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Pasteka R, Hufnagl L, Forjan M, Berger A, Werther T, Wagner M. Positive end-expiratory pressure and surfactant administration mode influence function in ex-vivo premature sheep lungs. Acta Paediatr 2024; 113:722-730. [PMID: 38149457 DOI: 10.1111/apa.17083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
AIM Respiratory distress syndrome often necessitates endotracheal surfactant administration in extremely preterm infants. Our study aimed to explore a multi-modal simulation tool for investigating treatment strategies in ex vivo sheep lungs during spontaneous breathing. METHODS An electromechanical lung simulator (xPULM) mimicking spontaneous breathing was coupled with a non-aerated premature sheep lung, replicating a premature respiratory system. Changes in tidal volume for different positive end-expiratory pressure (PEEP) levels prior to and after either bolus or nebulised surfactant administration were compared. RESULTS In two preterm sheep lungs, we observed a progressive decline in tidal volume with increasing PEEP levels prior to surfactant delivery from 0.30 ± 0.01 mL at zero PEEP to 0.04 ± 0.01 mL at 15 cmH2O PEEP. Our measurements showed that both bolus (p < 0.05) and nebulised (p < 0.05) surfactant administration resulted in a significant increase in tidal volume, with no significant difference (p = 0.71) between the two methods. CONCLUSION The experimental setup demonstrated the feasibility of xPULM for investigating the effectiveness of different PEEP levels and modes of surfactant administration with respect to tidal volume in premature sheep lungs. The lack of adequate lung water resorption in our model warrants further investigations.
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Affiliation(s)
- Richard Pasteka
- Department Life Science Engineering, Competence Centre Medical Engineering & Integrated Healthcare, University of Applied Sciences Technikum Wien, Vienna, Austria
| | - Lisa Hufnagl
- Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Mathias Forjan
- Department Life Science Engineering, Competence Centre Medical Engineering & Integrated Healthcare, University of Applied Sciences Technikum Wien, Vienna, Austria
| | - Angelika Berger
- Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Tobias Werther
- Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Michael Wagner
- Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria
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Forest V, Pourchez J. Nano-delivery to the lung - by inhalation or other routes and why nano when micro is largely sufficient? Adv Drug Deliv Rev 2022; 183:114173. [PMID: 35217112 DOI: 10.1016/j.addr.2022.114173] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/12/2022] [Accepted: 02/17/2022] [Indexed: 12/25/2022]
Abstract
Respiratory diseases gather a wide range of disorders which are generally difficult to treat, partly due to a poor delivery of drugs to the lung with adequate dose and minimum side effects. With the recent developments of nanotechnology, nano-delivery systems have raised interest. In this review, we detail the main types of nanocarriers that have been developed presenting their respective advantages and limitations. We also discuss the route of administration (systemic versus by inhalation), also considering technical aspects (different types of aerosol devices) with concrete examples of applications. Finally, we propose some perspectives of development in the field such as the nano-in-micro approaches, the emergence of drug vaping to generate airborne carriers in the submicron size range, the development of innovative respiratory models to assess regional aerosol deposition of nanoparticles or the application of nano-delivery to the lung in the treatment of other diseases.
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Montigaud Y, Pourchez J, Leclerc L, Tillement O, Clotagatide A, Bal C, Pinaud N, Ichinose N, Zhang B, Perinel S, Lux F, Crémillieux Y, Prevot N. Nebulised Gadolinium-Based Nanoparticles for a Multimodal Approach: Quantitative and Qualitative Lung Distribution Using Magnetic Resonance and Scintigraphy Imaging in Isolated Ventilated Porcine Lungs. Int J Nanomedicine 2020; 15:7251-7262. [PMID: 33061379 PMCID: PMC7533906 DOI: 10.2147/ijn.s260640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/18/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aims at determining lung distribution of gadolinium-based polysiloxane nanoparticles, AGuIX® (small rigid platform - SRP), as a potential theranostic approach by the pulmonary route. Methods First, the aerodynamic size distribution and the aerosol output rate were thoroughly characterized. Then, a multimodal approach using magnetic resonance (MR) and gamma-camera (GC) imaging allows to assess the deposition of the aerosolised nanoparticles in the respiratory tract using isolated ventilated porcine lungs. Results The SRP has proven to be radiolabelled by radioisotope with a good yield. Crude SRP or radiolabelled ones showed the same aerodynamic size distribution and output as a conventional molecular tracer, as sodium fluoride. With MR and GC imaging approaches, the nebulised dose represented about 50% of the initial dose of nanoparticles placed in the nebuliser. Results expressed as proportions of the deposited aerosol showed approximately a regional aerosol deposition of 50% of the deposited dose in the lungs and 50% in the upper airways. Each technique assessed a homogeneous pattern of deposited nanoparticles in Lungs. MR observed a strong signal enhancement with the SRP, similar to the one obtained with a commonly used MRI contrast agent, gadoterate meglumine. Conclusion As a known theranostic approach by intravenous administration, SRP appeared to be easily aerosolised with a conventional nebuliser. The present work proves that pulmonary administration of SRP is feasible in a human-like model and allows multimodal imaging with MR and GC imaging. This work presents the proof of concept of SRP nebulisation and aims to generate preclinical data for the potential clinical transfer of SRP for pulmonary delivery.
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Affiliation(s)
- Yoann Montigaud
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, Saint-Etienne, France
| | - Jérémie Pourchez
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, Saint-Etienne, France
| | - Lara Leclerc
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, Saint-Etienne, France
| | | | - Anthony Clotagatide
- INSERM U 1059 Sainbiose, Université Jean Monnet, Saint-Etienne, France.,CHU Saint-Etienne, Saint-Etienne, France
| | | | | | | | - Bei Zhang
- Canon Medical Systems Europe, Zoetermeer, Netherlands
| | - Sophie Perinel
- INSERM U 1059 Sainbiose, Université Jean Monnet, Saint-Etienne, France.,CHU Saint-Etienne, Saint-Etienne, France
| | - François Lux
- Institut Lumière Matière, Université de Lyon, Villeurbanne, France.,Institut Universitaire de France (IUF), Paris, France
| | | | - Nathalie Prevot
- INSERM U 1059 Sainbiose, Université Jean Monnet, Saint-Etienne, France.,CHU Saint-Etienne, Saint-Etienne, France
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Le Guellec S, Allimonnier L, Heuzé-Vourc’h N, Cabrera M, Ossant F, Pourchez J, Vecellio L, Plantier L. Low-Frequency Intrapulmonary Percussive Ventilation Increases Aerosol Penetration in a 2-Compartment Physical Model of Fibrotic Lung Disease. Front Bioeng Biotechnol 2020; 8:1022. [PMID: 32984287 PMCID: PMC7483496 DOI: 10.3389/fbioe.2020.01022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
In patients with fibrotic pulmonary disease such as idiopathic pulmonary fibrosis (IPF), inhaled aerosols deposit mostly in the less affected region of the lungs, resulting in suboptimal pharmacokinetics of airway-delivered treatments. Refinement of aerosol delivery technique requires new models to simulate the major alterations of lung physiology associated with IPF, i.e., heterogeneously reduced lung compliance and increased airway caliber. A novel physical model of the respiratory system was constructed to simulate aerosol drug delivery in spontaneously breathing (negative pressure ventilation) IPF patients. The model comprises upper (Alberta ideal throat) and lower airway (plastic tubing) models and branches into two compartments (Michigan lung models) which differ in compliance and caliber of conducting airway. The model was able to reproduce the heterogeneous, compliance-dependent reduction in ventilation and aerosol penetration (using NaF as a model aerosol) seen in fibrotic lung regions in IPF. Of note, intrapulmonary percussive ventilation induced a 2-3-fold increase in aerosol penetration in the low-compliance/high airway caliber compartment of the model, demonstrating the responsiveness of the model to therapeutic intervention.
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Affiliation(s)
- Sandrine Le Guellec
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- DTF Aerodrug, Tours, France
- Université de Tours, Tours, France
| | - Laurine Allimonnier
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- Université de Tours, Tours, France
| | - Nathalie Heuzé-Vourc’h
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- Université de Tours, Tours, France
| | - Maria Cabrera
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- Université de Tours, Tours, France
| | | | - Jérémie Pourchez
- Mines Saint-Etienne, Univ. Lyon, Univ. Jean Monnet, INSERM, U1059 Sainbiose, Centre CIS, Saint-Etienne, France
| | - Laurent Vecellio
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- Université de Tours, Tours, France
| | - Laurent Plantier
- INSERM, Research Center for Respiratory Diseases, U1100, Tours, France
- Université de Tours, Tours, France
- CHRU de Tours, Service de Pneumologie et Explorations Fonctionnelles Respiratoires, Tours, France
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