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Grimaldo Ruiz O, Rodriguez Reinoso M, Ingrassia E, Vecchio F, Maniero F, Burgio V, Civera M, Bitan I, Lacidogna G, Surace C. Design and Mechanical Characterization Using Digital Image Correlation of Soft Tissue-Mimicking Polymers. Polymers (Basel) 2022; 14:polym14132639. [PMID: 35808685 PMCID: PMC9269014 DOI: 10.3390/polym14132639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
Present and future anatomical models for biomedical applications will need bio-mimicking three-dimensional (3D)-printed tissues. These would enable, for example, the evaluation of the quality-performance of novel devices at an intermediate step between ex-vivo and in-vivo trials. Nowadays, PolyJet technology produces anatomical models with varying levels of realism and fidelity to replicate organic tissues. These include anatomical presets set with combinations of multiple materials, transitions, and colors that vary in hardness, flexibility, and density. This study aims to mechanically characterize multi-material specimens designed and fabricated to mimic various bio-inspired hierarchical structures targeted to mimic tendons and ligaments. A Stratasys® J750™ 3D Printer was used, combining the Agilus30™ material at different hardness levels in the bio-mimicking configurations. Then, the mechanical properties of these different options were tested to evaluate their behavior under uni-axial tensile tests. Digital Image Correlation (DIC) was used to accurately quantify the specimens’ large strains in a non-contact fashion. A difference in the mechanical properties according to pattern type, proposed hardness combinations, and matrix-to-fiber ratio were evidenced. The specimens V, J1, A1, and C were selected as the best for every type of pattern. Specimens V were chosen as the leading combination since they exhibited the best balance of mechanical properties with the higher values of Modulus of elasticity (2.21 ± 0.17 MPa), maximum strain (1.86 ± 0.05 mm/mm), and tensile strength at break (2.11 ± 0.13 MPa). The approach demonstrates the versatility of PolyJet technology that enables core materials to be tailored based on specific needs. These findings will allow the development of more accurate and realistic computational and 3D printed soft tissue anatomical solutions mimicking something much closer to real tissues.
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Affiliation(s)
- Oliver Grimaldo Ruiz
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
| | - Mariana Rodriguez Reinoso
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
| | - Elena Ingrassia
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
| | - Federico Vecchio
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
| | - Filippo Maniero
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
| | - Vito Burgio
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
| | - Marco Civera
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
- Correspondence:
| | - Ido Bitan
- Stratasys Headquarters, 1 Holtzman St. Science Park, Rehovot P.O. Box 2496, Israel;
| | - Giuseppe Lacidogna
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
| | - Cecilia Surace
- Department of Structural, Geotechnical and Building Engineering (DISEG), Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy; (O.G.R.); (M.R.R.); (E.I.); (F.V.); (F.M.); (V.B.); (G.L.); (C.S.)
- Laboratory of Bio-Inspired Nanomechanics “Giuseppe Maria Pugno”, Politecnico di Torino, Corso Duca Degli Abruzzi 24. P. C., 10129 Turin, Italy
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2
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Kiener M, Roldan N, Machahua C, Sengupta A, Geiser T, Guenat OT, Funke-Chambour M, Hobi N, Kruithof-de Julio M. Human-Based Advanced in vitro Approaches to Investigate Lung Fibrosis and Pulmonary Effects of COVID-19. Front Med (Lausanne) 2021; 8:644678. [PMID: 34026781 PMCID: PMC8139419 DOI: 10.3389/fmed.2021.644678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused considerable socio-economic burden, which fueled the development of treatment strategies and vaccines at an unprecedented speed. However, our knowledge on disease recovery is sparse and concerns about long-term pulmonary impairments are increasing. Causing a broad spectrum of symptoms, COVID-19 can manifest as acute respiratory distress syndrome (ARDS) in the most severely affected patients. Notably, pulmonary infection with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the causing agent of COVID-19, induces diffuse alveolar damage (DAD) followed by fibrotic remodeling and persistent reduced oxygenation in some patients. It is currently not known whether tissue scaring fully resolves or progresses to interstitial pulmonary fibrosis. The most aggressive form of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF). IPF is a fatal disease that progressively destroys alveolar architecture by uncontrolled fibroblast proliferation and the deposition of collagen and extracellular matrix (ECM) proteins. It is assumed that micro-injuries to the alveolar epithelium may be induced by inhalation of micro-particles, pathophysiological mechanical stress or viral infections, which can result in abnormal wound healing response. However, the exact underlying causes and molecular mechanisms of lung fibrosis are poorly understood due to the limited availability of clinically relevant models. Recently, the emergence of SARS-CoV-2 with the urgent need to investigate its pathogenesis and address drug options, has led to the broad application of in vivo and in vitro models to study lung diseases. In particular, advanced in vitro models including precision-cut lung slices (PCLS), lung organoids, 3D in vitro tissues and lung-on-chip (LOC) models have been successfully employed for drug screens. In order to gain a deeper understanding of SARS-CoV-2 infection and ultimately alveolar tissue regeneration, it will be crucial to optimize the available models for SARS-CoV-2 infection in multicellular systems that recapitulate tissue regeneration and fibrotic remodeling. Current evidence for SARS-CoV-2 mediated pulmonary fibrosis and a selection of classical and novel lung models will be discussed in this review.
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Affiliation(s)
- Mirjam Kiener
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Nuria Roldan
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Carlos Machahua
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Arunima Sengupta
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - Thomas Geiser
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olivier Thierry Guenat
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
- Department of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Manuela Funke-Chambour
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Hobi
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Marianna Kruithof-de Julio
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
- Organoid Core, Department for BioMedical Research, University of Bern, Bern, Switzerland
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Bianco F, Salomone F, Milesi I, Murgia X, Bonelli S, Pasini E, Dellacà R, Ventura ML, Pillow J. Aerosol drug delivery to spontaneously-breathing preterm neonates: lessons learned. Respir Res 2021; 22:71. [PMID: 33637075 PMCID: PMC7908012 DOI: 10.1186/s12931-020-01585-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023] Open
Abstract
Delivery of medications to preterm neonates receiving non-invasive ventilation (NIV) represents one of the most challenging scenarios for aerosol medicine. This challenge is highlighted by the undersized anatomy and the complex (patho)physiological characteristics of the lungs in such infants. Key physiological restraints include low lung volumes, low compliance, and irregular respiratory rates, which significantly reduce lung deposition. Such factors are inherent to premature birth and thus can be regarded to as the intrinsic factors that affect lung deposition. However, there are a number of extrinsic factors that also impact lung deposition: such factors include the choice of aerosol generator and its configuration within the ventilation circuit, the drug formulation, the aerosol particle size distribution, the choice of NIV type, and the patient interface between the delivery system and the patient. Together, these extrinsic factors provide an opportunity to optimize the lung deposition of therapeutic aerosols and, ultimately, the efficacy of the therapy. In this review, we first provide a comprehensive characterization of both the intrinsic and extrinsic factors affecting lung deposition in premature infants, followed by a revision of the clinical attempts to deliver therapeutic aerosols to premature neonates during NIV, which are almost exclusively related to the non-invasive delivery of surfactant aerosols. In this review, we provide clues to the interpretation of existing experimental and clinical data on neonatal aerosol delivery and we also describe a frame of measurable variables and available tools, including in vitro and in vivo models, that should be considered when developing a drug for inhalation in this important but under-served patient population.
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Affiliation(s)
- Federico Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy.
| | - Fabrizio Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Ilaria Milesi
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | | | - Sauro Bonelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Elena Pasini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Raffaele Dellacà
- TechRes Lab, Dipartimento Di Elettronica, Informazione E Bioingegneria (DEIB), Politecnico Di Milano University, Milano, Italy
| | | | - Jane Pillow
- School of Human Sciences, University of Western Australia, Perth, Australia
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Giusto K, Wanczyk H, Jensen T, Finck C. Hyperoxia-induced bronchopulmonary dysplasia: better models for better therapies. Dis Model Mech 2021; 14:dmm047753. [PMID: 33729989 PMCID: PMC7927658 DOI: 10.1242/dmm.047753] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is a chronic lung disease caused by exposure to high levels of oxygen (hyperoxia) and is the most common complication that affects preterm newborns. At present, there is no cure for BPD. Infants can recover from BPD; however, they will suffer from significant morbidity into adulthood in the form of neurodevelopmental impairment, asthma and emphysematous changes of the lung. The development of hyperoxia-induced lung injury models in small and large animals to test potential treatments for BPD has shown some success, yet a lack of standardization in approaches and methods makes clinical translation difficult. In vitro models have also been developed to investigate the molecular pathways altered during BPD and to address the pitfalls associated with animal models. Preclinical studies have investigated the efficacy of stem cell-based therapies to improve lung morphology after damage. However, variability regarding the type of animal model and duration of hyperoxia to elicit damage exists in the literature. These models should be further developed and standardized, to cover the degree and duration of hyperoxia, type of animal model, and lung injury endpoint, to improve their translational relevance. The purpose of this Review is to highlight concerns associated with current animal models of hyperoxia-induced BPD and to show the potential of in vitro models to complement in vivo studies in the significant improvement to our understanding of BPD pathogenesis and treatment. The status of current stem cell therapies for treatment of BPD is also discussed. We offer suggestions to optimize models and therapeutic modalities for treatment of hyperoxia-induced lung damage in order to advance the standardization of procedures for clinical translation.
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Affiliation(s)
- Kiersten Giusto
- Department of Pediatrics, University of Connecticut Health Center, Farmington, 06106 CT, USA
| | - Heather Wanczyk
- Department of Pediatrics, University of Connecticut Health Center, Farmington, 06106 CT, USA
| | - Todd Jensen
- Department of Pediatrics, University of Connecticut Health Center, Farmington, 06106 CT, USA
| | - Christine Finck
- Department of Pediatrics, University of Connecticut Health Center, Farmington, 06106 CT, USA
- Department of Surgery, Connecticut Children's Medical Center, Hartford, CT, USA
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5
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A Compartment-Based Mathematical Model for Studying Convective Aerosol Transport in Newborns Receiving Nebulized Drugs during Noninvasive Respiratory Support. Pharmaceutics 2020; 12:pharmaceutics12100936. [PMID: 33007894 PMCID: PMC7600494 DOI: 10.3390/pharmaceutics12100936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022] Open
Abstract
Nebulization could be a valuable solution to administer drugs to neonates receiving noninvasive respiratory support. Small and irregular tidal volumes and air leaks at the patient interface, which are specific characteristics of this patient population and are primarily responsible for the low doses delivered to the lung (DDL) found in this application, have not been thoroughly addressed in in vitro and in vivo studies for quantifying DDL. Therefore, we propose a compartment-based mathematical model able to describe convective aerosol transport mechanisms to complement the existing deposition models. Our model encompasses a mechanical ventilator, a nebulizer, and the patient; the model considers the gas flowing between compartments, including air leaks at the patient–ventilator interface. Aerosol particles are suspended in the gas flow and homogeneously distributed. The impact of breathing pattern variability, volume of the nebulizer, and leaks level on DDL is assessed in representative conditions. The main finding of this study is that convective mechanisms associated to air leaks and breathing patterns with tidal volumes smaller than the nebulizer dramatically reduce the DDL (up to 70%). This study provides a possible explanation to the inconsistent results of drug aerosolization in clinical studies and may provide guidance to improve nebulizer design and clinical procedures.
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Hatamikia S, Oberoi G, Unger E, Kronreif G, Kettenbach J, Buschmann M, Figl M, Knäusl B, Moscato F, Birkfellner W. Additively Manufactured Patient-Specific Anthropomorphic Thorax Phantom With Realistic Radiation Attenuation Properties. Front Bioeng Biotechnol 2020; 8:385. [PMID: 32457883 PMCID: PMC7225309 DOI: 10.3389/fbioe.2020.00385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022] Open
Abstract
Conventional medical imaging phantoms are limited by simplified geometry and radiographic skeletal homogeneity, which confines their usability for image quality assessment and radiation dosimetry. These challenges can be addressed by additive manufacturing technology, colloquially called 3D printing, which provides accurate anatomical replication and flexibility in material manipulation. In this study, we used Computed Tomography (CT)-based modified PolyJetTM 3D printing technology to print a hollow thorax phantom simulating skeletal morphology of the patient. To achieve realistic heterogenous skeletal radiation attenuation, we developed a novel radiopaque amalgamate constituting of epoxy, polypropylene and bone meal powder in twelve different ratios. We performed CT analysis for quantification of material radiodensity (in Hounsfield Units, HU) and for identification of specific compositions corresponding to the various skeletal structures in the thorax. We filled the skeletal structures with their respective radiopaque amalgamates. The phantom and isolated 3D printed rib specimens were rescanned by CT for reproducibility tests regarding verification of radiodensity and geometry. Our results showed that structural densities in the range of 42–705HU could be achieved. The radiodensity of the reconstructed phantom was comparable to the three skeletal structures investigated in a real patient thorax CT: ribs, ventral vertebral body and dorsal vertebral body. Reproducibility tests based on physical dimensional comparison between the patient and phantom CT-based segmentation displayed 97% of overlap in the range of 0.00–4.57 mm embracing the anatomical accuracy. Thus, the additively manufactured anthropomorphic thorax phantom opens new vistas for imaging- and radiation-based patient care in precision medicine.
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Affiliation(s)
- Sepideh Hatamikia
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gernot Kronreif
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
| | - Joachim Kettenbach
- Institute of Diagnostic, Interventional Radiology and Nuclear Medicine, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Martin Buschmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Michael Figl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Barbara Knäusl
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Wolfgang Birkfellner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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Ehrmann S, Schmid O, Darquenne C, Rothen-Rutishauser B, Sznitman J, Yang L, Barosova H, Vecellio L, Mitchell J, Heuze-Vourc’h N. Innovative preclinical models for pulmonary drug delivery research. Expert Opin Drug Deliv 2020; 17:463-478. [PMID: 32057260 PMCID: PMC8083945 DOI: 10.1080/17425247.2020.1730807] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
Introduction: Pulmonary drug delivery is a complex field of research combining physics which drive aerosol transport and deposition and biology which underpins efficacy and toxicity of inhaled drugs. A myriad of preclinical methods, ranging from in-silico to in-vitro, ex-vivo and in-vivo, can be implemented.Areas covered: The present review covers in-silico mathematical and computational fluid dynamics modelization of aerosol deposition, cascade impactor technology to estimated drug delivery and deposition, advanced in-vitro cell culture methods and associated aerosol exposure, lung-on-chip technology, ex-vivo modeling, in-vivo inhaled drug delivery, lung imaging, and longitudinal pharmacokinetic analysis.Expert opinion: No single preclinical model can be advocated; all methods are fundamentally complementary and should be implemented based on benefits and drawbacks to answer specific scientific questions. The overall best scientific strategy depends, among others, on the product under investigations, inhalation device design, disease of interest, clinical patient population, previous knowledge. Preclinical testing is not to be separated from clinical evaluation, as small proof-of-concept clinical studies or conversely large-scale clinical big data may inform preclinical testing. The extend of expertise required for such translational research is unlikely to be found in one single laboratory calling for the setup of multinational large-scale research consortiums.
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Affiliation(s)
- Stephan Ehrmann
- CHRU Tours, Médecine Intensive Réanimation, CIC INSERM 1415, CRICS-TriggerSep network, Tours France
- INSERM, Centre d’étude des pathologies respiratoires, U1100, Tours, France
- Université de Tours, Tours, France
| | - Otmar Schmid
- Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany
- Institute of Lung Biology and Disease, Helmholtz Zentrum München – German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
| | - Chantal Darquenne
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC0623A, La Jolla, CA 92093-0623, United States
| | | | - Josue Sznitman
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Julius Silver building, Office 246, Haifa 32000, Israel
| | - Lin Yang
- Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany
- Institute of Lung Biology and Disease, Helmholtz Zentrum München – German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
| | - Hana Barosova
- Adolphe Merkle Institute, University of Fribourg, Chemin des Verdiers 4, Fribourg, Switzerland
| | - Laurent Vecellio
- INSERM, Centre d’étude des pathologies respiratoires, U1100, Tours, France
- Université de Tours, Tours, France
| | - Jolyon Mitchell
- Jolyon Mitchell Inhaler Consulting Services Inc., 1154 St. Anthony Road, London, Ontario, Canada, N6H 2R1
| | - Nathalie Heuze-Vourc’h
- INSERM, Centre d’étude des pathologies respiratoires, U1100, Tours, France
- Université de Tours, Tours, France
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8
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Lignelli E, Palumbo F, Myti D, Morty RE. Recent advances in our understanding of the mechanisms of lung alveolarization and bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol 2019; 317:L832-L887. [PMID: 31596603 DOI: 10.1152/ajplung.00369.2019] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is the most common cause of morbidity and mortality in preterm infants. A key histopathological feature of BPD is stunted late lung development, where the process of alveolarization-the generation of alveolar gas exchange units-is impeded, through mechanisms that remain largely unclear. As such, there is interest in the clarification both of the pathomechanisms at play in affected lungs, and the mechanisms of de novo alveoli generation in healthy, developing lungs. A better understanding of normal and pathological alveolarization might reveal opportunities for improved medical management of affected infants. Furthermore, disturbances to the alveolar architecture are a key histopathological feature of several adult chronic lung diseases, including emphysema and fibrosis, and it is envisaged that knowledge about the mechanisms of alveologenesis might facilitate regeneration of healthy lung parenchyma in affected patients. To this end, recent efforts have interrogated clinical data, developed new-and refined existing-in vivo and in vitro models of BPD, have applied new microscopic and radiographic approaches, and have developed advanced cell-culture approaches, including organoid generation. Advances have also been made in the development of other methodologies, including single-cell analysis, metabolomics, lipidomics, and proteomics, as well as the generation and use of complex mouse genetics tools. The objective of this review is to present advances made in our understanding of the mechanisms of lung alveolarization and BPD over the period 1 January 2017-30 June 2019, a period that spans the 50th anniversary of the original clinical description of BPD in preterm infants.
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Affiliation(s)
- Ettore Lignelli
- Department of Lung Development and Remodeling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany.,Department of Internal Medicine (Pulmonology), University of Giessen and Marburg Lung Center, member of the German Center for Lung Research, Giessen, Germany
| | - Francesco Palumbo
- Department of Lung Development and Remodeling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany.,Department of Internal Medicine (Pulmonology), University of Giessen and Marburg Lung Center, member of the German Center for Lung Research, Giessen, Germany
| | - Despoina Myti
- Department of Lung Development and Remodeling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany.,Department of Internal Medicine (Pulmonology), University of Giessen and Marburg Lung Center, member of the German Center for Lung Research, Giessen, Germany
| | - Rory E Morty
- Department of Lung Development and Remodeling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany.,Department of Internal Medicine (Pulmonology), University of Giessen and Marburg Lung Center, member of the German Center for Lung Research, Giessen, Germany
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