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Pasero L, Susa F, Limongi T, Pisano R. A Review on Micro and Nanoengineering in Powder-Based Pulmonary Drug Delivery. Int J Pharm 2024; 659:124248. [PMID: 38782150 DOI: 10.1016/j.ijpharm.2024.124248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
Pulmonary delivery of drugs has emerged as a promising approach for the treatment of both lung and systemic diseases. Compared to other drug delivery routes, inhalation offers numerous advantages including high targeting, fewer side effects, and a huge surface area for drug absorption. However, the deposition of drugs in the lungs can be limited by lung defence mechanisms such as mucociliary and macrophages' clearance. Among the delivery devices, dry powder inhalers represent the optimal choice due to their stability, ease of use, and absence of propellants. In the last decades, several bottom-up techniques have emerged over traditional milling to produce inhalable powders. Among these techniques, the most employed ones are spray drying, supercritical fluid technology, spray freeze-drying, and thin film freezing. Inhalable dry powders can be constituted by micronized drugs attached to a coarse carrier (e.g., lactose) or drugs embedded into a micro- or nanoparticle. Particulate-based formulations are commonly composed of polymeric micro- and nanoparticles, liposomes, solid lipid nanoparticles, dendrimers, nanocrystals, extracellular vesicles, and inorganic nanoparticles. Moreover, engineered formulations including large porous particles, swellable microparticles, nano-in-microparticles, and effervescent nanoparticles have been developed. Particle engineering has also a crucial role in tuning the physical-chemical properties of both carrier-based and carrier-free inhalable powders. This approach can increase powder flowability, deposition, and targeting by customising particle surface features.
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Affiliation(s)
- Lorena Pasero
- Department of Applied Science and Technology, Politecnico di Torino, 24 Corso Duca Degli Abruzzi, 10129 Torino, Italy.
| | - Francesca Susa
- Department of Applied Science and Technology, Politecnico di Torino, 24 Corso Duca Degli Abruzzi, 10129 Torino, Italy.
| | - Tania Limongi
- Department of Applied Science and Technology, Politecnico di Torino, 24 Corso Duca Degli Abruzzi, 10129 Torino, Italy; Department of Drug Science and Technology, University of Turin, 9 P. Giuria Street, 10125 Torino, Italy.
| | - Roberto Pisano
- Department of Applied Science and Technology, Politecnico di Torino, 24 Corso Duca Degli Abruzzi, 10129 Torino, Italy.
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Dhege CT, Kumar P, Choonara YE. Pulmonary drug delivery devices and nanosystems as potential treatment strategies for acute respiratory distress syndrome (ARDS). Int J Pharm 2024; 657:124182. [PMID: 38697584 DOI: 10.1016/j.ijpharm.2024.124182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/28/2024] [Indexed: 05/05/2024]
Abstract
Despite advances in drug delivery technologies, treating acute respiratory distress syndrome (ARDS) is challenging due to pathophysiological barriers such as lung injury, oedema fluid build-up, and lung inflammation. Active pharmaceutical ingredients (API) can be delivered directly to the lung site of action with the use of aerosol-based drug delivery devices, and this circumvents the hepatic first-pass effect and improves the bioavailability of drugs. This review discusses the various challenges and barriers for pulmonary drug delivery, current interventions for delivery, considerations for effective drug delivery, and the use of nanoparticle drug delivery carriers as potential strategies for delivering therapeutics in ARDS. Nanosystems have the added benefit of entrapping drugs, increase pulmonary drug bioavailability, and using biocompatible and biodegradable excipients that can facilitate targeted and/or controlled delivery. These systems provide an alternative to existing conventional systems. An effective way to deliver drugs for the treatment of ARDS can be by using colloidal systems that are aerosolized or inhaled. Drug distribution to the deeper pulmonary tissues is necessary due to the significant endothelial cell destruction that is prevalent in ARDS. The particle size of nanoparticles (<0.5 μm) makes them ideal candidates for treating ARDS as they can reach the alveoli. A look into the various potential benefits and limitations of nanosystems used for other lung disorders is also considered to indicate how they may be useful for the potential treatment of ARDS.
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Affiliation(s)
- Clarence T Dhege
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa
| | - Pradeep Kumar
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa
| | - Yahya E Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa.
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Chakravarty A, Panchagnula MV, Mohan A, Patankar NA. Pulmonary drug delivery and retention: A computational study to identify plausible parameters based on a coupled airway-mucus flow model. PLoS Comput Biol 2022; 18:e1010143. [PMID: 35653381 PMCID: PMC9197018 DOI: 10.1371/journal.pcbi.1010143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/14/2022] [Accepted: 04/26/2022] [Indexed: 01/19/2023] Open
Abstract
Pulmonary drug delivery systems rely on inhalation of drug-laden aerosols produced from aerosol generators such as inhalers, nebulizers etc. On deposition, the drug molecules diffuse in the mucus layer and are also subjected to mucociliary advection which transports the drugs away from the initial deposition site. The availability of the drug at a particular region of the lung is, thus, determined by a balance between these two phenomena. A mathematical analysis of drug deposition and retention in the lungs is developed through a coupled mathematical model of aerosol transport in air as well as drug molecule transport in the mucus layer. The mathematical model is solved computationally to identify suitable conditions for the transport of drug-laden aerosols to the deep lungs. This study identifies the conditions conducive for delivering drugs to the deep lungs which is crucial for achieving systemic drug delivery. The effect of different parameters on drug retention is also characterized for various regions of the lungs, which is important in determining the availability of the inhaled drugs at a target location. Our analysis confirms that drug delivery efficacy remains highest for aerosols in the size range of 1-5 μm. Moreover, it is observed that amount of drugs deposited in the deep lung increases by a factor of 2 when the breathing time period is doubled, with respect to normal breathing, suggesting breath control as a means to increase the efficacy of drug delivery to the deep lung. A higher efficacy also reduces the drug load required to be inhaled to produce the same health effects and hence, can help in minimizing the side effects of a drug. Pulmonary drug delivery systems utilize the respiratory mechanism to directly deliver drugs to a target region of the lungs. The drug molecules deposit in the mucus lining, on reaching the target region, and are simultaneously transported away from the target region due to mucociliary transport and molecular diffusion. The availability of drugs at a target lung region and hence, efficacy of the drugs, therefore, determined by the delivery and retention of the drugs at the target region. The present study computationally solves the coupled transport equations to identify the conditions conducive for drug delivery and retention in the deep lungs. Drug delivery efficacy to the deep lung is observed to be highest for 1–5 μm aerosols. Breathing time period is also observed to influence efficacy. The amount of drugs deposited in the deep lung is observed to increase by a factor of 2 when the breathing time period is doubled with respect to normal breathing period. Such insights gained from this analysis will potentially help in devising mechanisms for increasing drug availability in the deep lung which is essential in achieving systemic drug delivery.
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Affiliation(s)
- Aranyak Chakravarty
- School of Nuclear Studies and Application, Jadavpur University, Kolkata, India
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India
| | - Mahesh V. Panchagnula
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India
| | - Alladi Mohan
- Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Neelesh A. Patankar
- Department of Mechanical Engineering, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
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Kumar R, Mehta P, Shankar KR, Rajora MAK, Mishra YK, Mostafavi E, Kaushik A. Nanotechnology-Assisted Metered-Dose Inhalers (MDIs) for High-Performance Pulmonary Drug Delivery Applications. Pharm Res 2022; 39:2831-2855. [PMID: 35552983 PMCID: PMC9097569 DOI: 10.1007/s11095-022-03286-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Respiratory disorders pose a major threat to the morbidity and mortality to public health. Here we reviewed the nanotechnology based pulmonary drug delivery using metered dose inhalers. METHODS Major respiratory diseases such as chronic obstructive pulmonary diseases (COPD), asthma, acute lower respiratory tract infections, tuberculosis (TB) and lung cancer. At present, common treatments for respiratory disorders include surgery, radiation, immunotherapy, and chemotherapy or a combination. The major challenge is development of systemic delivery of the chemotherapeutic agents to the respiratory system. Conventional delivery of chemotherapy has various limitation and adverse side effected. Hence, targeted, and systemic delivery need to be developed. Towards this direction nanotechnology, based controlled, targeted, and systemic drug delivery systems are potential candidate to enhance therapeutic efficacy with minimum side effect. Among different route of administration, pulmonary delivery has unique benefits such as circumvents first pass hepatic metabolism and reduces dose and side effects. RESULTS Respiratory disorders pose a major threat to the morbidity and mortality to public health globally. Pulmonary delivery can be achieved through various drug delivery devices such as nebulizers, dry powder inhalers, and metered dose inhalers. Among them, metered dose inhalers are the most interesting and first choice of clinician over others. This review focused on nanotechnology based pulmonary drug delivery using metered dose inhalers. This report focused on delivery of various types of therapeutics using nanocarriers such as polymeric nanoparticles and micelles, dendrimers, lipid nanocarriers such as liposomes, solid lipid nanostructures and nanostructured lipid carriers, and other using metered dose inhalers discussed comprehensively. This report provides insight about the effect of parameters of MDI such as co-solvent, propellants, actuators shape, nozzle diameters, and jet lengths, and respiratory flow rate, and particle size of co-suspension of drug on aerodynamics and lung deposition of formulation. This review also provided the insight about various metered dose inhalers market scenario and digital metered dose inhalers. CONCLUSION This report concluded the clinical potential of metered dose inhalers, summary of current progress and future perspectives towards the smart digital metered dose inhalers development.
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Affiliation(s)
- Raj Kumar
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, 68105, USA.
| | - Piyush Mehta
- Pharmaceutical Technology Center, Department of Aerosol, Zydus Life Sciences Ltd., Ahmedabad, Gujarat, India
| | | | - Manju A K Rajora
- College of Nursing, All India Institute of Medical Sciences, New Delhi, 100029, India
| | - Yogendra Kumar Mishra
- Mads Clausen Institute, NanoSYD, University of Southern Denmark, Alsion 2, 6400, Sønderborg, Denmark.,Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Ebrahim Mostafavi
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.,NanoBioTech Laboratory, Health Systems Engineering, Department of Natural Sciences, Florida Polytechnic University, Lakeland, FL, USA
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Health Systems Engineering, Department of Natural Sciences, Florida Polytechnic University, Lakeland, FL, USA.
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Xiroudaki S, Schoubben A, Giovagnoli S, Rekkas DM. Dry Powder Inhalers in the Digitalization Era: Current Status and Future Perspectives. Pharmaceutics 2021; 13:pharmaceutics13091455. [PMID: 34575530 PMCID: PMC8467565 DOI: 10.3390/pharmaceutics13091455] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022] Open
Abstract
During the last decades, the term "drug delivery systems" (DDSs) has almost fully replaced previously used terms, such as "dosage forms", in an attempt to emphasize the importance of the drug carrier in ensuring the claimed safety and effectiveness of the product. However, particularly in the case of delivery devices, the term "system", which by definition implies a profound knowledge of each single part and their interactions, is not always fully justified when using the DDS term. Within this context, dry powder inhalers (DPIs), as systems to deliver drugs via inhalation to the lungs, require a deep understanding of the complex formulation-device-patient interplay. As of now and despite the progress made in particle engineering and devices design, DPIs' clinical performance is limited by variable patients' breathing patterns. To circumvent this pitfall, next-generation DPIs should ideally adapt to the different respiratory capacity of individuals across age, health conditions, and other related factors. In this context, the recent wave of digitalization in the health care and industrial sectors may drive DPI technology towards addressing a personalized device-formulation-patient liaison. In this review, evolving technologies are explored and analyzed to outline the progress made as well as the gaps to fill to align novel DPIs technologies with the systems theory approach.
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Affiliation(s)
- Styliani Xiroudaki
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy; (S.X.); (A.S.)
| | - Aurélie Schoubben
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy; (S.X.); (A.S.)
| | - Stefano Giovagnoli
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy; (S.X.); (A.S.)
- Correspondence: (S.G.); (D.M.R.); Tel.: +39-075-5855162 (S.G.); +30-210-7274023 (D.M.R.)
| | - Dimitrios M. Rekkas
- Section of Pharmaceutical Technology, Department of Pharmacy, National & Kapodistrian University of Athens, 15784 Athens, Greece
- Correspondence: (S.G.); (D.M.R.); Tel.: +39-075-5855162 (S.G.); +30-210-7274023 (D.M.R.)
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Li Z. The effect of adjuvant therapy with ambroxol hydrochloride in elderly chronic obstructive pulmonary disease patients. Am J Transl Res 2021; 13:9285-9295. [PMID: 34540045 PMCID: PMC8430100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the influence of adjuvant therapy with ambroxol hydrochloride (ABH) on the clinical symptoms and pulmonary function of elderly chronic obstructive pulmonary disease (COPD) patients. METHODS From September 2018 to September 2019, 142 elderly COPD patients admitted to the Affiliated Hospital of Hebei University were recruited as the research cohort. Based on different treatment method each patient underwent, they were assigned to the control group (CG, n=69) or the research group (RG, n=73). In the CG, the patients were treated with routine symptomatic treatment, and the patients in the RG were treated with ABH in addition to the treatment administered in the control group. RESULTS After the therapy, the clinical symptom scores in the RG were significantly lower than they were in the CG (P<0.05), and the total effective rate of the clinical treatment was significantly higher than it was in the CG (P<0.05). The 6MWT scores in the RG were higher than they were in the CG (P<0.001), and the CAT scores were significantly lower than they were in the CG (P<0.001). The inflammatory factor levels in the RG were markedly lower than they were in the CG (P<0.001), and the pulmonary function and immune function indexes were better than they were in the CG (P<0.05). There was no significant difference in the adverse effects between the two groups (P>0.05). CONCLUSION ABH can effectively relieve the clinical symptoms and improve the pulmonary function of elderly COPD patients, with a significant clinical effectiveness and high drug safety, so it is worthy of promoting.
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Affiliation(s)
- Zheng Li
- Department of Respiratory Medicine, Affiliated Hospital of Hebei University Baoding 071000, Hebei Province, China
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Evaluation of sex-based differences in airway size and the physiological implications. Eur J Appl Physiol 2021; 121:2957-2966. [PMID: 34331574 DOI: 10.1007/s00421-021-04778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Recent evidence suggests healthy females have significantly smaller central conducting airways than males when matched for either height or lung volume during analysis. This anatomical sex-based difference could impact the integrative response to exercise. Our review critically evaluates the literature on direct and indirect techniques to measure central conducting airway size and their limitations. We present multiple sources highlighting the difference between male and female central conducting airway size in both pediatric and adult populations. Following the discussion of measurement techniques and results, we discuss the functional implications of these differences in central conducting airway size, including work of breathing, oxygen cost of breathing, and how these impacts will continue into elderly populations. We then discuss a range of topics for the future direction of airway differences and the benefits they could provide to both healthy and diseased populations. Specially, these sex-differences in central conducting airway size could result in different aerosol deposition or how lung disease manifests. Finally, we detail emerging techniques that uniquely allow for high-resolution imaging to be paired with detailed physiological measures.
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Rahman Sabuj MZ, Islam N. Inhaled antibiotic-loaded polymeric nanoparticles for the management of lower respiratory tract infections. NANOSCALE ADVANCES 2021; 3:4005-4018. [PMID: 36132845 PMCID: PMC9419283 DOI: 10.1039/d1na00205h] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/16/2021] [Indexed: 05/09/2023]
Abstract
Lower respiratory tract infections (LRTIs) are one of the leading causes of deaths in the world. Currently available treatment for this disease is with high doses of antibiotics which need to be administered frequently. Instead, pulmonary delivery of drugs has been considered as one of the most efficient routes of drug delivery to the targeted areas as it provides rapid onset of action, direct deposition of drugs into the lungs, and better therapeutic effects at low doses and is self-administrable by the patients. Thus, there is a need for scientists to design more convenient pulmonary drug delivery systems towards the innovation of a novel treatment system for LRTIs. Drug-encapsulating polymer nanoparticles have been investigated for lung delivery which could significantly reduce the limitations of the currently available treatment system for LRTIs. However, the selection of an appropriate polymer carrier for the drugs is a critical issue for the successful formulations of inhalable nanoparticles. In this review, the current understanding of LRTIs, management systems for this disease and their limitations, pulmonary drug delivery systems and the challenges of drug delivery through the pulmonary route are discussed. Drug-encapsulating polymer nanoparticles for lung delivery, antibiotics used in pulmonary delivery and drug encapsulation techniques have also been reviewed. A strong emphasis is placed on the impact of drug delivery into the infected lungs.
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Affiliation(s)
- Mohammad Zaidur Rahman Sabuj
- Pharmacy Discipline, School of Clinical Sciences, Queensland University of Technology (QUT) Brisbane QLD Australia
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT) Brisbane QLD Australia
| | - Nazrul Islam
- Pharmacy Discipline, School of Clinical Sciences, Queensland University of Technology (QUT) Brisbane QLD Australia
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT) Brisbane QLD Australia
- Centre for Immunology and Infection Control (CIIC), Queensland University of Technology (QUT) Brisbane QLD Australia
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Rodrigues AT, Romano S, Romão M, Figueira D, Bulhosa C, Madeira A, Rocha L, Alves J. Effectiveness of a pharmacist-led intervention on inhalation technique for asthma and COPD patients: The INSPIRA pilot cluster-randomized controlled trial. Respir Med 2021; 185:106507. [PMID: 34166959 DOI: 10.1016/j.rmed.2021.106507] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Asthma and COPD are leading causes of disability-adjusted life-years worldwide representing a huge burden on the health system and among patients. One of the reasons for the lack of disease control is poor inhalation technique, with impact on quality of life and symptom control. OBJECTIVE To assess the effectiveness of a community pharmacist-led educational intervention on asthma and COPD patients' inhalation technique. METHODS The INspira study is a 6-month pilot cluster randomized controlled trial, conducted in community pharmacies of Portugal, enrolling adults aged 18 years or older, with a self-reported diagnosis of asthma or COPD and on inhaled therapy. Pharmacies were randomly allocated to Intervention or Control group. Intervention focused mainly on inhalation technique education via demonstration and repetition. Primary outcome was the proportion of patients scoring 100% in at least one inhaler. RESULTS From January to November 2019, 48 pharmacies recruited 201 asthma and COPD patients, of which 132 completed the 6-month follow-up. At the end of follow-up, the odds of intervention group patients score 100% compared to the control group were 5.63 (95% CI, [2.21; 14.35]) in all inhalers in use and 6.77 (95% CI, [2.52; 18.20]) considering at least one inhaler. Intervention group patients reported having a significantly lower number of scheduled appointments compared with the control group (OR = 0.17; 95% CI, [0.037; 0.79]; p = 0.0135). No other significant differences were found between groups. CONCLUSION This pilot study suggested that pharmacist interventions can improve patients' inhalation technique, with possible positive impact in healthcare resource use.
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Affiliation(s)
- António Teixeira Rodrigues
- Centre for Health Evaluation & Research/Infosaude - National Association of Pharmacies (CEFAR/IS-ANF), Lisbon, Portugal.
| | - Sónia Romano
- Centre for Health Evaluation & Research/Infosaude - National Association of Pharmacies (CEFAR/IS-ANF), Lisbon, Portugal
| | - Mariana Romão
- Centre for Health Evaluation & Research/Infosaude - National Association of Pharmacies (CEFAR/IS-ANF), Lisbon, Portugal
| | - Débora Figueira
- Centre for Health Evaluation & Research/Infosaude - National Association of Pharmacies (CEFAR/IS-ANF), Lisbon, Portugal
| | - Carolina Bulhosa
- Centre for Health Evaluation & Research/Infosaude - National Association of Pharmacies (CEFAR/IS-ANF), Lisbon, Portugal
| | - Anabela Madeira
- Medicines Information Centre/Infosaude - National Association of Pharmacies (CEDIME/IS-ANF), Lisbon, Portugal
| | - Luis Rocha
- Pulmonology Department, Portuguese Oncology Institute of Porto, Porto, Portugal; Occupational Health Department, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - José Alves
- Portuguese Lung Society, Porto, Portugal
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Duong T, López-Iglesias C, Szewczyk PK, Stachewicz U, Barros J, Alvarez-Lorenzo C, Alnaief M, García-González CA. A Pathway From Porous Particle Technology Toward Tailoring Aerogels for Pulmonary Drug Administration. Front Bioeng Biotechnol 2021; 9:671381. [PMID: 34017828 PMCID: PMC8129550 DOI: 10.3389/fbioe.2021.671381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/06/2021] [Indexed: 12/29/2022] Open
Abstract
Pulmonary drug delivery has recognized benefits for both local and systemic treatments. Dry powder inhalers (DPIs) are convenient, portable and environmentally friendly devices, becoming an optimal choice for patients. The tailoring of novel formulations for DPIs, namely in the form of porous particles, is stimulating in the pharmaceutical research area to improve delivery efficiency. Suitable powder technological approaches are being sought to design such formulations. Namely, aerogel powders are nanostructured porous particles with particularly attractive properties (large surface area, excellent aerodynamic properties and high fluid uptake capacity) for these purposes. In this review, the most recent development on powder technologies used for the processing of particulate porous carriers are described via updated examples and critically discussed. A special focus will be devoted to the most recent advances and uses of aerogel technology to obtain porous particles with advanced performance in pulmonary delivery.
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Affiliation(s)
- Thoa Duong
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma group (GI-1645), Faculty of Pharmacy, and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Clara López-Iglesias
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma group (GI-1645), Faculty of Pharmacy, and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Piotr K Szewczyk
- Faculty of Metals Engineering and Industrial Computer Science, AGH University of Science and Technology, Krakow, Poland
| | - Urszula Stachewicz
- Faculty of Metals Engineering and Industrial Computer Science, AGH University of Science and Technology, Krakow, Poland
| | - Joana Barros
- i3S - Instituto de Investigação e Inovação em Saúde da Universidade do Porto - Associação, INEB - Instituto de Engenharia Biomédica, FEUP - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Carmen Alvarez-Lorenzo
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma group (GI-1645), Faculty of Pharmacy, and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Mohammad Alnaief
- Department of Pharmaceutical and Chemical Engineering, Faculty of Applied Medical Sciences, German Jordanian University, Amman, Jordan
| | - Carlos A García-González
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma group (GI-1645), Faculty of Pharmacy, and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Dong J, Li J, Tian L, Tu J. Transport and deposition of ultrafine particles in the upper tracheobronchial tree: a comparative study between approximate and realistic respiratory tract models. Comput Methods Biomech Biomed Engin 2021; 24:1125-1135. [PMID: 33410725 DOI: 10.1080/10255842.2020.1869220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This paper presents a computational fluid dynamics (CFD) study of air-particle flows in the upper tracheobronchial tree. Two respiratory tract models, including a parametrically controlled approximate airway model developed by Kitaoka (KG model) and a CT-based patient specific airway (realistic model) were used. Assuming laminar, quasi-steady, three-dimensional air flow and spherical non-interacting ultrafine particles in sequentially bifurcating rigid bronchial airways, airflow patterns and particle transport/deposition in these two airway models were evaluated and compared. Overall deposition efficiency data was compared with the widely adopted ICRP data published by The International Commission on Radiological Protection. Good deposition efficiency agreements were observed between the present respiratory tract models and the ICRP data, which validated the numerical prediction accuracy of the present computational fluid-particle dynamics (CFPD) model. For the two respiratory models, the comparison showed both difference and similarity between the approximate KG model and the realistic model. Specifically, the realistic model showed more complicated airflow patterns due to the increased surface irregularity. The deposition efficiency data revealed a deposition preference in the first-generation airways compared to the rest regions. For ultrafine particles smaller than 10 nm, Brownian diffusion remains the dominant particle deposition mechanism. However, for ultrafine particles with size ranging from 10 nm to 100 nm, the deposition efficiency decreased dramatically with the 100 nm particles approaching to zero deposition in the present bronchial tree scope. The generation-by-generation deposition data presented in this paper is indispensable to the formulation of new lung inhalation exposure models.
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Affiliation(s)
- Jingliang Dong
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Jiang Li
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Lin Tian
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Jiyuan Tu
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, VIC, Australia
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12
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Christou S, Chatziathanasiou T, Angeli S, Koullapis P, Stylianou F, Sznitman J, Guo HH, Kassinos SC. Anatomical variability in the upper tracheobronchial tree: sex-based differences and implications for personalized inhalation therapies. J Appl Physiol (1985) 2020; 130:678-707. [PMID: 33180641 DOI: 10.1152/japplphysiol.00144.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The morphometry of the large conducting airways is presumed to have a strong effect on the regional deposition of inhaled aerosol particles. Nevertheless, sex-based differences have not been fully quantified and are still largely ignored in designing inhalation therapies. To this end, we retrospectively analyzed high-resolution computed tomography scans for 185 individuals (90 women, 95 men) in the age range of 12-89 yr to determine airway luminal areas, airway lengths, and bifurcation angles. Only subjects free of chronic airway disease were considered. In men, luminal areas of the upper conducting airways were, on average, ∼30%-50% larger when compared with those in women, with the largest differences found in the trachea (289.72 ± 54.25 vs. 193.50 ± 42.37 mm2 for men and women, respectively). The ratio of the largest luminal area in men to the smallest luminal area in women (in any given segment) ranged between 4.5 and 8.6, the largest differences being found in the lobar bronchi. Sex-based differences were minor in the case of bifurcation angles (e.g., average main bifurcation angle: 93.04 ± 9.58° vs. 91.03 ± 9.81° for men and women, respectively), but large intersubject variability was found irrespective of sex (e.g., range of main bifurcation angle: 65.04°-122.01° vs. 69.46°-113.94° for men and women, respectively). Bronchial segments were shorter by ∼5%-20% in women relative to men, the largest differences being located in the upper lobes. False discovery rate analysis revealed statistically significant associations among morphometric measures of the right lung in women (but not in men), suggesting two phenotypes among women that we attribute to the smaller female thoracic volume.NEW & NOTEWORTHY We found significant sex-based morphometric differences in the central airways of healthy men and women that were only mildly attenuated in subsets matched for lung volume. Lumen areas were significantly larger in men (∼30%-50%). Large variability (∼75%-87%) in airway bifurcation angles (60°-122°) was found irrespective of sex. The branching pattern of the right main and right upper bronchi in women (but not in men) follows two phenotypes modulated by lung volume.
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Affiliation(s)
- Simoni Christou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Thanasis Chatziathanasiou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | | | - Pantelis Koullapis
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Fotos Stylianou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Haiwei Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Stavros C Kassinos
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
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13
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Craparo EF, Drago SE, Mauro N, Giammona G, Cavallaro G. Design of New Polyaspartamide Copolymers for siRNA Delivery in Antiasthmatic Therapy. Pharmaceutics 2020; 12:E89. [PMID: 31979001 PMCID: PMC7076449 DOI: 10.3390/pharmaceutics12020089] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/09/2020] [Accepted: 01/18/2020] [Indexed: 01/05/2023] Open
Abstract
Here, a novel protonable copolymer was realized for the production of polyplexes with a siRNA (inhibitor of STAT6 expression in asthma), with the aim of a pulmonary administration. The polycation was synthesized by derivatization of α,β-poly(N-2-hydroxyethyl)d,l-aspartamide (PHEA) with 1,2-Bis(3-aminopropylamino)ethane (bAPAE) in proper conditions to obtain a PHEA-g-bAPAE graft copolymer with a derivatization degree in amine (DDbAPAE%) equal to 35 mol%. The copolymer showed a proper buffering behavior, i.e., ranging between pH 5 and 7.4, to potentially give the endosomal escape of the obtained polycations. In effect, an in vitro experiment demonstrated the effect on biological membranes of the copolymer on bronchial epithelial cells (16-HBE) strongly dependent on the pH of the medium, i.e., higher at pH 5. bAPAE-based copolymers were further obtained with an increasing pegylation degree, i.e., equal to 1.9, 2.7, and 4.4 mol%, respectively. All the obtained copolymers were able to complex siRNA at a N/P ratio that decreases as the pegylation degree increases. At the same time, the tendency of polyplexes to aggregate and the capability to interact with mucin also decreases as the pegylation in the copolymer increases. Gene silencing experiments on 16-HBE showed that these copolymers have a significant role in improving the intracellular transport of naked siRNA, where the presence of PEG does not seem to hinder the cellular uptake of polyplexes. The latter obtained at polymer/siRNA weight ratio (R) equal to 10 with PHEA-g-PEG(C)-g-bAPAE also seems to be not susceptible to the presence of mucin, avoiding the polyanionic exchange of complexed siRNA, thus showing adequate behavior to be used as an effective vector for siRNA.
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Affiliation(s)
- Emanuela Fabiola Craparo
- Lab of Biocompatible Polymers, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, via Archirafi 32, 90123 Palermo, Italy; (E.F.C.); (S.E.D.); (N.M.); (G.G.)
| | - Salvatore Emanuele Drago
- Lab of Biocompatible Polymers, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, via Archirafi 32, 90123 Palermo, Italy; (E.F.C.); (S.E.D.); (N.M.); (G.G.)
| | - Nicolò Mauro
- Lab of Biocompatible Polymers, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, via Archirafi 32, 90123 Palermo, Italy; (E.F.C.); (S.E.D.); (N.M.); (G.G.)
- Fondazione Umberto Veronesi, Piazza Velasca 5, 20122 Milano, Italy
| | - Gaetano Giammona
- Lab of Biocompatible Polymers, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, via Archirafi 32, 90123 Palermo, Italy; (E.F.C.); (S.E.D.); (N.M.); (G.G.)
| | - Gennara Cavallaro
- Lab of Biocompatible Polymers, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, via Archirafi 32, 90123 Palermo, Italy; (E.F.C.); (S.E.D.); (N.M.); (G.G.)
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14
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Nurwidhiyasari D, Rachmi SF, Indracahyani A, Nuraini T. Relationship between severity and quality of life in chronic obstructive pulmonary disease patients at hospitals’ outpatient units in Jakarta. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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D'Urzo A, Chapman KR, Donohue JF, Kardos P, Maleki-Yazdi MR, Price D. Inhaler Devices for Delivery of LABA/LAMA Fixed-Dose Combinations in Patients with COPD. Pulm Ther 2019; 5:23-41. [PMID: 32026426 PMCID: PMC6967354 DOI: 10.1007/s41030-019-0090-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 02/07/2023] Open
Abstract
Inhaled fixed-dose combinations (FDCs) of a long-acting β-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) have become the cornerstone for the maintenance treatment of symptomatic COPD patients. In this regard, global COPD treatment guidelines have recognized the importance of inhaler devices as integral contributors to the effectiveness of LABA/LAMA FDCs and recommend regular assessment of inhaler device use by the patients in order to improve long-term clinical outcomes. Optimal disease control is also highly dependent upon patient preferences and adherence to inhaler devices. This review objectively examines and compares the major inhaler devices used to deliver different LABA/LAMA FDCs, discusses the inhaler device characteristics that determine drug deposition in the airways, real-life preference for inhaler devices, and handling of inhaler devices that impact the results of the long-term management of COPD. The introduction of new LABA/LAMA FDCs, new inhaler devices, and more clinical studies have created confusion among physicians in choosing the optimal inhaled therapy for COPD patients; in this context, this review attempts to provide an evidence-based framework for informed decision-making with a particular focus on the inhaler devices.Funding. The preparation of this manuscript was funded by Novartis Pharma AG.
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Affiliation(s)
- Anthony D'Urzo
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Kenneth R Chapman
- Asthma and Airway Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - James F Donohue
- Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Peter Kardos
- Group Practice and Centre for Allergy, Respiratory and Sleep Medicine, Red Cross Maingau Hospital, Frankfurt, Germany
| | - M Reza Maleki-Yazdi
- Division of Respiratory Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - David Price
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Observational and Pragmatic Research Institute, Singapore, Singapore
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