Effect of pH on the viscoelastic properties of pig gastric mucus

Mechanical Perspective on Increasing Brush Cytology Yield

Brush cytology is a sampling technique extensively used for mucosal surfaces, particularly to identify malignancies. A sample is obtained by rubbing the brush bristles over the stricture or lesion several times until cells are trapped. Brush cytology detection rate varies, with malignancy confirmed in 15-65% of cases of adenocarcinoma-associated biliary strictures and 44-80% of cases of cholangiocarcinoma. Despite the widespread use of brush cytology, there is no consensus to date defining the optimal biliary brushing parameters for the collection of suspicious lesions, such as the number of passes, brushing rate, and force applied. The aim of this work is to increase the brush cytology diagnostic yield by elucidating the underlying mechanical phenomena. First, the mechanical interactions between the brush bristles and sampled tissue are analyzed. During brushing, mucus and detached cells are transferred to the space between the bristles through the capillary rise and flow eddies. These mass transfer mechanisms and their dependence on mucus rheology as a function of pH, brush displacement rate, and bristle geometry and configuration are examined. Lastly, results from ex vivo brushing experiments performed on porcine stomachs are presented. Clinical practitioners from a variety of disciplines can apply the findings of this study to outline clear procedures for cytological brushing to increase the sensitivity and specificity of the brushings.

Mucus Structure, Viscoelastic Properties, and Composition in Chronic Respiratory Diseases

The respiratory mucus, a viscoelastic gel, effectuates a primary line of the airway defense when operated by the mucociliary clearance. In chronic respiratory diseases (CRDs), such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF), the mucus is overproduced and its solid content augments, changing its structure and viscoelastic properties and determining a derangement of essential defense mechanisms against opportunistic microbial (virus and bacteria) pathogens. This ensues in damaging of the airways, leading to a vicious cycle of obstruction and infection responsible for the harsh clinical evolution of these CRDs. Here, we review the essential features of normal and pathological mucus (i.e., sputum in CF, COPD, and asthma), i.e., mucin content, structure (mesh size), micro/macro-rheology, pH, and osmotic pressure, ending with the awareness that sputum biomarkers (mucins, inflammatory proteins and peptides, and metabolites) might serve to indicate acute exacerbation and response to therapies. There are some indications that old and novel treatments may change the structure, viscoelastic properties, and biomarker content of sputum; however, a wealth of work is still needed to embrace these measures as correlates of disease severity in association with (or even as substitutes of) pulmonary functional tests.

The yielding behaviour of human mucus

Mucus is a viscoelastic material with non-linear rheological properties such as a yield stress of the order of a few hundreds of millipascals to a few tens of pascals, due to a complex network of mucins in water along with non-mucin proteins, DNA and cell debris. In this review, we discuss the origin of the yield stress in human mucus, the changes in the rheology of mucus with the occurrence of diseases, and possible clinical applications in disease detection as well as cure. We delve into the domain of mucus rheology, examining both macro- and microrheology. Macrorheology involves investigations conducted at larger length scales (∼ a few hundreds of μm or higher) using traditional rheometers, which probe properties on a bulk scale. It is significant in elucidating various mucosal functions within the human body. This includes rejecting unwanted irritants out of lungs through mucociliary and cough clearance, protecting the stomach wall from the acidic environment as well as biological entities, safeguarding cervical canal from infections and providing a swimming medium for sperms. Additionally, we explore microrheology, which encompasses studies performed at length scales ranging from a few tens of nm to a μm. These microscale studies find various applications, including the context of drug delivery. Finally, we employ scaling analysis to elucidate a few examples in lung, cervical, and gastric mucus, including settling of irritants in lung mucus, yielding of lung mucus in cough clearance and cilial beating, spreading of exogenous surfactants over yielding mucus, swimming of Helicobacter pylori through gastric mucus, and lining of protective mucus in the stomach. The scaling analyses employed on the applications mentioned above provide us with a deeper understanding of the link between the rheology and the physiology of mucus.

Mucus Penetration of Surface-Engineered Nanoparticles in Various pH Microenvironments

The penetration behavior of nanoparticles in mucous depends on physicochemical properties of the nanoparticles and the mucus microenvironment, due to particle-mucin interactions and the presence of the mucin mesh space filtration effect. To date, it is still unclear how the surface properties of nanoparticles influence their mucus penetration behaviors in various physiological and pathophysiological conditions. In this study, we have prepared a comprehensive library of amine-, carboxyl-, and PEG-modified silica nanoparticles (SNPs) with controlled surface ligand densities. Using multiple particle tracking, we have studied the mechanism responsible for the mucus penetration behaviors of these SNPs. It was found that PEG- and amine-modified SNPs exhibited pH-independent immobilization under iso-density conditions, while carboxyl-modified SNPs exhibited enhanced movement only in weakly alkaline mucus. Biophysical characterizations demonstrated that amine- and carboxyl-modified SNPs were trapped in mucus due to electrostatic interactions and hydrogen bonding with mucin. In contrast, high-density PEGylated surface formed a brush conformation that shields particle-mucin interactions. We have further investigated the surface property-dependent mucus penetration behavior using a murine airway distribution model. This study provides insights for designing efficient transmucosal nanocarriers for prevention and treatment of pulmonary diseases.

Physical and barrier changes in gastrointestinal mucus induced by the permeation enhancer sodium 8-[(2-hydroxybenzoyl)amino]octanoate (SNAC)

Drug delivery systems (DDS) for oral delivery of peptide drugs contain excipients that facilitate and enhance absorption. However, little knowledge exists on how DDS excipients such as permeation enhancers interact with the gastrointestinal mucus barrier. This study aimed to investigate interactions of the permeation enhancer sodium 8-[(2-hydroxybenzoyl)amino]octanoate (SNAC) with ex vivo porcine intestinal mucus (PIM), ex vivo porcine gastric mucus (PGM), as well as with in vitro biosimilar mucus (BM) by profiling their physical and barrier properties upon exposure to SNAC. Bulk mucus permeability studies using the peptides cyclosporine A and vancomycin, ovalbumin as a model protein, as well as fluorescein-isothiocyanate dextrans (FDs) of different molecular weights and different surface charges were conducted in parallel to mucus retention force studies using a texture analyzer, rheological studies, cryo-scanning electron microscopy (cryo-SEM), and single particle tracking of fluorescence-labelled nanoparticles to investigate the effects of the SNAC-mucus interaction. The exposure of SNAC to PIM increased the mucus retention force, storage modulus, viscosity, increased nanoparticle confinement within PIM as well as decreased the permeation of cyclosporine A and ovalbumin through PIM. Surprisingly, the viscosity of PGM and the permeation of cyclosporine A and ovalbumin through PGM was unaffected by the presence of SNAC, thus the effect of SNAC depended on the regional site that mucus was collected from. In the absence of SNAC, the permeation of different molecular weight and differently charged FDs through PIM was comparable to that through BM. However, while bulk permeation of neither of the FDs through PIM was affected by SNAC, the presence of SNAC decreased the permeation of FD4 and increased the permeation of FD150 kDa through BM. Additionally, and in contrast to observations in PIM, nanoparticle confinement within BM remained unaffected by the presence of SNAC. In conclusion, the present study showed that SNAC altered the physical and barrier properties of PIM, but not of PGM. The effects of SNAC in PIM were not observed in the BM in vitro model. Altogether, the study highlights the need for further understanding how permeation enhancers influence the mucus barrier and illustrates that the selected mucus model for such studies should be chosen with care.

An overview of gastrointestinal mucus rheology under different pH conditions and introduction to pH-dependent rheological interactions with PLGA and chitosan nanoparticles

This review discusses the physicochemical and mechanical properties of porcine gastrointestinal mucus from a rheological point of view. Considering mucus as a viscoelastic gel that functions as a biological barrier by limiting particles passage, lubricating the gastrointestinal tract, and protecting the stomach from gastric acids. The viscoelastic and protective properties of mucus are mainly produced by its mucin network, which is stabilized through electrostatic, hydrophobic and hydrogen bonding interactions. Otherwise, mucus rheology is determined by its polyanionic nature at physiological pH. At neutral pH, mucus presents a viscous behavior produced by chains crosslinking. While, at acidic pH, mucus exhibits an elastic behavior related with the extended conformation that produces mucus gelation at the stomach. Additionally, rheology studies the degree of adhesion between a polymer-mucus mixture through rheological synergism, and how it varies at different pH conditions. Finally, mucoadhesion phenomenon is exemplified with chitosan (cationic) and poly (lactic-co-glycolic) acid (anionic) polymers.