanwhile the trapped was less (1024 < 1160). There was higher by 12.9% possibility that the PM2.5 entered the lungs than the normal control.

CONCLUSION

The aerodynamic performances of HF patients are different from normal control. Compared to the normal control, under similar environment, there is higher possibility of PM2.5 moving into lungs, and these particles could affect the function of the respiratory system, resulting in the deterioration of the state of cardiovascular system. In short, it's necessary to pay more attention to the living environment of HF patients, to reduce the content of PM2.5 particles in the air, and reduce the damage of PM2.5 particles caused by breathing patterns.

Do nanoparticles provide a new opportunity for diagnosis of distal airspace disease?

There is a need for efficient techniques to assess abnormalities in the peripheral regions of the lungs, for example, for diagnosis of pulmonary emphysema. Considerable scientific efforts have been directed toward measuring lung morphology by studying recovery of inhaled micron-sized aerosol particles (0.4-1.5 µm). In contrast, it is suggested that the recovery of inhaled airborne nanoparticles may be more useful for diagnosis. The objective of this work is to provide a theoretical background for the use of nanoparticles in measuring lung morphology and to assess their applicability based on a review of the literature. Using nanoparticles for studying distal airspace dimensions is shown to have several advantages over other aerosol-based methods. 1) Nanoparticles deposit almost exclusively by diffusion, which allows a simpler breathing maneuver with minor artifacts from particle losses in the oropharyngeal and upper airways. 2) A higher breathing flow rate can be utilized, making it possible to rapidly inhale from residual volume to total lung capacity (TLC), thereby eliminating the need to determine the TLC before measurement. 3) Recent studies indicate better penetration of nanoparticles than micron-sized particles into poorly ventilated and diseased regions of the lungs; thus, a stronger signal from the abnormal parts is expected. 4) Changes in airspace dimensions have a larger impact on the recovery of nanoparticles. Compared to current diagnostic techniques with high specificity for morphometric changes of the lungs, computed tomography and magnetic resonance imaging with hyperpolarized gases, an aerosol-based method is likely to be less time consuming, considerably cheaper, simpler to use, and easier to interpret (providing a single value rather than an image that has to be analyzed). Compared to diagnosis by carbon monoxide (DL,CO), the uptake of nanoparticles in the lung is not affected by blood flow, hemoglobin concentration or alterations of the alveolar membranes, but relies only on lung morphology.

Computationally efficient analysis of particle transport and deposition in a human whole-lung-airway model. Part I: Theory and model validation

Computational predictions of aerosol transport and deposition in the human respiratory tract can assist in evaluating detrimental or therapeutic health effects when inhaling toxic particles or administering drugs. However, the sheer complexity of the human lung, featuring a total of 16 million tubular airways, prohibits detailed computer simulations of the fluid-particle dynamics for the entire respiratory system. Thus, in order to obtain useful and efficient particle deposition results, an alternative modeling approach is necessary where the whole-lung geometry is approximated and physiological boundary conditions are implemented to simulate breathing. In Part I, the present new whole-lung-airway model (WLAM) represents the actual lung geometry via a basic 3-D mouth-to-trachea configuration while all subsequent airways are lumped together, i.e., reduced to an exponentially expanding 1-D conduit. The diameter for each generation of the 1-D extension can be obtained on a subject-specific basis from the calculated total volume which represents each generation of the individual. The alveolar volume was added based on the approximate number of alveoli per generation. A wall-displacement boundary condition was applied at the bottom surface of the first-generation WLAM, so that any breathing pattern due to the negative alveolar pressure can be reproduced. Specifically, different inhalation/exhalation scenarios (rest, exercise, etc.) were implemented by controlling the wall/mesh displacements to simulate realistic breathing cycles in the WLAM. Total and regional particle deposition results agree with experimental lung deposition results. The outcomes provide critical insight to and quantitative results of aerosol deposition in human whole-lung airways with modest computational resources. Hence, the WLAM can be used in analyzing human exposure to toxic particulate matter or it can assist in estimating pharmacological effects of administered drug-aerosols. As a practical WLAM application, the transport and deposition of asthma drugs from a commercial dry-powder inhaler is discussed in Part II.

Measurements of Deposition, Lung Surface Area and Lung Fluid for Simulation of Inhaled Compounds

Modern strategies in drug development employ in silico techniques in the design of compounds as well as estimations of pharmacokinetics, pharmacodynamics and toxicity parameters. The quality of the results depends on software algorithm, data library and input data. Compared to simulations of absorption, distribution, metabolism, excretion, and toxicity of oral drug compounds, relatively few studies report predictions of pharmacokinetics and pharmacodynamics of inhaled substances. For calculation of the drug concentration at the absorption site, the pulmonary epithelium, physiological parameters such as lung surface and distribution volume (lung lining fluid) have to be known. These parameters can only be determined by invasive techniques and by postmortem studies. Very different values have been reported in the literature. This review addresses the state of software programs for simulation of orally inhaled substances and focuses on problems in the determination of particle deposition, lung surface and of lung lining fluid. The different surface areas for deposition and for drug absorption are difficult to include directly into the simulations. As drug levels are influenced by multiple parameters the role of single parameters in the simulations cannot be identified easily.

A Conjugate Fluid-Porous Approach for Simulating Airflow in Realistic Geometric Representations of the Human Respiratory System

Simulation of flow in the human lung is of great practical interest as a means to study the detailed flow patterns within the airways for many physiological applications. While computational simulation techniques are quite mature, lung simulations are particularly complicated due to the vast separation of length scales between upper airways and alveoli. Many past studies have presented numerical results for truncated airway trees, however, there are significant difficulties in connecting such results with respiratory airway models. This article presents a new modeling paradigm for flow in the full lung, based on a conjugate fluid-porous formulation where the upper airway is considered as a fluid region with the remainder of the lung being considered as a coupled porous region. Results are presented for a realistic lung geometry obtained from computed tomography (CT) images, which show the method's potential as being more efficient and practical than attempting to directly simulate flow in the full lung.

Loco-regional administration of nanomedicines for the treatment of lung cancer

Lung cancer poses one of the most significant challenges to modern medicine, killing thousands every year. Current therapy involves surgical resection supplemented with chemotherapy and radiotherapy due to high rates of relapse. Shortcomings of currently available chemotherapy protocols include unacceptably high levels of systemic toxicity and low accumulation of drug at the tumor site. Loco-regional delivery of nanocarriers loaded with anticancer agents has the potential to significantly increase efficacy, while minimizing systemic toxicity to anticancer agents. Local drug administration at the tumor site using nanoparticulate drug delivery systems can reduce systemic toxicities observed with intravenously administered anticancer drugs. In addition, this approach presents an opportunity for sustained delivery of anticancer drug over an extended period of time. Herein, the progress in the development of locally administered nanomedicines for the treatment of lung cancer is reviewed. Administration by inhalation, intratumoral injection and means of direct in situ application are discussed, the benefits and drawbacks of each modality are explored.

Fluid flow and particle transport in mechanically ventilated airways. Part II: particle transport

The flow mechanisms that play a role on aerosol deposition were identified and presented in a companion paper (Timothy et al. in Med Biol Eng Comput. doi: 10.1007/s11517-015-1407-3 , 2015). In the current paper, the effects of invasive conventional mechanical ventilation waveforms and endotracheal tube (ETT) on the aerosol transport were investigated. In addition to the enhanced deposition seen at the carinas of the airway bifurcations, enhanced deposition was also seen in the right main bronchus due to impaction and turbulent dispersion resulting from the fluid structures created by jet caused by the ETT. The orientation of the ETT toward right bronchus resulted in a substantial deposition inside right lung compared to left lung. The deposition inside right lung was ~12-fold higher than left lung for all considered cases, except for the case of using pressure-controlled sinusoidal waveform where a reduction of this ratio by ~50 % was found. The total deposition during pressure constant, volume ramp, and ascending ramp waveforms was similar and ~1.44 times higher than deposition fraction when using pressure sinusoidal waveform. Varying respiratory waveform demonstrated a significant role on the deposition enhancement factors and give evidence of drug aerosol concentrations in key deposition sites, which may be significant for drugs with negative side effects in high concentrations. These observations are thought to be important for ventilation treatment strategy.

Nanoparticle mass transfer from lung airways to systemic regions--Part I: Whole-lung aerosol dynamics

This is a two-part paper describing inhaled nanoparticle (NP) transport and deposition in a model of a human respiratory tract (Part I) as well as NP-mass transfer across barriers into systemic regions (Part II). Specifically, combining high-resolution computer simulation results of inhaled NP deposition in the human airways (Part I) with a multicompartmental model for NP-mass transfer (Part II) allows for the prediction of temporal NP accumulation in the blood and lymphatic systems as well as in organs. An understanding of nanoparticle transport and deposition in human respiratory airways is of great importance, as exposure to nanomaterial has been found to cause serious lung diseases, while the use of nanodrugs may have superior therapeutic effects. In Part I, the fluid-particle dynamics of a dilute NP suspension was simulated for the entire respiratory tract, assuming steady inhalation and planar airways. Thus, a realistic airway configuration was considered from nose/mouth to generation 3, and then an idealized triple-bifurcation unit was repeated in series and parallel to cover the remaining generations. Using the current model, the deposition of NPs in distinct regions of the lung, namely extrathoracic, bronchial, bronchiolar, and alveolar, was calculated. The region-specific NP-deposition results for the human lung model were used in Part II to determine the multicompartmental model parameters from experimental retention and clearance data in human lungs. The quantitative, experimentally validated results are useful in diverse fields, such as toxicology for exposure-risk analysis of ubiquitous nanomaterial as well as in pharmacology for nanodrug development and targeting.

Simulation of nanoparticle transport in airways using Petrov-Galerkin finite element methods

The transport and deposition properties of nanoparticles with a range of aerodynamic diameters ( 1 nm ≤ d ≤ 150 nm) were studied for the human airways. A finite element code was developed that solved both the Navier-Stokes and advection-diffusion equations monolithically. When modeling nanoparticle transport in the airways, the finite element method becomes unstable, and, in order resolve this issue, various stabilization methods were considered in terms of accuracy and computational cost. The stabilization methods considered here include the streamline upwind, streamline upwind Petrov-Galerkin, and Galerkin least squares approaches. In order to compare the various stabilization approaches, the approximate solution from each stabilization approach was compared to the analytical Graetz solution, which is a model for monodispersed, dilute particle transport in a straight cylinder. The optimal stabilization method, especially with regard to accuracy, was found to be the Galerkin least squares approach for the Graetz problem when the Péclet number was larger than 10(4). In the human airways geometry, the Galerkin least squares stabilization approach once more provided the most accurate approximate solution for particles with an aerodynamic diameter of 10 nm or larger, but mesh size had a much greater effect on accuracy than the choice of stabilization method. The choice of stabilization method had a greater impact than mesh size for particles with an aerodynamic diameter 10 nm or smaller, but the most accurate stabilization method was streamline upwind Petrov-Galerkin in these cases.

Deposition of inhaled particles in the lungs

Inhaled medication is the first-line treatment of diseases such as asthma or chronic obstructive pulmonary disease. Its effectiveness is related to the amount of drug deposited beyond the oropharyngeal region, the place where the deposit occurs and its distribution (uniform or not). It is also important to consider the size of the inhaled particles, the breathing conditions, the geometry of the airways and the mucociliary clearance mechanisms. Currently, mathematical models are being applied to describe the deposition of inhaled drugs based on the size of the particles, the inspiratory flow and the anatomical distribution of the bronchial tree. The deposition of particles in the small airways gets maximum attention from pharmaceutical companies and is of great interest as it is related with a better control in patients receiving these drugs.

Inhaled chemotherapy in lung cancer: future concept of nanomedicine

Regional chemotherapy was first used for lung cancer 30 years ago. Since then, new methods of drug delivery and pharmaceuticals have been investigated in vitro, and in animals and humans. An extensive review of drug delivery systems, pharmaceuticals, patient monitoring, methods of enhancing inhaled drug deposition, safety and efficacy, and also additional applications of inhaled chemotherapy and its advantages and disadvantages are presented. Regional chemotherapy to the lung parenchyma for lung cancer is feasible and efficient. Safety depends on the chemotherapy agent delivered to the lungs and is dose-dependent and time-dependent. Further evaluation is needed to provide data regarding early lung cancer stages, and whether regional chemotherapy can be used as neoadjuvant or adjuvant treatment. Finally, inhaled chemotherapy could one day be administered at home with fewer systemic adverse effects.

Efficient, physiologically realistic lung airflow simulations

One of the key challenges for computational fluid dynamics (CFD) simulations of human lung airflow is the sheer size and complexity of the complete, multiscale geometry of the bronchopulmonary tree. Since 3-D CFD simulations of the full airway tree are currently intractable, researchers have proposed reduced geometry models in which multiple airway paths are truncated downstream of the first few generations. This paper investigates a recently proposed method for closing the CFD model by application of physiologically correct boundary conditions at truncated outlets. A realistic, reduced geometry model of the lung airway based on CT data has been constructed up to generation 18, including extrathoracic, bronchi, and bronchiole regions. Results indicate that the new method yields reasonable results for pressure drop through the airway, at a small fraction of the cost of fully resolved simulations.

Computational fluid dynamics simulations of particle deposition in large-scale, multigenerational lung models

Computational fluid dynamics (CFD) has emerged as a useful tool for the prediction of airflow and particle transport within the human lung airway. Several published studies have demonstrated the use of Eulerian finite-volume CFD simulations coupled with Lagrangian particle tracking methods to determine local and regional particle deposition rates in small subsections of the bronchopulmonary tree. However, the simulation of particle transport and deposition in large-scale models encompassing more than a few generations is less common, due in part to the sheer size and complexity of the human lung airway. Highly resolved, fully coupled flowfield solution and particle tracking in the entire lung, for example, is currently an intractable problem and will remain so for the foreseeable future. This paper adopts a previously reported methodology for simulating large-scale regions of the lung airway (Walters, D. K., and Luke, W. H., 2010, "A Method for Three-Dimensional Navier-Stokes Simulations of Large-Scale Regions of the Human Lung Airway," ASME J. Fluids Eng., 132(5), p. 051101), which was shown to produce results similar to fully resolved geometries using approximate, reduced geometry models. The methodology is extended here to particle transport and deposition simulations. Lagrangian particle tracking simulations are performed in combination with Eulerian simulations of the airflow in an idealized representation of the human lung airway tree. Results using the reduced models are compared with those using the fully resolved models for an eight-generation region of the conducting zone. The agreement between fully resolved and reduced geometry simulations indicates that the new method can provide an accurate alternative for large-scale CFD simulations while potentially reducing the computational cost of these simulations by several orders of magnitude.