In silico study of patient-specific magnetic drug targeting for a coronary LAD atherosclerotic plaque

Drug Delivery Angle for Various Atherosclerosis and Aneurysm Percentages of the Carotid Artery

Stroke is the second cause of mortality among adult males and the first cause of death in adult females all around the world. It is also recognized as one of the most important causes of morbidity and dementia in adults. Stenosis or rupture of the only channels of the blood supply from the heart to the brain (carotid arteries) is among the main causes of stroke. In this regard, treatment of the lesions of carotid arteries, including atherosclerosis and aneurysm, could be a huge step in preventing stroke and improving brain performance. Targeted drug delivery by drug-carrying nanoparticles is the latest method for optimal delivery of drug to the damaged parts of the artery. In this study, a wide range of carotid artery lesions, including different percentages of atherosclerosis and aneurysm, were considered. After analyzing the dynamics of the fluid flow in different damaged regions and selecting the magnetic framework with proper ligand (Fe3O4@MOF) as the drug carrier, the size of the particles and their number per cycle were analyzed. Based on the results, the particle size of 100 nm and the use of 300 particles per injection at each cardiac cycle can result in maximum drug delivery to the target site. Then, the effect of the hospital bed angle on drug delivery was investigated. The results showed a unique optimal drug delivery angle for each extent of atherosclerosis or aneurysm. For example, in a 50% aneurysm, drug delivery at an angle of 30° is about 387% higher than that at an angle of 15°. Finally, simulation of real geometry indicated the effectiveness of simple geometry instead of real geometry for the simulation of carotid arteries, which can remarkably decrease the computational time and costs.

Unsteady blood flow of Carreau fluid in a porous saturated medium with stenosis under the influence of acceleration and magnetic fields: A comprehensive analysis

Blood flow in stenosed arteries is a common cause of cardiovascular diseases, leading to serious health problems. The present study aims to investigate the unsteady Womersley blood flow in a stenosed, porous saturated artery under the influence of acceleration and magnetic fields. The study utilizes a Carreau constitutive equation to model blood rheology and employs the finite difference technique to compute the governing equations under the assumption of unsteady, unidirectional, and laminar flow. The importance of this study lies in its potential to provide a better understanding of the complex behavior of hemodynamic flow in the presence of external fields and porous media, which has significant implications for the control and management of cardiovascular diseases. In particular, the study analyses the impacts of non-dimensional parameters, such as magnetic field, channel permeability, acceleration field, Weissenberg number, and stenosis amplitude, on critical flow variables, such as velocity, resistivity, wall shear stress, and flow rate. Our calculations suggest that a magnetic field is an effective instrument for regulating hemodynamic flow because it increases resistance by up to 8.31% while decreasing flow by up to 8.44%. Channel permeability, on the other hand, improves blood velocity by up to 33.35% while eliminating resistance by up to 23.43%. Furthermore, greater acceleration fields decrease resistivity while increasing velocity, flow rate, and wall shear stress. Additionally, the severity of the stenosis and the Weissenberg number substantially affect flow factors. By raising the stenosis amplitude, resistivity rises, and other flow characteristics diminish, whereas modifying the Weissenberg number causes the reverse effect.

Modeling of an Ultrasound System in Targeted Drug Delivery to Abdominal Aortic Aneurysm: A Patient-Specific in Silico Study Based on Ligand-Receptor Binding

Targeted drug delivery methods have shown a significant impact on enhancing drug delivery efficiency and reducing drug side effects. While various stimuli have been used to promote the drug delivery process, applying ultrasound (US) waves to control drug particles through the human body, noninvasively, has drawn the scientist's attention. However, microcarriers delivery reaches the aneurysmal artery by US waves that exert volumetric forces on blood, and drug carriers, which can therefore affect blood flow patterns and movement pathways of drug carriers, have not yet been studied. In this study, we developed a 3-D patient-specific model of abdominal aortic aneurysm (AAA) to evaluate the effect of US waves in enhancing the drug-containing microbubbles (MBs) adhered on the AAA lumen through ligand-receptor binding. Thus, a focused US (FUS) transducer with a resonance frequency of ~1.1 MHz was added to the geometry. Then, the surface density of MBs (SDM) adhered on the AAA lumen was calculated at peak acoustic pressure of ~1.1, ~2.2, and ~4.3 MPa. Results indicated that increasing the US pressure had a significant impact on improving the MBs adhered to the intended wall, whereby US waves with the maximum pressure of ~4.3 MPa could enhance ~1- [Formula: see text] MBs adhesion ~98% relative to not using the waves. While US waves have the advantage of more SDM adhered to the whole artery wall, they adversely affect the SDM adhered on the critical wall of the abdominal aorta. Furthermore, when the US strength goes up, a reduction occurs in the SDM adhered. This reduction is higher for smaller MBs, which is the mentioned MBs' size and US strength reduced SDM adhesion by about ~50% relative to systemic injection. Therefore, it can be concluded that drug delivery using the US field increases the SDM adhered to the whole AAA wall and decreases the SDM adhered to the critical wall of AAA.

Targeted drug delivery of magnetic microbubble for abdominal aortic aneurysm: an in silico study

Targeted drug delivery (TDD) to abdominal aortic aneurysm (AAA) using a controlled and efficient approach has recently been a significant challenge. In this study, by using magnetic microbubbles (MMBs) under a magnetic field, we investigated the MMBs performance in TDD to AAA based on the amount of surface density of MMBs (SDMM) adhered to the AAA lumen. The results showed that among the types of MMBs studied in the presence of the magnetic field, micromarkers are the best type of microbubble with a -[Formula: see text] increase in SDMM adhered to the critical area of AAA. The results show that applying a magnetic field causes the amount of SDMM adhered to the whole area of AAA to increase -[Formula: see text] times compared to the condition in which the magnetic field is absent. This optimal and maximum value occurs for Definity MMBs with - 3.3 μm diameter. Applying a magnetic field also increases the adhesion surface density by - [Formula: see text], - [Formula: see text], and -[Formula: see text] times for the Micromarker, Optison, and Sonovue microbubbles, respectively, relative to the condition in which the magnetic field is absent. It was shown that using MBBs under magnetic field has the best performance in delivery to AAA for patients with negative inlet blood flow. Also, we have exposed that in an efficient TDD to AAA using MMBs, decreasing the density of MMBs increases drug delivery efficiency and performance. When density is - [Formula: see text], there is the highest difference (about - 75%) between the SDMM adhered to AAA in the presence of a magnetic field and in the absence of a magnetic field.

Targeted pulmonary drug delivery in coronavirus disease (COVID-19) therapy: A patient-specific in silico study based on magnetic nanoparticles-coated microcarriers adhesion

Since the beginning of the COVID-19 pandemic, nearly most confirmed cases develop respiratory syndromes. Using targeted drug delivery by microcarriers is one of the most important noteworthy methods for delivering drugs to the involved bronchi. This study aims to investigate the performance of a drug delivery that applies microcarriers to each branch of the lung under the influence of a magnetic field. The results show that by changing the inlet velocity from constant to pulsatile, the drug delivery performance to the lungs increases by ∼31%. For transferring the microcarriers to the right side branches (LUL and LLL), placing the magnet at zero height and ∼30° angle yields the best outcome. Also, the microcarriers' delivery to branch LUL improves by placing the magnet at LUL-LLL bifurcation and the angle of ∼30°. It was observed that dense (9300[kgm³]) microcarriers show the best performance for delivering drugs to LLL and RLL&RML branches. Also, low-density (1000[kgm³]) microcarriers are best for delivering drugs to LUL and RUL branches. The findings of this study can improve our understanding of different factors, such as inlet velocity, the magnet's position, and the choice of microcarrier - that affect drug delivery to the infected parts of the lung.

A mathematical model of hiPSC cardiomyocytes electromechanics

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are becoming instrumental in cardiac research, human-based cell level cardiotoxicity tests, and developing patient-specific care. As one of the principal functional readouts is contractility, we propose a novel electromechanical hiPSC-CM computational model named the hiPSC-CM-CE. This model comprises a reparametrized version of contractile element (CE) by Rice et al., 2008, with a new passive force formulation, integrated into a hiPSC-CM electrophysiology formalism by Paci et al. in 2020. Our simulated results were validated against in vitro data reported for hiPSC-CMs at matching conditions from different labs. Specifically, key action potential (AP) and calcium transient (CaT) biomarkers simulated by the hiPSC-CM-CE model were within the experimental ranges. On the mechanical side, simulated cell shortening, contraction-relaxation kinetic indices (RT50 and RT25 ), and the amplitude of tension fell within the experimental intervals. Markedly, as an inter-scale analysis, correct classification of the inotropic effects due to non-cardiomyocytes in hiPSC-CM tissues was predicted on account of the passive force expression introduced to the CE. Finally, the physiological inotropic effects caused by Verapamil and Bay-K 8644 and the aftercontractions due to the early afterdepolarizations (EADs) were simulated and validated against experimental data. In the future, the presented model can be readily expanded to take in pharmacological trials and genetic mutations, such as those involved in hypertrophic cardiomyopathy, and study arrhythmia trigger mechanisms.

FEM based simulation of magnetic drug targeting in a multibranched vessel model

BACKGROUND AND OBJECTIVE

Magnetic drug targeting (MDT) is a promising technology to improve cancer therapy. MDT describes the accumulation of drug loaded superparamagnetic iron oxide nanoparticles (SPIONs) at a desired location, e. g. a tumor, by application of a magnetic field. Here, we evaluate the effectivity of MDT for an endoscopic placement of two different configurations of magnet arrays, i. e. six magnets with same poles facing each other and a Halbach array. Compared to conventional magnet setups outside the body, this endoscopic placement gives the possibility to achieve higher magnetic field gradients inside the tumor.

METHODS

For such a MDT concept, we present FEM based simulations of MDT tracing single SPIONs in a 3D geometry of eight multibranched vessels with sizes in the range of capillaries. In these simulations, the effect of the magnetic field gradient as well as of magnet distance to the vessel geometry, magnetic flux density of the magnets, SPIONs hydrodynamic diameter and magnetic moment on the MDT effectivity is calculated. The blood flow is modelled as an incompressible Newtonian fluid and the SPIONs are suspended in the blood flow. Statistical significance of the targeting effectivity results is tested with the Mann-Whitney-U-Test.

RESULTS

The results show that the magnetic targeting effectivity is up to 32 % higher than the one calculated without the presence of a magnetic field. In the investigated vessel network, this effect on the targeting effectivity is dependent on the number of local magnetic field maxima that are approached with a high gradient and is noticeable up to 200 µm distance of the magnet to the vessel geometry.

CONCLUSIONS

We conclude that for an effective application of MDT, the magnet configuration needs to be placed close to the tumor and should yield a large number of magnetic field maxima that are approached with a high gradient.

Targeted Drug Delivery for Cardiovascular Disease: Modeling of Modulated Extracellular Vesicle Release Rates

Invasive and medical therapy has led to major improvements in cardiovascular disease management, but important challenges remain open. The discovery of a nano-sized system of extracellular vesicles (EVs) is opening new possibilities for reprogramming malfunctioning cells and indicates that EVs can be employed in therapeutic biomedical applications as engineered drug vehicles. Molecular communication (MC) has applications for treating cells with directed drug delivery, employing special targeting transmembrane proteins. In this paper, we propose a novel drug delivery system for cardiovascular diseases using an EV-mediated MC platform and exemplify the potential use in hypertrophic cardiomyopathy. We utilize intracellular calcium signaling as a natural mediator of EVs released from synthetic cells and model the release rate. We propose to use the cells as a therapeutic release system with a control signal input which modulates the EVs release rate as the output signal. We also study the frequency domain of the proposed model and estimate the transfer function of the therapeutic release system model numerically where the root-mean-square error for two separate estimated output signals are 0.0353 and 0.0124. The proposed EV-mediated targeted drug delivery system can make breakthroughs in future healthcare, in cardiovascular and other diseases where targeting is required.

Investigation of the plaque morphology effect on changes of pulsatile blood flow in a stenosed curved artery induced by an external magnetic field

In a new therapeutic technique, called magnetic drug targeting (MDT), magnetic particles carrying therapeutic agents are directed to the target tissue by applying an external magnetic field. Meanwhile, this magnetic field also affects the blood as a biomagnetic fluid. Therefore, it is necessary to select a magnetic field with an acceptable range of influence on the blood flow. This study investigates the effect of an external magnetic field on the pulsatile blood flow in a stenosed curved artery to identify a safe magnetic field. The effects of a number of parameters, including the magnetic susceptibility of blood in oxygenated and deoxygenated states and the magnetic field strength, were studied. Moreover, the effect of the plaque morphology, including the occlusion percentage and the chord length of the stenosis, on changes in blood flow induced by the magnetic field was investigated. The results show that applying a magnetic field increases the wall shear stress (WSS) and the pressure of the deoxygenated blood. Comparing the wall shear stresses of the deoxygenated and oxygenated blood shows that the effect of magnetic field on the deoxygenated blood is more significant than its effect on the oxygenated blood due to its higher magnetic susceptibility. The study of the stenosis geometry shows that the influence of magnetic field on the blood flow is increased by decreasing the occlusion percentage of the artery. Furthermore, among the evaluated lengths, the 50° chord length results in the highest variation under the influence of the magnetic field. Finally, the magnetic field of Mn = 2.5 can be utilized as a safe field for MDT purposes in such a stenosed curved artery.

Effect of Material and Population on the Delivery of Nanoparticles to an Atherosclerotic Plaque: A Patient-specific In Silico Study

Coronary artery disease (CAD) is the prevalent reason of mortality all around the world. Targeting CAD, specifically atherosclerosis, with controlled delivery of micro and nanoparticles, as drug carriers, is a very proficient approach. In this work, a patient-specific and realistic model of an atherosclerotic plaque in the left anterior descending (LAD) artery was created by image-processing of CT-scan images and implementing a finite-element mesh. Next, a fluid-solid interaction simulation considering the physiological boundary conditions was conducted. By considering the simulated force fields and particle-particle interactions, the correlation between injected particles at each cardiac cycle and the surface density of adhered particles over the atherosclerotic plaque (SDP) were examined. For large particles (800 and 1000 nm) the amount of SDP on the plaque increased significantly when the number of the injected particles became higher. However, by increasing the number of the injected particles, for the larger particles (800 and 1000 nm) the increase in SDP was about 50% greater than that of the smaller ones (400 and 600 nm). Furthermore, for constant number of particles, depending on their size, different trends in SDP were observed. Subsequently, the distribution and adhesion of metal-based nanoparticles including SiO₂, Fe₃O₄, NiO₂, silver and gold with different properties were simulated. The injection of metal particles with medium density among the considered particles resulted in the highest SDP. Remarkably, the affinity, the geometrical features, and the biophysical factors involved in the adhesion outweighed the effect of difference in the density of particles on the SDP. Finally, the consideration of the lift force in the simulations significantly reduced the SDP and consistently decreased the particle residence time in the studied domain.

Drug delivery performance of nanocarriers based on adhesion and interaction for abdominal aortic aneurysm treatment

Targeted drug delivery using nanocarriers (NCs) is one of the novel techniques that has recently been used to improve drug delivery to the Abdominal aortic aneurysm (AAA) disease. The purpose of this study is to evaluate the surface density of NCs (SDNC) adhered via ligand-receptor binding to the inner wall of AAA. For this purpose, fluid-structure interaction (FSI) analysis was first performed for the patient-specific and ideal AAA models. Then, by injecting NCs into the aortic artery, the values of SDNC adhered to and interacted with AAA wall were obtained. Two types of NCs, liposomes, and solid particles in four different diameters, were used to investigate the effect of the diameter and the type of NCs on the drug delivery. Additionally, the effect of the number of the injected NCs to the artery on the values of SDNC adhered to and interacted with AAA wall was investigated. The simulation results showed that the interaction and adhesion values of SDNC for Liposome nanoparticles were higher than the ones for the solid particles. Furthermore, as the diameter of NCs increases, the values of SDNC adhered to AAA wall increase, but the values of SDNC interacted with the inner wall of AAA decrease. In the low number of inserted NCs in the artery (1000 NCs), the interaction and adhesion values of SDNC were very slight, and by increasing the number of NCs inserted into the artery, the drug delivery was improved. By examining different AAA models, it was found that the complexity of the shape of AAA has a minor effect on the pattern of increase or decrease of the values of SDNC adhered to and interacted with AAA wall.This study's findings can improve the understanding of NCs design and propose the appropriate amount of their injection into various AAA models.

Targeted Drug Delivery of Microbubble to Arrest Abdominal Aortic Aneurysm Development: A Simulation Study Towards Optimized Microbubble Design

Abdominal aortic aneurysm (AAA) is an irreversible bulge in the artery with higher prevalence among the elderlies. Increase of the aneurysm diameter by time is a fatal phenomenon which will lead to its sidewall rupture. Invasive surgical treatments are vital in preventing from AAA development. These approaches however have considerable side effects. Targeted drug delivery using microbubbles (MBs) has been recently employed to suppress the AAA growth. The present study is aimed to investigate the surface adhesion of different types of drug-containing MBs to the inner wall of AAA through ligand-receptor binding, using fluid-structure interaction (FSI) simulation by using a patient CT-scan images of the vascular system. The effect of blood flow through AAA on MBs delivery to the intended surface was also addressed. For this purpose, the adherence of four types of MBs with three different diameters to the inner surface wall of AAA was studied in a patient with 40-mm diameter aneurysm. The effects of the blood mechanical properties on the hematocrit (Hct) percentage of patients suffering from anemia and diabetes were studied. Moreover, the impact of variations in the artery inlet velocity on blood flow was addressed. Simulation results demonstrated the dependency of the surface density of MBs (SDM) adhered on the AAA lumen to the size and the type of MBs. It was observed that the amount of SDM due to adhesion on the AAA lumen for one of the commercially-approved MBs (Optison) with a diameter of 4.5 μm was higher than the other MBs. Furthermore, we have shown that the targeted drug delivery to the AAA lumen is more favorable in healthy individuals (45% Hct) compared to the patients with diabetes and anemia. Also, it was found that the targeted drug delivery method using MBs on the patients having AAA with complicated aneurysm shape and negative inlet blood flow velocity can be severely affected.