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Gou D, Zhu Q, Chan HK, Kourmatzis A, Cheng S, Yang R. Effects of the deformation and size of the upper airway on the deposition of aerosols. Int J Pharm 2024; 657:124165. [PMID: 38663643 DOI: 10.1016/j.ijpharm.2024.124165] [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: 02/21/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
Aerosol drug delivery in the human airway is significantly affected by the morphology and size of the airway. This work developed a CFD-DEM model to simulate and analyze air flow and powder dynamics in combined inhaler-airway systems with different degrees of airway deformation (non-deformed, 50%, and 75% deformed) and sizes (adult, 0.80, and 0.62 scaled). The airways were generated based on a regular airway constructed from the MRI images through finite element method (for deformed airways) or scaling-down (for smaller airways). The airways were connected to Turbuhaler® through a connector. The results showed that under the same flow rate, the variation in the airway geometry and size had a minimum impact on the flow field and powder deposition in the device and the connector. However, deformation caused more particle deposition in the deformed region. Notably, the airway with 50% deformation had the most particles passing through the airway with the largest particle sizes due to its lower air velocity in the deformed area. Reducing airway size resulted in more powder deposition on the airway, particularly at the pharynx and mouth regions. This was because, with the same flow rate, the flow velocity in the smaller airway was higher, causing more particle-wall collisions in the mouth and pharynx regions. More importantly, the deposition efficiency in the 0.62-scaled airway was significantly higher than the other two airways, highlighting the importance of the different administration of aerosol drugs for young children.
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Affiliation(s)
- Dazhao Gou
- School of Materials Science and Engineering, UNSW Sydney, NSW 2052, Australia
| | - Qixuan Zhu
- School of Materials Science and Engineering, UNSW Sydney, NSW 2052, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Sydney Pharmacy School, The University of Sydney, NSW 2006, Australia
| | - Agisilaos Kourmatzis
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW 2006, Australia
| | - Shaokoon Cheng
- School of Engineering, Macquarie University, NSW 2109, Australia
| | - Runyu Yang
- School of Materials Science and Engineering, UNSW Sydney, NSW 2052, Australia.
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Yang Y, Ma Z, Zhuang Y, Long X, Yu Y. Development of multi-generation lower respiratory tract model and insights into the transport and deposition characteristics of inhalable particles. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166725. [PMID: 37657539 DOI: 10.1016/j.scitotenv.2023.166725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
Airborne particles can spread quickly and enter human respiratory system via inhalation, causing chronic diseases, even cancer. Although recent studies have informed of toxicity of various pollutants, understanding the transport and deposition characteristics of particles in lower respiratory tract is still challenging. The current study proposes a novel model to simulate flow field change from the entrance of lower respiratory tract to pulmonary acinus, while studying particle transport and deposition characteristics. This model for lower respiratory tract with several bronchial extensions containing virtual pulmonary acinus is calculated using computational fluid dynamics and dynamics mesh. The results showed that in the first 10 generations of the lower respiratory tract, vortices and gravity interfered with particles' trajectory, affecting particle deposition distribution. For the first to the tenth-generation respiratory tract, coarse particles were deposited throughout almost the whole respiratory tract model. In contrast, ultrafine particles did not deposit in the higher-generation respiratory tract. The particle enrichment ability of various lobes was uneven with three particle deposition fraction variation patterns. Virtual pulmonary acinus influenced particle deposition and distribution because of vortex ring's trapped ability during expansion and contraction. This new attempt to build a virtual pulmonary acinus model to simulate particle deposition effects in human respiratory system may provide a reference for studying the toxicities of inhalable particles in the exposed human body.
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Affiliation(s)
- Yan Yang
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, Guangdong, China; Synergy Innovation Institute of GDUT, Shantou 515041, Guangdong, China
| | - Zijian Ma
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, Guangdong, China
| | - Yijie Zhuang
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, Guangdong, China
| | - Xiaoao Long
- Neurosurgery Department, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524023, Guangdong, China
| | - Yingxin Yu
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, Guangdong, China; Synergy Innovation Institute of GDUT, Shantou 515041, Guangdong, China.
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Gurgel ML, Junior CC, Cevidanes LHS, de Barros Silva PG, Carvalho FSR, Kurita LM, Cunha TCA, Dal Fabbro C, Costa FWG. Methodological parameters for upper airway assessment by cone-beam computed tomography in adults with obstructive sleep apnea: a systematic review of the literature and meta-analysis. Sleep Breath 2023; 27:1-30. [PMID: 35190957 PMCID: PMC9392812 DOI: 10.1007/s11325-022-02582-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND A reliable method for analyzing the upper airway (UA) remains a challenge. This study aimed to report the methods for UA assessment using cone-beam computed tomography (CBCT) in adults with obstructive sleep apnea (OSA). METHODS We performed a systematic review (PROSPERO #CRD42021237490 and PRISMA checklist) that applied a search strategy to seven databases and grey literature. RESULTS In 29 studies with moderate-to-high risk of bias, investigators mostly reported the body position during CBCT (upright or supine) and hard tissue references, diverging in UA delimitation and terminologies. The meta-analysis showed two subgroups (upright and supine), and no statistical differences were identified (p = 0.18) considering the UA area. The volume in the OSA group was smaller than that in the control group (p < 0.003 and Cohen's d = - 0.81) in the upright position. Patients with OSA showed smaller anteroposterior dimensions than the control group and were not affected by the position during image acquisition (p = 0.02; Cohen's d = - 0.52). The lateral measurements were also lower in the OSA group (supine) (p = 0.002; Cohen's d = - 0.6). CONCLUSIONS Patients with OSA showed smaller UA measurements in the upright (volume) and supine (lateral dimension) positions. The anteroposterior dimension was also reduced in patients with OSA compared to the control group, regardless of the position during CBCT acquisition.
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Affiliation(s)
- Marcela Lima Gurgel
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
| | - Cauby Chaves Junior
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
| | | | | | | | - Lúcio Mitsuo Kurita
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
| | | | - Cibele Dal Fabbro
- Faculty of Dental Medicine, Center for Advance Research in Sleep Medicine & Stomatology, Universite de Montreal & CIUSSS Nord Ile de Montreal, CHUM, Montreal, QC, Canada
| | - Fabio Wildson Gurgel Costa
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
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A review of upper airway physiology relevant to the delivery and deposition of inhalation aerosols. Adv Drug Deliv Rev 2022; 191:114530. [PMID: 36152685 DOI: 10.1016/j.addr.2022.114530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/07/2022] [Accepted: 09/01/2022] [Indexed: 01/24/2023]
Abstract
Developing effective oral inhaled drug delivery treatment strategies for respiratory diseases necessitates a thorough knowledge of the respiratory system physiology, such as the differences in the airway channel's structure and geometry in health and diseases, their surface properties, and mechanisms that maintain their patency. While respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma and their implications on the lower airways have been the core focus of most of the current research, the role of the upper airway in these diseases is less known, especially in the context of inhaled drug delivery. This is despite the fact that the upper airway is the passageway for inhaled drugs to be delivered to the lower airways, and their replicas are indispensable in current standards, such as the cascade impactor experiments for testing inhaled drug delivery technology. This review provides an overview of upper airway collapsibility and their mechanical properties, the effects of age and gender on upper airway geometry, and surface properties. The review also discusses how COPD and asthma affect the upper airway and the typical inhalation flow characteristics exhibited by the patients with these diseases.
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Ma Z, Kourmatzis A, Milton-McGurk L, Chan HK, Farina D, Cheng S. Simulating the effect of individual upper airway anatomical features on drug deposition. Int J Pharm 2022; 628:122219. [PMID: 36179925 DOI: 10.1016/j.ijpharm.2022.122219] [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: 04/01/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 10/31/2022]
Abstract
This study aims to systematically isolate different anatomical features of the human pharynx with the goal to investigate their independent influence on airflow dynamics and particle deposition characteristics in a geometrically realistic human airway. Specifically, the effects of the uvula, epiglottis and soft palate on drug particle deposition are studied systematically, by carefully removing each of these anatomical features from reconstructed models based on MRI data and comparing them to a benchmark realistic airway model. Computational Fluid Dynamics using established turbulence models is employed to simulate the transport of mono-dispersed particles (3 µm) in the airway at two flow-rates. The simulations suggest three findings: 1) widening the space between the oral cavity and oropharynx and where the soft palate is situated leads to the most dramatic reduction in drug deposition in the upper airway; 2) exclusion of the uvula and epiglottis: a) affects flow dynamics in the airway; b) alters regional deposition behaviour; c) does not significantly affect the total number of particles deposited in the pharynx; and 3) the space adjacent to the soft palate is a key determinant for aerosol deposition in the extrathoracic region and is related to mechanisms of flow acceleration, diversion and recirculation.
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Affiliation(s)
- Zhaoqi Ma
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006
| | - Agisilaos Kourmatzis
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006
| | - Liam Milton-McGurk
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW 2006
| | - Hak-Kim Chan
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006
| | - Dino Farina
- Proveris Scientific Corporation, Hudson, Massachusetts, United States
| | - Shaokoon Cheng
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109.
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Effects of respiratory rate on the fluid mechanics of a reconstructed upper airway. Med Eng Phys 2022; 100:103746. [DOI: 10.1016/j.medengphy.2021.103746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/25/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022]
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Gallagher C, Jalalifar S, Salehi F, Kourmatzis A, Cheng S. A two-fluid model for powder fluidisation in turbulent channel flows. POWDER TECHNOL 2021. [DOI: 10.1016/j.powtec.2021.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gou K, Baek S, Lutnesky MMF, Han HC. Growth-profile configuration for specific deformations of tubular organs: A study of growth-induced thinning and dilation of the human cervix. PLoS One 2021; 16:e0255895. [PMID: 34379659 PMCID: PMC8357173 DOI: 10.1371/journal.pone.0255895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/26/2021] [Indexed: 12/02/2022] Open
Abstract
Growth is a significant factor that results in deformations of tubular organs, and particular deformations associated with growth enable tubular organs to perform certain physiological functions. Configuring growth profiles that achieve particular deformation patterns is critical for analyzing potential pathological conditions and for developing corresponding clinical treatments for tubular organ dysfunctions. However, deformation-targeted growth is rarely studied. In this article, the human cervix during pregnancy is studied as an example to show how cervical thinning and dilation are generated by growth. An advanced hyperelasticity theory called morphoelasticity is employed to model the deformations, and a growth tensor is used to represent growth in three principle directions. The computational results demonstrate that both negative radial growth and positive circumferential growth facilitate thinning and dilation. Modeling such mixed growth represents an advancement beyond commonly used uniform growth inside tissues to study tubular deformations. The results reveal that complex growth may occur inside tissues to achieve certain tubular deformations. Integration of further biochemical and cellular activities that initiate and mediate such complex growth remains to be explored.
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Affiliation(s)
- Kun Gou
- Department of Mathematical, Physical, and Engineering Sciences, Texas A&M University-San Antonio, San Antonio, Texas, United States of America
- * E-mail:
| | - Seungik Baek
- Department of Mechanical Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Marvin M. F. Lutnesky
- Department of Life Sciences, Texas A&M University-San Antonio, San Antonio, Texas, United States of America
| | - Hai-Chao Han
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas, United States of America
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Non-intrusive high resolution in-vitro measurement of regional drug powder deposition. Int J Pharm 2020; 582:119286. [PMID: 32278719 DOI: 10.1016/j.ijpharm.2020.119286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/07/2020] [Accepted: 03/27/2020] [Indexed: 01/15/2023]
Abstract
Optical Coherence Tomography (OCT) is a high-resolution and non-invasive cross-sectional imaging technique mainly used for medical imaging and industrial non-destructive testing. However, its feasibility in the quantification of pulmonary drug deposition has not been investigated. In this study, an optically accessible airway model of the upper airway and the tracheobronchial tree was used, and experiments were performed at flow rates of 40 L/min, 60 L/min and 80 L/min. Drug deposition in different regions of the airway cast has been determined and quantified from OCT images of the deposition layer. Regionally resolved measurement of deposition shows that flow rate has a significant effect (p = 0.04) on the average thickness of the deposition layer in the upper airway but not in the tracheobronchial tree under these test conditions. These localized and high-resolution measurements of deposition also demonstrate that the flow rate can influence the spatial uniformity of the deposition layer. The technique is able to provide significant regional drug deposition details, including the thickness, spatial deposition pattern and micro-cavities in the deposition layer, that would potentially serve to assess the efficacy of inhalation drug delivery systems.
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Numerical and Experimental Analysis of Inhalation Airflow Dynamics in a Human Pharyngeal Airway. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051556. [PMID: 32121245 PMCID: PMC7084933 DOI: 10.3390/ijerph17051556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/17/2022]
Abstract
This paper presents a computational and experimental study of steady inhalation in a realistic human pharyngeal airway model. To investigate the intricate fluid dynamics inside the pharyngeal airway, the numerical predicted flow patterns are compared with in vitro measurements using Particle Image Velocimetry (PIV) approach. A structured mesh with 1.4 million cells is used with a laminar constant flow rate of 10 L/min. PIV measurements are taken in three sagittal planes which showed flow acceleration after the pharynx bend with high velocities in the posterior pharyngeal wall. Computed velocity profiles are compared with the measurements which showed generally good agreements with over-predicted velocity distributions on the anterior wall side. Secondary flow patterns on cross-sectional slices in the transverse plane revealed vortices posterior of pharynx and a pair of secondary flow vortexes due to the abrupt cross-sectional area increase. Finally, pressure and flow resistance analysis demonstrate that greatest pressure occurs in the superior half of the airway and maximum in-plane pressure variation is observed at the velo-oropharynx junction, which expects to induce a high tendency of airway collapse during inhalation. This study provides insights of the complex fluid dynamics in human pharyngeal airway and can contribute to a reliable approach to assess the probability of flow-induced airway collapse and improve the treatment of obstructive sleep apnea.
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