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Jeon D, Kim SH, Kim J, Jeong H, Uhm C, Oh H, Cho K, Cho Y, Park IH, Oh J, Kim JJ, Hwang JY, Lee HJ, Lee HY, Seo JY, Shin JS, Seong JK, Nam KT. Discovery of a new long COVID mouse model via systemic histopathological comparison of SARS-CoV-2 intranasal and inhalation infection. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167347. [PMID: 39019092 DOI: 10.1016/j.bbadis.2024.167347] [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: 02/29/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
Intranasal infection is commonly used to establish a SARS-CoV-2 mouse model due to its non-invasive procedures and a minimal effect from the operation itself. However, mice intranasally infected with SARS-CoV-2 have a high mortality rate, which limits the utility of this model for exploring therapeutic strategies and the sequelae of non-fatal COVID-19 cases. To resolve these limitations, an aerosolised viral administration method has been suggested. However, an in-depth pathological analysis comparing the two models is lacking. Here, we show that inhalation and intranasal SARS-CoV-2 (106 PFU) infection models established in K18-hACE2 mice develop unique pathological features in both the respiratory and central nervous systems, which could be directly attributed to the infection method. While the inhalation-infection model exhibited relatively milder pathological parameters, it closely mimicked the prevalent chest CT pattern observed in COVID-19 patients with focal, peripheral lesions and fibrotic scarring in the recuperating lung. We also found the evidence of direct neuron-invasion from the olfactory receptor neurons to the olfactory bulb in the intranasal model and showed the trigeminal nerve as an alternative route of transmission to the brain in inhalation infected mice. Even after viral clearance confirmed at 14 days post-infection, mild lesions were still found in the brain of inhalation-infected mice. These findings suggest that the inhalation-infection model has advantages over the intranasal-infection model in closely mimicking the pathological features of non-fatal symptoms of COVID-19, demonstrating its potential to study the sequelae and possible interventions for long COVID.
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Affiliation(s)
- Donghun Jeon
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung-Hee Kim
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiseon Kim
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Haengdueng Jeong
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Chanyang Uhm
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Heeju Oh
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyungrae Cho
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Yejin Cho
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - In Ho Park
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea; Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Jooyeon Oh
- Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jeong Jin Kim
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Yeon Hwang
- Preclinical Research Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Nuclear Medicine, Seoul National University, College of Medicine, Seoul, South Korea
| | - Jun-Young Seo
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Jeon-Soo Shin
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea; Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea; Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Je Kyung Seong
- Korea Mouse Phenotyping Center (KMPC), Seoul National University, Seoul, South Korea; Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, BK 21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul, South Korea; BIO MAX Institute, Seoul National University, Seoul, South Korea; Interdisciplinary Program for Bioinformatics, Seoul National University, Seoul, South Korea.
| | - Ki Taek Nam
- Department of Biomedical Sciences, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea.
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2
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Fazla B, Erken O, Izbassarov D, Romanò F, Grotberg JB, Muradoglu M. Effects of Kinematic Hardening of Mucus Polymers in an Airway Closure Model. JOURNAL OF NON-NEWTONIAN FLUID MECHANICS 2024; 330:105281. [PMID: 39036645 PMCID: PMC11258864 DOI: 10.1016/j.jnnfm.2024.105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
The formation of a liquid plug inside a human airway, known as airway closure, is computationally studied by considering the elastoviscoplastic (EVP) properties of the pulmonary mucus covering the airway walls for a range of liquid film thicknesses and Laplace numbers. The airway is modeled as a rigid tube lined with a single layer of an EVP liquid. The Saramito-Herschel-Bulkley (Saramito-HB) model is coupled with an Isotropic Kinematic Hardening model (Saramito-HB-IKH) to allow energy dissipation at low strain rates. The rheological model is fitted to the experimental data under healthy and cystic fibrosis (CF) conditions. Yielded/unyielded regions and stresses on the airway wall are examined throughout the closure process. Yielding is found to begin near the closure in the Saramito-HB model, whereas it occurs noticeably earlier in the Saramito-HB-IKH model. The kinematic hardening is seen to have a notable effect on the closure time, especially for the CF case, with the effect being more pronounced at low Laplace numbers and initial film thicknesses. Finally, standalone effects of rheological properties on wall stresses are examined considering their physiological values as baseline.
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Affiliation(s)
- Bartu Fazla
- Department of Mechanical Engineering, Koc University, Istanbul, 34450, Turkey
| | - Oguzhan Erken
- School of Engineering, Institute for Infrastructure and Environment, The University of Edinburgh, Edinburgh, United Kingdom
| | - Daulet Izbassarov
- Finnish Meteorological Institute, Erik Palmenin aukio 1, Helsinki, 00560, Finland
| | - Francesco Romanò
- Univ. Lille, CNRS, ONERA, Arts et Métiers Institute of Technology, Lille, France
| | - James B. Grotberg
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Metin Muradoglu
- Department of Mechanical Engineering, Koc University, Istanbul, 34450, Turkey
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3
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Neelakantan S, Xin Y, Gaver DP, Cereda M, Rizi R, Smith BJ, Avazmohammadi R. Computational lung modelling in respiratory medicine. J R Soc Interface 2022; 19:20220062. [PMID: 35673857 PMCID: PMC9174712 DOI: 10.1098/rsif.2022.0062] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Computational modelling of the lungs is an active field of study that integrates computational advances with lung biophysics, biomechanics, physiology and medical imaging to promote individualized diagnosis, prognosis and therapy evaluation in lung diseases. The complex and hierarchical architecture of the lung offers a rich, but also challenging, research area demanding a cross-scale understanding of lung mechanics and advanced computational tools to effectively model lung biomechanics in both health and disease. Various approaches have been proposed to study different aspects of respiration, ranging from compartmental to discrete micromechanical and continuum representations of the lungs. This article reviews several developments in computational lung modelling and how they are integrated with preclinical and clinical data. We begin with a description of lung anatomy and how different tissue components across multiple length scales affect lung mechanics at the organ level. We then review common physiological and imaging data acquisition methods used to inform modelling efforts. Building on these reviews, we next present a selection of model-based paradigms that integrate data acquisitions with modelling to understand, simulate and predict lung dynamics in health and disease. Finally, we highlight possible future directions where computational modelling can improve our understanding of the structure–function relationship in the lung.
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Affiliation(s)
- Sunder Neelakantan
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Yi Xin
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Donald P. Gaver
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, USA
| | - Maurizio Cereda
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahim Rizi
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bradford J. Smith
- Department of Bioengineering, University of Colorado Denver
- Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Reza Avazmohammadi
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
- J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, TX, USA
- Department of Cardiovascular Sciences, Houston Methodist Academic Institute, Houston, TX, USA
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4
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Coelho RCV, Cordeiro LARG, Gazola RB, Teixeira PIC. Dynamics of two-dimensional liquid bridges. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2022; 34:205001. [PMID: 35226894 DOI: 10.1088/1361-648x/ac594b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
We have simulated the motion of a single vertical, two-dimensional liquid bridge spanning the gap between two flat, horizontal solid substrates of given wettabilities, using a multicomponent pseudopotential lattice Boltzmann method. For this simple geometry, the Young-Laplace equation can be solved (quasi-)analytically to yield the equilibrium bridge shape under gravity, which provides a check on the validity of the numerical method. In steady-state conditions, we calculate the drag force exerted by the moving bridge on the confining substrates as a function of its velocity, for different contact angles and Bond numbers. We also study how the bridge deforms as it moves, as parametrized by the changes in the advancing and receding contact angles at the substrates relative to their equilibrium values. Finally, starting from a bridge within the range of contact angles and Bond numbers in which it can exist at equilibrium, we investigate how fast it must move in order to break up.
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Affiliation(s)
- Rodrigo C V Coelho
- Centro de Física Teórica e Computacional, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Departamento de Física, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Luís A R G Cordeiro
- Centro de Física Teórica e Computacional, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Departamento de Física, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Rodrigo B Gazola
- Centro de Física Teórica e Computacional, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Departamento de Física, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Paulo I C Teixeira
- Centro de Física Teórica e Computacional, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- ISEL-Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisboa, Portugal
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5
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Bauer K, Janke T, Schwarze R. Oxygen transport during liquid ventilation: an in vitro study. Sci Rep 2022; 12:1244. [PMID: 35075158 PMCID: PMC8786849 DOI: 10.1038/s41598-022-05105-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
An in vitro experiment on the dissolved oxygen transport during liquid ventilation by means of measuring global oxygen concentration fields is presented within this work. We consider the flow in an idealized four generation model of the human airways in a range of peak Reynolds numbers of \documentclass[12pt]{minimal}
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\begin{document}$$\alpha = 3$$\end{document}α=3–5. Fluorescence quenching measurements were employed in order to visualize and quantify the oxygen distribution with high temporal and spatial resolution during the breathing cycle. Measurements with varying tidal volumes and oscillating frequencies reveal short living times of characteristic concentration patterns for all parameter variations. Similarities to typical velocity patterns in similar lung models persist only in early phases during each cycle. Concentration gradients are quickly homogenized by secondary motions within the lung model. A strong dependency of peak oxygen concentration on tidal volume is observed with considerably higher relative concentrations for higher tidal volumes.
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Affiliation(s)
- Katrin Bauer
- Institute of Mechanics and Fluid Dynamics, TU Bergakademie Freiberg, Freiberg, Germany.
| | | | - Rüdiger Schwarze
- Institute of Mechanics and Fluid Dynamics, TU Bergakademie Freiberg, Freiberg, Germany
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6
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Munir B, Xu Y. The steady motion of microbubbles in bifurcating airways: Role of shear-thinning and surface tension. Respir Physiol Neurobiol 2021; 290:103675. [PMID: 33915302 DOI: 10.1016/j.resp.2021.103675] [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] [Received: 01/06/2021] [Accepted: 04/21/2021] [Indexed: 12/11/2022]
Abstract
Mucous fluid is non-Newtonian secretions in the lower lung airways that accumulates when the alveolar-capillary membrane ruptures during acute respiratory distress syndrome. The mucus fluid has, therefore, different types of non-Newtonian properties like shear-thinning, viscoelasticity, and non-zero yield stress. In this paper, we numerically solved the steady Stokes equations along with arbitrary Eulerian-Lagrangian moving mesh techniques to study the microbubble propagation in a two-dimensional asymmetric bifurcating airway filled with non-Newtonian fluid where the fluid has shear-thinning behavior described by the power-law model. Numerical results show that both shear-thinning and surface tension characterized by the behavior index (n) and Capillary number (Ca), respectively, had a significant impact on microbubble flow patterns and the magnitude of the pressure gradient. At low values of both n and Ca, the microbubble leaves a thin film-thickness with the airway wall while a large and sharp peak of the pressure gradient near the thin bubble tip. Interestingly, increasing both n and Ca, leads to an increase in film thickness and a decrease in the pressure gradient magnitude in both the daughter airway walls. It is observed the magnitude of the pressure gradient is more sensitive to Ca compared to n. We concluded that shear-thinning and surface tension not only significantly impact the patterns of microbubble propagation but also the hydrodynamic stress magnitudes at the airway wall.
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Affiliation(s)
- Bacha Munir
- School of Natural and Applied Sciences, Department of Applied Mathematics, Northwestern Polytechnical University, Xi'an, Shaanxi, 710029, People's Republic of China.
| | - Yong Xu
- School of Natural and Applied Sciences, Department of Applied Mathematics, Northwestern Polytechnical University, Xi'an, Shaanxi, 710029, People's Republic of China
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7
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Romanò F, Muradoglu M, Fujioka H, Grotberg JB. The effect of viscoelasticity in an airway closure model. JOURNAL OF FLUID MECHANICS 2021; 913:A31. [PMID: 33776140 PMCID: PMC7996000 DOI: 10.1017/jfm.2020.1162] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The closure of a human lung airway is modeled as a pipe coated internally with a liquid that takes into account the viscoelastic properties of mucus. For a thick enough coating, the Plateau-Rayleigh instability blocks the airway by the creation of a liquid plug, and the pre-closure phase is dominated by the Newtonian behavior of the liquid. Our previous study with a Newtonian-liquid model demonstrated that the bifrontal plug growth consequent to airway closure induces a high level of stress and stress gradients on the airway wall, which is large enough to damage the epithelial cells, causing sub-lethal or lethal responses. In this study, we explore the effect of the viscoelastic properties of mucus by means of the Oldroyd-B and FENE-CR model. Viscoelasticity is shown to be very relevant in the post-coalescence process, introducing a second peak of the wall shear stresses. This second peak is related to an elastic instability due to the presence of the polymeric extra stresses. For high-enough Weissenberg and Laplace numbers, this second shear stress peak is as severe as the first one. Consequently, a second lethal or sub-lethal response of the epithelial cells is induced.
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Affiliation(s)
- F. Romanò
- Univ. Lille, CNRS, ONERA, Arts et Métiers Institute of Technology, Centrale Lille, UMR 9014 - LMFL - Laboratoire de Mécanique des Fluides de Lille - Kampé de Fériet, F-59000, Lille, France
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - M. Muradoglu
- Department of Mechanical Engineering, Koc University, Istanbul, Turkey
| | - H. Fujioka
- Center for Computational Science, Tulane University, New Orleans, LA, 70118, USA
| | - J. B. Grotberg
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
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8
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Biomimetic lipid Nanocomplexes incorporating STAT3-inhibiting peptides effectively infiltrate the lung barrier and ameliorate pulmonary fibrosis. J Control Release 2021; 332:160-170. [PMID: 33631224 DOI: 10.1016/j.jconrel.2021.02.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/14/2021] [Accepted: 02/18/2021] [Indexed: 01/09/2023]
Abstract
Activation of signal transducer and activator of transcription 3 (STAT3) under conditions of inflammation plays a crucial role in the pathogenesis of life-threatening pulmonary fibrosis (PF), initiating pro-fibrotic signaling following its phosphorylation. While there have been attempts to interfere with STAT3 activation and associated signaling as a strategy for ameliorating PF, potent inhibitors with minimal systemic toxicity have yet to be developed. Here, we assessed the in vitro and in vivo therapeutic effectiveness of a cell-permeable peptide inhibitor of STAT3 phosphorylation, designated APTstat3-9R, for ameliorating the indications of pulmonary fibrosis. Our results demonstrate that APTstat3-9R formulated with biomimetic disc-shaped lipid nanoparticles (DLNPs) markedly enhanced the penetration of pulmonary surfactant barrier and alleviated clinical symptoms of PF while causing negligible systemic cytotoxicity. Taken together, our findings suggest that biomimetic lipid nanoparticle-assisted pulmonary delivery of APTstat3-9R may be a feasible therapeutic option for PF in the clinic, and could be applied to treat other fibrotic diseases.
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9
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Sauleda ML, Chu HCW, Tilton RD, Garoff S. Surfactant Driven Marangoni Spreading in the Presence of Predeposited Insoluble Surfactant Monolayers. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2021; 37:3309-3320. [PMID: 33689367 DOI: 10.1021/acs.langmuir.0c03348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
When an insoluble surfactant is deposited on the surface of a thin fluid film, stresses induced by surface tension gradients drive Marangoni spreading across the subphase surface. The presence of a predeposited layer of an insoluble surfactant alters that spreading. In this study, the fluid film was aqueous, the predeposited insoluble surfactant was dipalmitoylphosphatidylcholine (DPPC), and the deposited insoluble surfactant was oleic acid. An optical density-based method was used to measure subphase surface distortion, called the Marangoni ridge, associated with propagation of the spreading front. The movement of the Marangoni ridge was correlated with movement of surface tracer particles that indicated both the boundary between the two surfactant layers and the surface fluid velocities. As the deposited oleic acid monolayer spread, it compressed the predeposited DPPC monolayer. During spreading, the surface tension gradient extended into the predeposited monolayer, which was compressed nonuniformly, from the deposited monolayer. The spreading was so rapid that the compressed predeposited surfactant could not have been in quasi-equilibrium states during the spreading. As the initial concentrations of the predeposited surfactant were increased, the shape of the Marangoni ridge deformed. When the initial concentration of the predeposited surfactant reached about 70 A2/molecule, there was no longer a Marangoni ridge but rather a broadly distributed excess of fluid above the initial fluid height. The nonuniform compression of the annulus of the predeposited monolayer also caused tangential motion ahead of both the Marangoni ridge and the boundary between the two monolayers. Spreading ceased when the two monolayers reached the same final surface tension. The final area per molecule of the DPPC monolayer matched that expected from the equilibrium DPPC isotherm at the same final surface tension. Thus, at the end of spreading, there was a simple surface tension balance between the two distinct monolayers.
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Affiliation(s)
- Madeline L Sauleda
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Center for Complex Fluids Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
| | - Henry C W Chu
- Center for Complex Fluids Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - Robert D Tilton
- Center for Complex Fluids Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
| | - Stephen Garoff
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
- Center for Complex Fluids Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
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10
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Jamshidi E, Babajani A, Soltani P, Niknejad H. Proposed Mechanisms of Targeting COVID-19 by Delivering Mesenchymal Stem Cells and Their Exosomes to Damaged Organs. Stem Cell Rev Rep 2021; 17:176-192. [PMID: 33432484 PMCID: PMC7799400 DOI: 10.1007/s12015-020-10109-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 12/13/2022]
Abstract
With the outbreak of coronavirus disease (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the world has been facing an unprecedented challenge. Considering the lack of appropriate therapy for COVID-19, it is crucial to develop effective treatments instead of supportive approaches. Mesenchymal stem cells (MSCs) as multipotent stromal cells have been shown to possess treating potency through inhibiting or modulating the pathological events in COVID-19. MSCs and their exosomes participate in immunomodulation by controlling cell-mediated immunity and cytokine release. Furthermore, they repair the renin-angiotensin-aldosterone system (RAAS) malfunction, increase alveolar fluid clearance, and reduce the chance of hypercoagulation. Besides the lung, which is the primary target of SARS-CoV-2, the heart, kidney, nervous system, and gastrointestinal tract are also affected by COVID-19. Thus, the efficacy of targeting these organs via different delivery routes of MSCs and their exosomes should be evaluated to ensure safe and effective MSCs administration in COVID-19. This review focuses on the proposed therapeutic mechanisms and delivery routes of MSCs and their exosomes to the damaged organs. It also discusses the possible application of primed and genetically modified MSCs as a promising drug delivery system in COVID-19. Moreover, the recent advances in the clinical trials of MSCs and MSCs-derived exosomes as one of the promising therapeutic approaches in COVID-19 have been reviewed.
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Affiliation(s)
- Elham Jamshidi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhesam Babajani
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Soltani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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11
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Chen CM, Chang CH, Chao CH, Wang MH, Yeh TF. Biophysical and chemical stability of surfactant/budesonide and the pulmonary distribution following intra-tracheal administration. Drug Deliv 2019; 26:604-611. [PMID: 31204848 PMCID: PMC6586100 DOI: 10.1080/10717544.2019.1618418] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Intra-tracheal instillation of budesonide using surfactant as a vehicle significantly decreased the incidence of bronchopulmonary dysplasia or death in preterm infants. The formularity of surfactant supplemented with budesonide and biophysical and chemical stability of the suspension has not been well reported. The aims are to investigate the biophysical and chemical stability of two surfactant preparations, Survanta and Curosurf, supplemented with budesonide. Biophysical property of the surface tension of Survanta and Survanta/budesonide suspension and of Curosurf and Curosurf/budesonide suspension was conducted by a pulsating bubble surfactometer and by a drop shape tensiometer. Chemical stability of Survanta/budesonide and of Curosurf/budesonide suspensions was tested by high-performance liquid chromatography analysis (HPLC). Pulmonary distribution of Survanta/18F-budesonide suspension was examined by a Nano/PET digital scan in rats. The Marangoni effect of Survanta, Curosurf, and budesonide was tested by digital high speed photography. For Survanta supplemented with budesonide, with a concentration ratio of ≥50, the surface tension-lowering activity was minimally affected. Similarly, the surface tension-lowering activity of Curosurf was not significantly affected by addition of budesonide, if the concentration ratio was ≥160. With these concentration ratios of both suspensions, HPLC analysis revealed no new compounds identified. Curosurf as compared to Survanta exhibited a significantly higher Marangoni effect. We conclude that with current dosage recommended for Survanta and Curosurf, both surfactant/budesonide suspensions are biophysically and chemically stable. Both surfactants can act as an effective vehicle for budesonide delivery.
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Affiliation(s)
- Chung-Ming Chen
- a Department of Pediatrics , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.,b Department of Pediatrics , Taipei Medical University Hospital , Taipei , Taiwan.,c Maternal Child Health Research Center , College of Medicine, Taipei Medical University , Taipei , Taiwan
| | - Chien-Hsiang Chang
- d Department of Chemical Engineering , National Cheng Kung University , Tainan , Taiwan
| | - Chih-Hua Chao
- e Department of Pharmacy , China Medical University , Taichung , Taiwan
| | - Mei-Hui Wang
- f Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Tsu-Fu Yeh
- c Maternal Child Health Research Center , College of Medicine, Taipei Medical University , Taipei , Taiwan.,g Department of Pediatrics , Children's Hospital, China Medical University , Taichung , Taiwan
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12
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Tenenbaum-Katan J, Artzy-Schnirman A, Fishler R, Korin N, Sznitman J. Biomimetics of the pulmonary environment in vitro: A microfluidics perspective. BIOMICROFLUIDICS 2018; 12:042209. [PMID: 29887933 PMCID: PMC5973897 DOI: 10.1063/1.5023034] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/20/2018] [Indexed: 05/08/2023]
Abstract
The entire luminal surface of the lungs is populated with a complex yet confluent, uninterrupted airway epithelium in conjunction with an extracellular liquid lining layer that creates the air-liquid interface (ALI), a critical feature of healthy lungs. Motivated by lung disease modelling, cytotoxicity studies, and drug delivery assessments amongst other, in vitro setups have been traditionally conducted using macroscopic cultures of isolated airway cells under submerged conditions or instead using transwell inserts with permeable membranes to model the ALI architecture. Yet, such strategies continue to fall short of delivering a sufficiently realistic physiological in vitro airway environment that cohesively integrates at true-scale three essential pillars: morphological constraints (i.e., airway anatomy), physiological conditions (e.g., respiratory airflows), and biological functionality (e.g., cellular makeup). With the advent of microfluidic lung-on-chips, there have been tremendous efforts towards designing biomimetic airway models of the epithelial barrier, including the ALI, and leveraging such in vitro scaffolds as a gateway for pulmonary disease modelling and drug screening assays. Here, we review in vitro platforms mimicking the pulmonary environment and identify ongoing challenges in reconstituting accurate biological airway barriers that still widely prevent microfluidic systems from delivering mainstream assays for the end-user, as compared to macroscale in vitro cell cultures. We further discuss existing hurdles in scaling up current lung-on-chip designs, from single airway models to more physiologically realistic airway environments that are anticipated to deliver increasingly meaningful whole-organ functions, with an outlook on translational and precision medicine.
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Affiliation(s)
- Janna Tenenbaum-Katan
- Department of Biomedical Engineering, Technion–Israel Institute of Technology, 32000 Haifa, Israel
| | - Arbel Artzy-Schnirman
- Department of Biomedical Engineering, Technion–Israel Institute of Technology, 32000 Haifa, Israel
| | - Rami Fishler
- Department of Biomedical Engineering, Technion–Israel Institute of Technology, 32000 Haifa, Israel
| | - Netanel Korin
- Department of Biomedical Engineering, Technion–Israel Institute of Technology, 32000 Haifa, Israel
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion–Israel Institute of Technology, 32000 Haifa, Israel
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13
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Semenov S, Carle F, Medale M, Brutin D. Boundary conditions for a one-sided numerical model of evaporative instabilities in sessile drops of ethanol on heated substrates. Phys Rev E 2018; 96:063113. [PMID: 29347292 DOI: 10.1103/physreve.96.063113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Indexed: 11/07/2022]
Abstract
The work is focused on obtaining boundary conditions for a one-sided numerical model of thermoconvective instabilities in evaporating pinned sessile droplets of ethanol on heated substrates. In the one-sided model, appropriate boundary conditions for heat and mass transfer equations are required at the droplet surface. Such boundary conditions are obtained in the present work based on a derived semiempirical theoretical formula for the total droplet's evaporation rate, and on a two-parametric nonisothermal approximation of the local evaporation flux. The main purpose of these boundary conditions is to be applied in future three-dimensional (3D) one-sided numerical models in order to save a lot of computational time and resources by solving equations only in the droplet domain. Two parameters, needed for the nonisothermal approximation of the local evaporation flux, are obtained by fitting computational results of a 2D two-sided numerical model. Such model is validated here against parabolic flight experiments and the theoretical value of the total evaporation rate. This study combines theoretical, experimental, and computational approaches in convective evaporation of sessile droplets. The influence of the gravity level on evaporation rate and contributions of different mechanisms of vapor transport (diffusion, Stefan flow, natural convection) are shown. The qualitative difference (in terms of developing thermoconvective instabilities) between steady-state and unsteady numerical approaches is demonstrated.
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Affiliation(s)
- Sergey Semenov
- Aix-Marseille University, IUSTI UMR 7343 CNRS, 13453 Marseille, France.,Aix-Marseille University, MADIREL UMR 7246 CNRS, 13013 Marseille, France
| | - Florian Carle
- Aix-Marseille University, IUSTI UMR 7343 CNRS, 13453 Marseille, France.,Yale Quantum Institute, Yale University, New Haven, Connecticut 06511, USA
| | - Marc Medale
- Aix-Marseille University, IUSTI UMR 7343 CNRS, 13453 Marseille, France
| | - David Brutin
- Aix-Marseille University, IUSTI UMR 7343 CNRS, 13453 Marseille, France.,Institut Universitaire de France, 75231 Paris, France
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14
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Kim J, Guenthart B, O'Neill JD, Dorrello NV, Bacchetta M, Vunjak-Novakovic G. Controlled delivery and minimally invasive imaging of stem cells in the lung. Sci Rep 2017; 7:13082. [PMID: 29026127 PMCID: PMC5638808 DOI: 10.1038/s41598-017-13280-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 09/19/2017] [Indexed: 12/11/2022] Open
Abstract
Intratracheal delivery of stem cells into injured or diseased lungs can provide a variety of therapeutic and immunomodulatory effects for the treatment of acute lung injury and chronic lung disease. While the efficacy of this approach depends on delivering the proper cell dosage into the target region of the airway, tracking and analysis of the cells have been challenging, largely due to the limited understanding of cell transport and lack of suitable cell monitoring techniques. We report on the transport and deposition of intratracheally delivered stem cells as well as strategies to modulate the number of cells (e.g., dose), topographic distribution, and region-specific delivery in small (rodent) and large (porcine and human) lungs. We also developed minimally invasive imaging techniques for real-time monitoring of intratracheally delivered cells. We propose that this approach can facilitate the implementation of patient-specific cells and lead to enhanced clinical outcomes in the treatment of lung disease with cell-based therapies.
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Affiliation(s)
- Jinho Kim
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | | | - John D O'Neill
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - N Valerio Dorrello
- Department of Biomedical Engineering, Columbia University, New York, NY, USA.,Department of Pediatrics, Columbia University, New York, NY, USA
| | | | - Gordana Vunjak-Novakovic
- Department of Biomedical Engineering, Columbia University, New York, NY, USA. .,Department of Medicine, Columbia University, New York, NY, USA.
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15
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Pepicelli M, Verwijlen T, Tervoort TA, Vermant J. Characterization and modelling of Langmuir interfaces with finite elasticity. SOFT MATTER 2017; 13:5977-5990. [PMID: 28776048 DOI: 10.1039/c7sm01100h] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Interfaces differ from bulk materials in many ways, one particular aspect is that they are compressible. Changing the area per molecule or per particle changes the thermodynamic state variables such as surface pressure. Yet, when compressing to high surface pressures, dense packing of the interfacial species induces phase transitions, with highly structured phases, which can display elastic or strongly viscoelastic behaviour. When these are deformed, in addition to the changes in the surface pressure, extra and deviatoric stresses can be induced. The traditional tool to study the phase behaviour of monolayers is a rectangular Langmuir-Pockels trough, but as both the area and shape of the interface are changed upon compression, the interfacial-strain field in this instrument is mixed with a priori unknown amounts of dilatational and shear deformations, making it difficult to separate the rheological and equilibrium thermodynamic effects. In the present work, the design of a radial trough is described, in which the deformation field is simple, purely dilation or compression. The possibility to now independently measure the compressional properties of different strains and the development of an appropriate finite strain constitutive model for elastic interfaces make it possible to interrogate the underlying constitutive behaviour. This is shown here for a strongly elastic, soft glassy polymer monolayer during its initial compression but is easily generalised to many viscoelastic soft matter interfaces.
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Affiliation(s)
- Martina Pepicelli
- ETH Zurich, Department of Materials, Vladimir-Prelog-Weg 5, 8093, Zurich, Switzerland.
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16
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Whang J, Faulman C, Itin TA, Gaver DP. The influence of tethering and gravity on the stability of compliant liquid-lined airways. J Biomech 2017; 50:228-233. [DOI: 10.1016/j.jbiomech.2016.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 11/05/2016] [Indexed: 11/28/2022]
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17
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Magniez JC, Baudoin M, Liu C, Zoueshtiagh F. Dynamics of liquid plugs in prewetted capillary tubes: from acceleration and rupture to deceleration and airway obstruction. SOFT MATTER 2016; 12:8710-8717. [PMID: 27714328 DOI: 10.1039/c6sm01463a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The dynamics of individual liquid plugs pushed at a constant pressure head inside prewetted cylindrical capillary tubes is investigated experimentally and theoretically. It is shown that, depending on the thickness of the prewetting film and the magnitude of the pressure head, the plugs can either experience a continuous acceleration leading to a dramatic decrease of their size and eventually their rupture or conversely, a progressive deceleration associated with their growth and an exacerbation of the airway obstruction. These behaviors are quantitatively reproduced using a simple nonlinear model [Baudoin et al., Proc. Natl. Acad. Sci. U. S. A., 2013, 110, 859] adapted here for cylindrical channels. Furthermore, an analytical criterion for the transition between these two regimes is derived and successfully compared with extensive experimental data. The potential implications of this work for pulmonary obstructive diseases are discussed.
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Affiliation(s)
- J C Magniez
- IEMN, International Laboratory LEMAC/LICS, UMR CNRS 8520, Université de Lille, Avenue Poincaré, 59652 Villeneuve d'Ascq, France.
| | - M Baudoin
- IEMN, International Laboratory LEMAC/LICS, UMR CNRS 8520, Université de Lille, Avenue Poincaré, 59652 Villeneuve d'Ascq, France.
| | - C Liu
- IEMN, International Laboratory LEMAC/LICS, UMR CNRS 8520, Université de Lille, Avenue Poincaré, 59652 Villeneuve d'Ascq, France.
| | - F Zoueshtiagh
- IEMN, International Laboratory LEMAC/LICS, UMR CNRS 8520, Université de Lille, Avenue Poincaré, 59652 Villeneuve d'Ascq, France.
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18
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Hermans E, Bhamla MS, Kao P, Fuller GG, Vermant J. Lung surfactants and different contributions to thin film stability. SOFT MATTER 2015; 11:8048-57. [PMID: 26307946 DOI: 10.1039/c5sm01603g] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The surfactant lining the walls of the alveoli in the lungs increases pulmonary compliance and prevents collapse of the lung at the end of expiration. In premature born infants, surfactant deficiency causes problems, and lung surfactant replacements are instilled to facilitate breathing. These pulmonary surfactants, which form complex structured fluid-fluid interfaces, need to spread with great efficiency and once in the alveolus they have to form a thin stable film. In the present work, we investigate the mechanisms affecting the stability of surfactant-laden thin films during spreading, using drainage flows from a hemispherical dome. Three commercial lung surfactant replacements Survanta, Curosurf and Infasurf, along with the phospholipid dipalmitoylphosphatidylcholine (DPPC), are used. The surface of the dome can be covered with human alveolar epithelial cells and experiments are conducted at the physiological temperature. Drainage is slowed down due to the presence of all the different lung surfactant replacements and therefore the thin films show enhanced stability. However, a scaling analysis combined with visualization experiments demonstrates that different mechanisms are involved. For Curosurf and Infasurf, Marangoni stresses are essential to impart stability and interfacial shear rheology does not play a role, in agreement with what is observed for simple surfactants. Survanta, which was historically the first natural surfactant used, is rheologically active. For DPPC the dilatational properties play a role. Understanding these different modes of stabilization for natural surfactants can benefit the design of effective synthetic surfactant replacements for treating infant and adult respiratory disorders.
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Affiliation(s)
- Eline Hermans
- Department of Chemical Engineering, KU Leuven, Belgium
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19
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Bayat S, Porra L, Broche L, Albu G, Malaspinas I, Doras C, Strengell S, Peták F, Habre W. Effect of surfactant on regional lung function in an experimental model of respiratory distress syndrome in rabbit. J Appl Physiol (1985) 2015; 119:290-8. [DOI: 10.1152/japplphysiol.00047.2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/14/2015] [Indexed: 11/22/2022] Open
Abstract
We assessed the changes in regional lung function following instillation of surfactant in a model of respiratory distress syndrome (RDS) induced by whole lung lavage and mechanical ventilation in eight anaesthetized, paralyzed, and mechanically ventilated New Zealand White rabbits. Regional specific ventilation (sV̇) was measured by K-edge subtraction synchrotron computed tomography during xenon washin. Lung regions were classified as poorly aerated (PA), normally aerated (NA), or hyperinflated (HI) based on regional density. A functional category was defined within each class based on sV̇ distribution (High, Normal, and Low). Airway resistance (Raw), respiratory tissue damping (G), and elastance (H) were measured by forced oscillation technique at low frequencies before and after whole lung saline lavage-induced (100 ml/kg) RDS, and 5 and 45 min after intratracheal instillation of beractant (75 mg/kg). Surfactant instillation improved Raw, G, and H ( P < 0.05 each), and gas exchange and decreased atelectasis ( P < 0.001). It also significantly improved lung aeration and ventilation in atelectatic lung regions. However, in regions that had remained normally aerated after lavage, it decreased regional aeration and increased sV̇ ( P < 0.001) and sV̇ heterogeneity. Although surfactant treatment improved both central airway and tissue mechanics and improved regional lung function of initially poorly aerated and atelectatic lung, it deteriorated regional lung function when local aeration was normal prior to administration. Local mechanical and functional heterogeneity can potentially contribute to the worsening of RDS and gas exchange. These data underscore the need for reassessing the benefits of routine prophylactic vs. continuous positive airway pressure and early “rescue” surfactant therapy in very immature infants.
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Affiliation(s)
- Sam Bayat
- Université de Picardie Jules Verne, Inserm U1105 and Pediatric Lung Function Laboratory, Amiens University Hospital, Amiens, France
| | - Liisa Porra
- Department of Physics, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Ludovic Broche
- Université de Picardie Jules Verne, Inserm U1105 and Pediatric Lung Function Laboratory, Amiens University Hospital, Amiens, France
- European Synchrotron Radiation Facility, Biomedical Beamline-ID17, Grenoble, France
| | - Gergely Albu
- Anesthesiological Investigation Unit, University of Geneva, Geneva, Switzerland
| | - Iliona Malaspinas
- Anesthesiological Investigation Unit, University of Geneva, Geneva, Switzerland
| | - Camille Doras
- Anesthesiological Investigation Unit, University of Geneva, Geneva, Switzerland
| | - Satu Strengell
- Department of Physics, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | - Ferenc Peták
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary; and
| | - Walid Habre
- Anesthesiological Investigation Unit, University of Geneva, Geneva, Switzerland
- Geneva Children's Hospital, University Hospitals of Geneva and Geneva University, Geneva, Switzerland
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20
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Takahashi A, Bartolák-Suki E, Majumdar A, Suki B. Changes in respiratory elastance after deep inspirations reflect surface film functionality in mice with acute lung injury. J Appl Physiol (1985) 2015; 119:258-65. [PMID: 26066828 DOI: 10.1152/japplphysiol.00476.2014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 05/13/2015] [Indexed: 01/11/2023] Open
Abstract
Pulmonary surfactant reduces surface tension in the lung and prevents alveolar collapse. Following a deep inspiration (DI), respiratory elastance first drops then gradually increases due to surface film and tissue viscoelasticity. In acute lung injury (ALI), this increase is faster and governed by alveolar collapse due to increased surface tension. We hypothesized that the rate of increase in elastance reflects the deficiency of surfactant in the lung. To test this, mice were ventilated before (baseline) and after saline lavage obtained by injecting 0.8 ml and withdrawing 0.7 ml fluid (severe ALI) or injecting 0.1 ml (mild ALI). After two DIs, elastance was tracked for 10 min followed by a full lavage to assess surfactant proteins B (SP-B) and C (SP-C) content. Following 2 DIs, the increases in elastance during 10 min ventilation (ΔH) were 3.60 ± 0.61, 5.35 ± 1.04, and 8.33 ± 0.84 cmH2O/ml in baseline mice and mice with mild and severe ALI, respectively (P < 0.0001). SP-B and SP-C in the lavage fluid dropped by 32.4% and 24.9% in the mild and 50.4% and 39.6% in the severe ALI, respectively. Furthermore, ΔH showed a strong negative correlation with both SP-B (r(2) = 0.801) and SP-C (r(2) = 0.810) content. The ΔH was, however, much smaller when the lavage fluid also contained exogeneous SP-B and SP-C. Thus ΔH can be interpreted as an organ level measure of surface film functionality in lavage-induced ALI in mice. This method could prove useful in clinical situations such as diagnosing surfactant problems, monitoring recovery from lung injury or the effectiveness of surfactant therapy.
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Affiliation(s)
- Ayuko Takahashi
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | | | - Arnab Majumdar
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | - Béla Suki
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
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21
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Rimensberger PC. Surfactant. PEDIATRIC AND NEONATAL MECHANICAL VENTILATION 2015. [PMCID: PMC7175631 DOI: 10.1007/978-3-642-01219-8_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Exogenous pulmonary surfactant, widely used in neonatal care, is one of the best-studied treatments in neonatology, and its introduction in the 1990s led to a significant improvement in neonatal outcomes in preterm infants, including a decrease in mortality. This chapter provides an overview of surfactant composition and function in health and disease and summarizes the evidence for its clinical use.
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Affiliation(s)
- Peter C. Rimensberger
- Service of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneve, Switzerland
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22
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Levy R, Hill DB, Forest MG, Grotberg JB. Pulmonary fluid flow challenges for experimental and mathematical modeling. Integr Comp Biol 2014; 54:985-1000. [PMID: 25096289 PMCID: PMC4296202 DOI: 10.1093/icb/icu107] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Modeling the flow of fluid in the lungs, even under baseline healthy conditions, presents many challenges. The complex rheology of the fluids, interaction between fluids and structures, and complicated multi-scale geometry all add to the complexity of the problem. We provide a brief overview of approaches used to model three aspects of pulmonary fluid and flow: the surfactant layer in the deep branches of the lung, the mucus layer in the upper airway branches, and closure/reopening of the airway. We discuss models of each aspect, the potential to capture biological and therapeutic information, and open questions worthy of further investigation. We hope to promote multi-disciplinary collaboration by providing insights into mathematical descriptions of fluid-mechanics in the lung and the kinds of predictions these models can make.
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Affiliation(s)
- Rachel Levy
- *Department of Mathematics, Harvey Mudd College, Claremont, CA 91711, USA; The Marsico Lung Institute, Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Mathematics, Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; NASA Bioscience and Engineering Institute, The University of Michigan, Ann Arbor, MI 48109, USA
| | - David B Hill
- *Department of Mathematics, Harvey Mudd College, Claremont, CA 91711, USA; The Marsico Lung Institute, Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Mathematics, Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; NASA Bioscience and Engineering Institute, The University of Michigan, Ann Arbor, MI 48109, USA
| | - M Gregory Forest
- *Department of Mathematics, Harvey Mudd College, Claremont, CA 91711, USA; The Marsico Lung Institute, Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Mathematics, Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; NASA Bioscience and Engineering Institute, The University of Michigan, Ann Arbor, MI 48109, USA
| | - James B Grotberg
- *Department of Mathematics, Harvey Mudd College, Claremont, CA 91711, USA; The Marsico Lung Institute, Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Mathematics, Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; NASA Bioscience and Engineering Institute, The University of Michigan, Ann Arbor, MI 48109, USA
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23
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Yamaguchi E, Giannetti MJ, Van Houten MJ, Forouzan O, Shevkoplyas SS, Gaver DP. The unusual symmetric reopening effect induced by pulmonary surfactant. J Appl Physiol (1985) 2014; 116:635-44. [PMID: 24458752 DOI: 10.1152/japplphysiol.00814.2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigates the stability of a finger of air as it propagates into a liquid-filled model of a liquid-filled model of a pulmonary bifurcation. We seek to elucidate the stability characteristics of the reopening of daughter airways, an event that may be important to the treatment of acute lung disease. To do so, we investigated the symmetry of reopening under conditions of nearly constant surface tension with 1) purified H2O or 2) an anionic surfactant (sodium dodecyl sulfate). Dynamic surface tension was investigated using pulmonary surfactant (Infasurf) with and without the presence of albumin. Flow visualization was accomplished using a microparticle image velocimetry (μ-PIV)/shadowgraph system through which we measured 1) the propagation velocity of the finger of air that reopens each daughter branch, and 2) the instantaneous and averaged velocity field of liquid phase surrounding the tip of the propagating bubble. Only pulmonary surfactant demonstrated the ability of maintaining a nearly symmetric propagation in the daughter channels, which is likely to lead to homogeneous airway reopening. In contrast, when pulmonary surfactant was inactivated by albumin or when the system was held at a nearly constant surface tension, reopening occurred asymmetrically. Our analysis suggests that Infasurf's dynamic surface tension qualities are important to stabilize the removal of liquid obstructions. This demonstrates a new important function of pulmonary surfactant for airway reopening of a multibranched network.
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Affiliation(s)
- Eiichiro Yamaguchi
- Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana
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24
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El-Gendy N, Kaviratna A, Berkland C, Dhar P. Delivery and performance of surfactant replacement therapies to treat pulmonary disorders. Ther Deliv 2013; 4:951-80. [PMID: 23919474 PMCID: PMC3840129 DOI: 10.4155/tde.13.72] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Lung surfactant is crucial for optimal pulmonary function throughout life. An absence or deficiency of surfactant can affect the surfactant pool leading to respiratory distress. Even if the coupling between surfactant dysfunction and the underlying disease is not always well understood, using exogenous surfactants as replacement is usually a standard therapeutic option in respiratory distress. Exogenous surfactants have been extensively studied in animal models and clinical trials. The present article provides an update on the evolution of surfactant therapy, types of surfactant treatment, and development of newer-generation surfactants. The differences in the performance between various surfactants are highlighted and advanced research that has been conducted so far in developing the optimal delivery of surfactant is discussed.
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Affiliation(s)
- Nashwa El-Gendy
- Department of Pharmaceutical Chemistry, The University of Kansas, 1530 W 15th Street, Lawrence, KS 66045, USA
- Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, Beni-suef University, Egypt
| | - Anubhav Kaviratna
- Department of Chemical & Petroleum Engineering, The University of Kansas, 1530 W 15th Street, Lawrence, KS 66045, USA
| | - Cory Berkland
- Department of Pharmaceutical Chemistry, The University of Kansas, 1530 W 15th Street, Lawrence, KS 66045, USA
- Department of Chemical & Petroleum Engineering, The University of Kansas, 1530 W 15th Street, Lawrence, KS 66045, USA
| | - Prajnaparamita Dhar
- Department of Chemical & Petroleum Engineering, The University of Kansas, 1530 W 15th Street, Lawrence, KS 66045, USA
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25
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26
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Halpern D, Gaver DP. The influence of surfactant on the propagation of a semi-infinite bubble through a liquid-filled compliant channel. JOURNAL OF FLUID MECHANICS 2012; 698:125-159. [PMID: 22997476 PMCID: PMC3445425 DOI: 10.1017/jfm.2012.66] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We investigate the influence of a soluble surfactant on the steady-state motion of a finger of air through a compliant channel. This study provides a basic model from which to understand the fluid-structure interactions and physicochemical hydrodynamics of pulmonary airway reopening. Airway closure occurs in lung diseases such as respiratory distress syndrome and acute respiratory distress syndrome as a result of fluid accumulation and surfactant insufficiency. This results in 'compliant collapse' with the airway walls buckled and held in apposition by a liquid occlusion that blocks the passage of air. Airway reopening is essential to the recovery of adequate ventilation, but has been associated with ventilator-induced lung injury because of the exposure of airway epithelial cells to large interfacial flow-induced pressure gradients. Surfactant replacement is helpful in modulating this deleterious mechanical stimulus, but is limited in its effectiveness owing to slow surfactant adsorption. We investigate the effect of surfactant on micro-scale models of reopening by computationally modelling the steady two-dimensional motion of a semi-infinite bubble propagating through a liquid-filled compliant channel doped with soluble surfactant. Many dimensionless parameters affect reopening, but we primarily investigate how the reopening pressure p(b) depends upon the capillary number Ca (the ratio of viscous to surface tension forces), the adsorption depth parameter λ (a bulk concentration parameter) and the bulk Péclet number Pe(b) (the ratio of bulk convection to diffusion). These studies demonstrate a dependence of p(b) on λ, and suggest that a critical bulk concentration must be exceeded to operate as a low-surface-tension system. Normal and tangential stress gradients remain largely unaffected by physicochemical interactions - for this reason, further biological studies are suggested that will clarify the role of wall flexibility and surfactant on the protection of the lung from atelectrauma.
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Affiliation(s)
- David Halpern
- Department of Mathematics, University of Alabama, Tuscaloosa, AL 35487, USA
- Email address for correspondence:
| | - Donald P. Gaver
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70130, USA
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27
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Corcoran TE, Thomas KM, Garoff S, Tilton RD, Przybycien TM, Pilewski JM. Imaging the postdeposition dispersion of an inhaled surfactant aerosol. J Aerosol Med Pulm Drug Deliv 2012; 25:290-6. [PMID: 22393908 DOI: 10.1089/jamp.2011.0920] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aerodynamic forces provide the primary means of distributing aerosol medications within the lungs. Partial airway obstructions can limit both air flow and aerosol penetration into diseased zones. We hypothesize that low surface tension additives may help to disperse aerosol medications after deposition in the airways, improving dose uniformity and drug delivery to underventilated regions. To test this, we performed a pilot scintigraphy study of surfactant and saline deposition and postdeposition dispersion. METHODS Because inhaled antibiotics for cystic fibrosis provide an example of where self-dispersing medications may be useful, we administered calfactant and saline aerosols with added Technetium 99m sulfur colloid (Tc-SC; 100 nm filtered) on different days in randomized order to eight cystic fibrosis (CF) subjects (average FEV(1)%, p=85 ± 12%). Nebulized delivery was matched (similar aerosol sizes and volume delivery rates, fixed breathing patterns). Tc-SC distribution in the lungs was imaged continuously for 30 min after delivery. RESULTS Both aerosols were well tolerated. Aerosol distribution was mostly peripheral (58/42%) and initially similar for saline and surfactant. Changes in whole lung counts after 30 min were also similar. Peripheral lung activity decreased more rapidly on average with calfactant though the difference versus saline was not statistically significant. Central to peripheral count ratio decreased with saline and increased with calfactant and c/p changes approached significance (-0.05 ± 0.16 vs. 0.10 ± 0.10; p=0.07 Wilcoxon). CONCLUSIONS Our results lack statistical significance, but suggest that inhaled calfactant increased peripheral clearance, due to either surfactant-based dispersion or mucociliary effects. Further studies are needed to define the potential for low surface tension carriers to improve drug delivery.
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Affiliation(s)
- Timothy E Corcoran
- Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
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Grotberg JB. Respiratory fluid mechanics. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2011; 23:21301. [PMID: 21403768 PMCID: PMC3055904 DOI: 10.1063/1.3517737] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 07/28/2010] [Indexed: 05/02/2023]
Abstract
This article covers several aspects of respiratory fluid mechanics that have been actively investigated by our group over the years. For the most part, the topics involve two-phase flows in the respiratory system with applications to normal and diseased lungs, as well as therapeutic interventions. Specifically, the topics include liquid plug flow in airways and at airway bifurcations as it relates to surfactant, drug, gene, or stem cell delivery into the lung; liquid plug rupture and its damaging effects on underlying airway epithelial cells as well as a source of crackling sounds in the lung; airway closure from "capillary-elastic instabilities," as well as nonlinear stabilization from oscillatory core flow which we call the "oscillating butter knife;" liquid film, and surfactant dynamics in an oscillating alveolus and the steady streaming, and surfactant spreading on thin viscous films including our discovery of the Grotberg-Borgas-Gaver shock.
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Affiliation(s)
- James B Grotberg
- Department of Biomedical Engineering, The University of Michigan, 1107 Gerstacker Building, 2200 Bonisteel Boulevard, Ann Arbor, Michigan 48109-2099, USA
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Tavana H, Kuo CH, Lee QY, Mosadegh B, Huh D, Christensen PJ, Grotberg JB, Takayama S. Dynamics of liquid plugs of buffer and surfactant solutions in a micro-engineered pulmonary airway model. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2010; 26:3744-52. [PMID: 20017471 PMCID: PMC2827626 DOI: 10.1021/la903038a] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We describe a bioinspired microfluidic system that resembles pulmonary airways and enables on-chip generation of airway occluding liquid plugs from a stratified air-liquid two-phase flow. User-defined changes in the air stream pressure facilitated by mechanical components and tuning the wettability of the microchannels enable generation of well-defined liquid plugs. Significant differences are observed in liquid plug generation and propagation when surfactant is added to the buffer. The plug flow patterns suggest a protective role of surfactant for airway epithelial cells against pathological flow-induced mechanical stresses. We discuss the implications of the findings for clinical settings. This approach and the described platform will enable systematic investigation of the effect of different degrees of fluid mechanical stresses on lung injury at the cellular level and administration of exogenous therapeutic surfactants.
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Affiliation(s)
- Hossein Tavana
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Chuan-Hsien Kuo
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Qian Yi Lee
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Bobak Mosadegh
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Dongeun Huh
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Paul J. Christensen
- Department of Internal Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-2399, USA
| | - James B. Grotberg
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
| | - Shuichi Takayama
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI 48109-2099, USA
- Corresponding Author, Tel.: (734) 615-5539, Fax: (734) 936-1905,
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Zamir M, Moore JE, Fujioka H, Gaver DP. Biofluid mechanics of special organs and the issue of system control. Sixth International Bio-Fluid Mechanics Symposium and Workshop, March 28-30, 2008 Pasadena, California. Ann Biomed Eng 2010; 38:1204-15. [PMID: 20336840 PMCID: PMC2917121 DOI: 10.1007/s10439-010-9902-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the field of fluid flow within the human body, focus has been placed on the transportation of blood in the systemic circulation since the discovery of that system; but, other fluids and fluid flow phenomena pervade the body. Some of the most fascinating fluid flow phenomena within the human body involve fluids other than blood and a service other than transport--the lymphatic and pulmonary systems are two striking examples. While transport is still involved in both cases, this is not the only service which they provide and blood is not the only fluid involved. In both systems, filtration, extraction, enrichment, and in general some "treatment" of the fluid itself is the primary function. The study of the systemic circulation has also been conventionally limited to treating the system as if it were an open-loop system governed by the laws of fluid mechanics alone, independent of physiological controls and regulations. This implies that system failures can be explained fully in terms of the laws of fluid mechanics, which of course is not the case. In this paper we examine the clinical implications of these issues and of the special biofluid mechanics issues involved in the lymphatic and pulmonary systems.
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Affiliation(s)
- Mair Zamir
- Department of Applied Mathematics, The University of Western Ontario, London, ON, Canada.
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