On the effect of mucus rheology on the muco-ciliary transport

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.

Chitooligosaccharide reconstitutes intestinal mucus layer to improve oral absorption of water-soluble drugs

Intestinal mucus is a complex natural hydrogel barrier with unique physical properties that impede the absorption of various oral drugs. Both washout from the upper water layer and the physical resistance of the mucus layer particularly affect bioavailability of, especially, highly water-soluble molecules. One potential strategy for designing pharmaceutical formulations is to add absorption enhancers (AEs). However, there are few reports of AEs that work on mucus and their underlying mechanisms, leading to imprecise application. In this study, we investigated chitooligosaccharide (COS) as a safe, low-cost, and effective oral drug AE. We revealed the hydrodynamic law of interaction between COS and the intestinal mucus layer, which was associated with absorption benefiting mucus structural reconstruction. Based on this, we designed a translational strategy to improve the bioavailability of a group of soluble oral drugs by drinking COS solution before administration. Moreover, this research is expected to expand its application scenario by reducing drug dosage such as avoiding gastro-intestinal irritation and slowing veterinary antibiotic resistance.

Nanoparticle Diffusion in Respiratory Mucus Influenced by Mucociliary Clearance: A Review of Mathematical Modeling

Background: Inhalation and deposition of particles in human airways have attracted considerable attention due to importance of particulate pollutants, transmission of infectious diseases, and therapeutic delivery of drugs at targeted areas. We summarize current state-of-the art research in particle deposition on airway surface liquid (ASL) influenced by mucociliary clearance (MCC) by identifying areas that need further investigation. Methodology: We aim to review focus on governing and constitutive equations describing MCC geometry followed by description of mathematical modeling of ciliary forces, mucus rheology properties, and numerical approaches to solve modified time-dependent Navier-Stokes equations. We also review mathematical modeling of particle deposition in ASL influenced by MCC, particle transport in ASL in terms of Eulerian and Lagrangian approaches, and discuss the corresponding mass transport issues in this layer. Whenever required, numerical predictions are contrasted with the pertinent experimental data. Results: Results indicate that mean mucus and periciliary liquid velocities are strongly influenced by mucus rheological characteristics as well as ciliary abnormalities. However, most of the currently available literature on mucus fiber spacing, ciliary beat frequency, and particle surface chemistry is based on particle deposition on ASL by considering a fixed value of ASL velocity. The effects of real ASL flow regimes on particle deposition in this layer are limited. In addition, no other study is available on modeling nonhomogeneous and viscoelastic characteristics of mucus layer on ASL drug delivery. Conclusion: Simplification of assumptions on governing equations of drug delivery in ASL influenced by MCC leads to imposing some limitations on numerical results.

Mucociliary clearance affected by mucus-periciliary interface stimulations using analytical solution during cough and sneeze

Assessment of mucus velocity variations under different conditions including viscosity variation and boundary conditions is useful to develop mucosal-based medical treatments. This paper deals with the analytical investigation of mucus-periciliary velocities under mucus-periciliary interface movements and mucus viscosity variations. The results for mucus velocity show that there is no difference between the two cases under the free-slip condition. Therefore, power-law mucus can be substituted with a high viscosity Newtonian fluid since the upper boundary of the mucus layer is exposed to the free-slip condition. However, when the upper boundary of the mucus layer is under nonzero shear stress levels, including cough or sneeze, the assumption of a high viscosity Newtonian mucus layer is invalid. Moreover, mucus viscosity variations are investigated for both Newtonian and power-law mucus layers under sneeze and cough to propose a mucosal-based medical treatment. The results indicate by varying mucus viscosity up to a critical value, the direction of mucus movement changes. The critical values of viscosity in sneezing and coughing for Newtonian and power-law mucus layers are 10-4 and 5 × 10-5 and 0.0263 and 006.024 m2 s-1, respectively. Therefore, the pathogen entry into the respiratory system can be prevented by varying mucus viscosity during sneeze and cough.

Numerical investigation of mucociliary clearance using power law and thixotropic mucus layers under discrete and continuous cilia motion

Mucus layer movement inside the airway system is an important phenomenon as the first defensive mechanism against pathogens. This research deals with the mucus velocity variations inside the nasal cavity using two different power law and thixotropic mucus layers. The cilia movement is replaced with four cyclic velocity profiles at the lower boundary of the mucus layer, while the upper boundary is exposed to the free-slip condition. The effects of boundary conditions and different fluid parameters are evaluated on the mucus flow. Furthermore, the replacement of power law and thixotropic mucus layers with a high viscous Newtonian mucus is examined under the free-slip condition at the mucus upper boundary. The adaptation rate is used as the criteria for replacing fluids instead of each other. The results show the mucus flow has enough time to adjust the changes from the lower boundary and the recovery stroke does not affect the mucus velocity in the effective stroke. Moreover, it is observed that the mucus flow variations are the same under the influence of recovery, breakdown, and breakdown exponent parameters. However, the effects of the exponent parameter on the mucus flow are more than the other two parameters in the recovery stroke. It is concluded that the assumption for replacing the power law mucus with a high viscous Newtonian one is acceptable. However, this assumption leads to the maximum error of 98.5% for thixotropic mucus in the recovery stroke.

Effects of continuous and discrete boundary conditions on the movement of upper-convected maxwell and Newtonian mucus layers in coughing and sneezing

Mucociliary clearance is an important phenomenon inside the respiratory system as a first defensive mechanism against pathogens. Therefore, any assumption considered for the mucociliary clearance and affects its functionality must be validated. The present research deals with the effects of boundary conditions on the movement of upper-convected Maxwell and high viscosity Newtonian mucus layers, numerically. Furthermore, the validity of replacing the viscoelastic mucus layer with a high viscosity Newtonian layer is evaluated. The airway surface liquid layer is considered a two-layer model including non-Newtonian mucus and Newtonian periciliary layers. Four cyclic boundary conditions are imposed at the mucus-periciliary interface as the cilia movement to obtain variations of mucociliary clearance. The upper boundary of the mucus layer is also exposed to different shear stress levels including free slip, cough, and sneeze conditions. By investigation of velocity variations inside mucus and periciliary layers, it is concluded the differences between viscoelastic and Newtonian mucus are not negligible. The maximum velocity differences between the two fluids are more than 52% and 215% during cough and sneeze, respectively. The results show there is a high order of dependency between the relaxation time and the imposed boundary conditions at the mucus-periciliary interface that leads to the invalidation of replacing two fluids with each other. Moreover, the results show substituting the viscoelastic mucus with a high viscosity Newtonian one depends on the mucus-periciliary interface boundary condition. If an independent time-varying boundary condition is used, the substitution leads to an error less than 7% under different shear stress levels. However, time-varying boundary condition shows 38% and 88% differences between high viscosity Newtonian and viscoelastic mucus layers. Furthermore, neglecting the recovery stroke leads to a velocity underestimation up to 50% by substituting viscoelastic mucus with a high viscosity Newtonian one. Therefore, replacing the viscoelastic mucus with a high viscosity Newtonian one is not acceptable for numerical simulations.

A quantitative interspecies comparison of the respiratory mucociliary clearance mechanism

Collectively coordinated ciliary activity propels the airway mucus, which lines the luminal surface of the vertebrate respiratory system, in cranial direction. Our contemporary understanding on how the quantitative characteristics of the metachronal wave field determines the resulting mucociliary transport is still limited, partly due to the sparse availability of quantitative observational data. We employed high-speed video reflection microscopy to image and quantitatively characterize the metachronal wave field as well as the mucociliary transport in excised bovine, porcine, ovine, lapine, turkey and ostrich samples. Image processing techniques were used to determine the ciliary beating frequency (CBF), the velocity and wavelength of the metachronal wave and the mucociliary transport velocity. The transport direction was found to strongly correlate with the mean wave propagation direction in all six species. The CBF yielded similar values (10-15 Hz) for all six species. Birds were found to exhibit higher transport speeds (130-260 [Formula: see text]m/s) than mammals (20-80 [Formula: see text]m/s). While the average transport direction significantly deviates from the tracheal long axis in mammals, no significant deviation was found in birds. The metachronal waves were found to propagate at about 4-8 times the speed of mucociliary transport in mammals, whereas in birds they propagate at about the transport speed. The mucociliary transport in birds is fast and roughly follows the TLA, whereas the transport is slower and proceeds along a left-handed spiral in mammals. The longer wavelengths and the lower ratio between the metachronal wave speed and the mucociliary transport speed provide evidence that the mucociliary clearance mechanism operates differently in birds than in mammals.

Purely Elastic Fluid-Structure Interactions in Microfluidics: Implications for Mucociliary Flows

Fluid-structure interactions lie at the heart of the complex, and often highly coordinated, motions of actively driven microscale biological systems (e.g., translating cilia, flagella, and motile cells). Due to the highly viscoelastic nature of most relevant biological fluids and the small length scales involved, the viscous and inertial forces in such flows are dominated by elasticity. However, elastic effects are often overlooked in studies seeking to address phenomena like the synchronization of beating cilia. In this study, unique microfluidic experiments are presented to demonstrate that inertia-free viscoelastic flows can lead to highly regular beating of an immersed (passive) flexible structure, herein named "purely-elastic" fluid-structure interaction. It is also shown how two such flexible structures can achieve an extraordinary degree of synchronization, with a correlation coefficient approaching unity. The synchronization is a result of the generation of localized elastic stresses in the fluid that effectively link the two objects. These purely elastic interactions may be important to consider toward developing a complete understanding of the motions of microscale biological systems.

Simulation Study on the Mass Transport Based on the Ciliated Dynamic System of the Respiratory Tract

To study the mass transport of mucociliary clearance of the human upper respiratory tract, a two-dimensional mass transport model based on the ciliated movement was established by using the immersed boundary-lattice Boltzmann method (IB-LBM). In this model, different characteristics of the mucus layer (ML) and the periciliary liquid (PCL) were taken into account. A virtual elastic membrane was introduced to divide the two layers dynamically. All moving boundaries that were involved in the present simulation were modeled with the immersed boundary. The Newtonian fluid was used to model the flow in PCL, and the viscoelastic fluid based on the Oldroyd-B model was used for the flow in ML; the two types of flow were both solved by the LBM framework. Based on the model, the ML thickness, the cilia density, and the phase difference of adjacent cilia were regulated, respectively, to study the transport velocity of the ML. In addition, the motion law of solid particles in PCL was also studied. According to the results, four primary conclusions were drawn. (1) At a given beating pattern, the increase of the ML thickness will decrease its transport velocity. (2) Increasing the cilia density can promote the mean transport velocity of the ML. (3) By raising the phase difference of adjacent cilia to a certain scope, the transport of ML can be accelerated. (4) In PCL, particles initially located on the upper part of the cilia tend to migrate upward and then get close to the ML. The above study can provide some reasonable explanations for the mechanism of the mucociliary clearance system, which is also helpful to the further understanding of the mass transport principle of the human upper respiratory tract.

Analysis of the volume of fluid (VOF) method for the simulation of the mucus clearance process with CFD

The clearance of mucus through coughing is a complex, multiphase process, which is affected principally by mucus viscosity and airflow velocity; however, it is also critically affected by the thickness of the two layers of mucus-the serous and gel layers-and oscillation level. The present study examines the effects of the latter parameters more closely. To do so, the mucus clearance process is simulated with a transient 3D volume of fluid (VOF) multiphase model in ANSYS Fluent. The model includes mucus' bilayer properties and a wide range of boundary conditions were tested. The model was analysed in both a straight tube and a realistic trachea. Ultimately, the model was able to both capture air-mucus interface wave evolution and predict the overall behaviour of the clearance process. The results were consistent with experimental clearance data and numerical airflow simulations, which indicates our methodology is appropriate for future studies. Ultimately, the mere presence of the serous layer was found to increase mucus clearance by more than 15 percent. An oscillating flow enhanced clearance by up to 5 percent. Interestingly, interface wave steepness was found to be inversely correlated with mucus thickness, but directly with mucus velocity, which suggests it will be an interesting parameter for further study.

Transport and Mixing Induced by Beating Cilia in Human Airways

The fluid transport and mixing induced by beating cilia, present in the bronchial airways, are studied using a coupled lattice Boltzmann-Immersed Boundary solver. This solver allows the simulation of both single and multi-component fluid flows around moving solid boundaries. The cilia are modeled by a set of Lagrangian points, and Immersed Boundary forces are computed onto these points in order to ensure the no-slip velocity conditions between the cilia and the fluids. The cilia are immersed in a two-layer environment: the periciliary layer (PCL) and the mucus above it. The motion of the cilia is prescribed, as well as the phase lag between two cilia in order to obtain a typical collective motion of cilia, known as metachronal waves. The results obtained from a parametric study show that antiplectic metachronal waves are the most efficient regarding the fluid transport. A specific value of phase lag, which generates the larger mucus transport, is identified. The mixing is studied using several populations of tracers initially seeded into the pericilary liquid, in the mucus just above the PCL-mucus interface, and in the mucus far away from the interface. We observe that each zone exhibits different chaotic mixing properties. The larger mixing is obtained in the PCL layer where only a few beating cycles of the cilia are required to obtain a full mixing, while above the interface, the mixing is weaker and takes more time. Almost no mixing is observed within the mucus, and almost all the tracers do not penetrate the PCL layer. Lyapunov exponents are also computed for specific locations to assess how the mixing is performed locally. Two time scales are introduced to allow a comparison between mixing induced by fluid advection and by molecular diffusion. These results are relevant in the context of respiratory flows to investigate the transport of drugs for patients suffering from chronic respiratory diseases.

The biology of mucus: Composition, synthesis and organization

In this review we discuss mucus, the viscoelastic secretion from goblet or mucous producing cells that lines the epithelial surfaces of all organs exposed to the external world. Mucus is a complex aqueous fluid that owes its viscoelastic, lubricating and hydration properties to the glycoprotein mucin combined with electrolytes, lipids and other smaller proteins. Electron microscopy of mucosal surfaces reveals a highly convoluted surface with a network of fibers and pores of varying sizes. The major structural and functional component, mucin is a complex glycoprotein coded by about 20 mucin genes which produce a protein backbone having multiple tandem repeats of Serine, Threonine (ST repeats) where oligosaccharides are covalently O-linked. The N- and C-terminals of this apoprotein contain other domains with little or no glycosylation but rich in cysteines leading to dimerization and further multimerization via SS bonds. The synthesis of this complex protein starts in the endoplasmic reticulum with the formation of the apoprotein and is further modified via glycosylation in the cis and medial Golgi and packaged into mucin granules via Ca2+ bridging of the negative charges on the oligosaccharide brush in the trans Golgi. The mucin granules fuse with the plasma membrane of the secretory cells and following activation by signaling molecules release Ca2+ and undergo a dramatic change in volume due to hydration of the highly negatively charged polymer brush leading to exocytosis from the cells and forming the mucus layer. The rheological properties of mucus and its active component mucin and its mucoadhesivity are briefly discussed in light of their importance to mucosal drug delivery.

Modeling and Simulation of Mucus Flow in Human Bronchial Epithelial Cell Cultures - Part I: Idealized Axisymmetric Swirling Flow

A multi-mode nonlinear constitutive model for mucus is constructed directly from micro- and macro-rheology experimental data on cell culture mucus, and a numerical algorithm is developed for the culture geometry and idealized cilia driving conditions. This study investigates the roles that mucus rheology, wall effects, and HBE culture geometry play in the development of flow profiles and the shape of the air-mucus interface. Simulations show that viscoelasticity captures normal stress generation in shear leading to a peak in the air-mucus interface at the middle of the culture and a depression at the walls. Linear and nonlinear viscoelastic regimes can be observed in cultures by varying the hurricane radius and mean rotational velocity. The advection-diffusion of a drug concentration dropped at the surface of the mucus flow is simulated as a function of Peclet number.

In the lungs, the airway surface liquid protects the airway epithelium from inhaled pathogens and particulates. It is well known that failure to properly clear mucus from the airways leads to chronic, even fatal, lung infections. To date, there is no validated constitutive model capable of recapitulating mucus rheology under diverse, physiological stress and deformation conditions. This gap has hindered studies into the causal relationship between mucus rheology and mucociliary clearance. Our modeling-experimental approach fulfills several purposes: to implement linear and nonlinear constitutive modeling of mucus from micro- and macro-rheology, to test constitutive modeling in an independent experimental system, to build a coarse-grained model of the PCL-mucus boundary condition, to measure and understand modifications in mucociliary transport during and after deposition of a controlled drug concentration, to measure and simulate both the flow and stress fields throughout the mucus layer, and to measure and simulate how the advection profiles in the culture couple with diffusion of particulates landing on the air-mucus interface. These results lay the groundwork for extension of the code to three dimensions and more realistic metachronal wave boundary conditions, both in cell cultures and in airways.