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Del Castillo D, Lo DD. Deciphering the M-cell niche: insights from mouse models on how microfold cells "know" where they are needed. Front Immunol 2024; 15:1400739. [PMID: 38863701 PMCID: PMC11165056 DOI: 10.3389/fimmu.2024.1400739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Known for their distinct antigen-sampling abilities, microfold cells, or M cells, have been well characterized in the gut and other mucosa including the lungs and nasal-associated lymphoid tissue (NALT). More recently, however, they have been identified in tissues where they were not initially suspected to reside, which raises the following question: what external and internal factors dictate differentiation toward this specific role? In this discussion, we will focus on murine studies to determine how these cells are identified (e.g., markers and function) and ask the broader question of factors triggering M-cell localization and patterning. Then, through the consideration of unconventional M cells, which include villous M cells, Type II taste cells, and medullary thymic epithelial M cells (microfold mTECs), we will establish the M cell as not just a player in mucosal immunity but as a versatile niche cell that adapts to its home tissue. To this end, we will consider the lymphoid structure relationship and apical stimuli to better discuss how the differing cellular programming and the physical environment within each tissue yield these cells and their unique organization. Thus, by exploring this constellation of M cells, we hope to better understand the multifaceted nature of this cell in its different anatomical locales.
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Affiliation(s)
| | - David D. Lo
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
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2
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Makrufardi F, Chuang HC, Suk CW, Lin YC, Rusmawatiningtyas D, Murni IK, Arguni E, Chung KF, Bai KJ. Particulate matter deposition and its impact on tuberculosis severity: A cross-sectional study in Taipei. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171534. [PMID: 38453064 DOI: 10.1016/j.scitotenv.2024.171534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
The objective of this study was to examine the association between the lung lobe-deposited dose of inhaled fine particulate matter (PM2.5) and chest X-ray abnormalities in different lung lobes of pulmonary tuberculosis (TB), multidrug-resistant tuberculosis (MDR-TB), and non-tuberculosis mycobacteria infections (NTM). A cross-sectional study was conducted between 2014 and 2022, comprising 1073 patients who were recruited from chest department clinic in a tertial refer hospital in Taipei City, Taiwan. Ambient 1-, 7-, and 30-day PM2.5 exposure and the deposition of PM2.5 in different lung lobes were estimated in each subject. The β coefficient for PM2.5 and deposited PM2.5 in lungs with the outcome variables (pulmonary TB, MDR-TB, and NTM infection) was derived through regression analysis and adjusted for age, gender, BMI, smoking status, and family income. We observed that a 1 μg/m3 increase in ambient PM2.5 was associated with an increase of MDR-TB infections of 0.004 times (95%CI: 0.001-0.007). A 1 μg/m3 increase in 1-day and 7-day PM2.5 deposition in left upper lobe and left lower lobe was associated with an increase in chest X-ray abnormalities of 9.19 % and 1.18 % (95%CI: 0.87-17.51 and 95%CI: 0.08-2.28), and 4.52 % and 5.20 % (95%CI: 0.66-8.38 and 95%CI: 0.51-9.89) in left lung of TB patients, respectively. A 1 μg/m3 increase in 30-day PM2.5 deposition in alveolar region was associated with an increase in percent abnormality of 2.50 % (95%CI: 0.65-4.35) in left upper lobe and 3.33 % (95%CI: 0.65-6.01) in right middle lobe, while in total lung was 0.63 % (95%CI: 0.01-1.27) in right upper lobe and 0.37 % (95%CI, 0.06-0.81) in right lung of MDR-TB patients. Inhaled PM2.5 deposition in lungs was associated with an exacerbation of the radiographic severity of pulmonary TB, particularly in pulmonary MDR-TB patients in upper and middle lobes. Particulate air pollution may potentially exacerbate the radiographic severity and treatment resistance in individuals with pulmonary TB.
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Affiliation(s)
- Firdian Makrufardi
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
| | - Hsiao-Chi Chuang
- National Heart and Lung Institute, Imperial College London, London, UK; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chi-Won Suk
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Yuan-Chien Lin
- Department of Civil Engineering, National Central University, Taoyuan City, Taiwan.
| | - Desy Rusmawatiningtyas
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
| | - Indah Kartika Murni
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
| | - Eggi Arguni
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Kuan-Jen Bai
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Emmerling J, Vahaji S, Morton DAV, Fletcher DF, Inthavong K. Scale resolving simulations of the effect of glottis motion and the laryngeal jet on flow dynamics during respiration. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 247:108064. [PMID: 38382308 DOI: 10.1016/j.cmpb.2024.108064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/27/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND OBJECTIVE The movement of the respiratory walls has a significant impact on airflow through the respiratory tract. The majority of computational fluid dynamics (CFD) studies assume a static geometry which may not provide a realistic flow field. Furthermore, many studies use Reynolds Averaged Navier-Stokes (RANS) turbulence models that do not resolve turbulence structure. Combining the application of advanced scale-resolving turbulence models with moving respiratory walls using CFD will provide detailed insights into respiratory flow structures. METHODS This study simulated a complete breathing cycle involving inhalation and exhalation in a nasal cavity to trachea geometry that incorporated moving glottis walls. A second breathing cycle was simulated with static glottis walls for comparison. A recently developed hybrid RANS-LES turbulence model, the Stress-Blended Eddy Simulation (SBES), was incorporated to resolve turbulent flow structures in fine detail for both transient simulations. Transient results were compared with steady-state RANS simulations for the same respiratory geometry. RESULTS Glottis motion caused substantial effects on flow structure through the complete breathing cycle. Significant flow structure and velocity variations were observed due to glottal motion, primarily in the larynx and trachea. Resolved turbulence structures using SBES showed an intense mixing section in the glottis region during inhalation and in the nasopharynx during expiration, which was not present in the RANS simulations. CONCLUSION Transient simulations of a realistic breathing cycle uncovered flow structures absent in simulations with a constant flow rate. Furthermore, the incorporation of glottis motion impacted airflow characteristics that suggest rigid respiratory walls do not accurately describe respiratory flow. Future research in respiratory airflow should be conducted using transient scale-resolving models in conjunction with moving respiratory walls to capture flow structures in detail.
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Affiliation(s)
- Jake Emmerling
- School of Engineering, Deakin University, Waurn Ponds 3216, Australia
| | - Sara Vahaji
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - David A V Morton
- School of Engineering, Deakin University, Waurn Ponds 3216, Australia
| | - David F Fletcher
- School of Chemical and Biomolecular Engineering, University of Sydney, NSW 2006, Australia
| | - Kiao Inthavong
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia.
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Burkes RM, Zafar MA, Panos RJ. The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease. Curr Opin Pulm Med 2024; 30:129-135. [PMID: 38227648 DOI: 10.1097/mcp.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to compile recent data on the clinical associations of computed tomography (CT) scan findings in the literature and potential avenues for implementation into clinical practice. RECENT FINDINGS Airways dysanapsis, emphysema, chronic bronchitis, and pulmonary vascular metrics have all recently been associated with poor chronic obstructive pulmonary disease (COPD) outcomes when controlled for clinically relevant covariables, including risk of mortality in the case of emphysema and chronic bronchitis. Other authors suggest that CT scan may provide insight into both lung parenchymal damage and other clinically important comorbidities in COPD. SUMMARY CT scan findings in COPD relate to clinical outcomes. There is a continued need to develop processes to best implement the results of these studies into clinical practice.
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Affiliation(s)
- Robert M Burkes
- Cincinnati Veterans Affairs Medical Center
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
| | - Muhammad A Zafar
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
| | - Ralph J Panos
- Cincinnati Veterans Affairs Medical Center
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
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Smyth T, Jaspers I. Diesel exhaust particles induce polarization state-dependent functional and transcriptional changes in human monocyte-derived macrophages. Am J Physiol Lung Cell Mol Physiol 2024; 326:L83-L97. [PMID: 38084400 PMCID: PMC11279754 DOI: 10.1152/ajplung.00085.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/30/2023] [Accepted: 11/23/2023] [Indexed: 01/10/2024] Open
Abstract
Macrophage populations exist on a spectrum between the proinflammatory M1 and proresolution M2 states and have demonstrated the ability to reprogram between them after exposure to opposing polarization stimuli. Particulate matter (PM) has been repeatedly linked to worsening morbidity and mortality following respiratory infections and has been demonstrated to modify macrophage function and polarization. The purpose of this study was to determine whether diesel exhaust particles (DEP), a key component of airborne PM, would demonstrate polarization state-dependent effects on human monocyte-derived macrophages (hMDMs) and whether DEP would modify macrophage reprogramming. CD14+CD16- monocytes were isolated from the blood of healthy human volunteers and differentiated into macrophages with macrophage colony-stimulating factor (M-CSF). Resulting macrophages were left unpolarized or polarized into the proresolution M2 state before being exposed to DEP, M1-polarizing conditions (IFN-γ and LPS), or both and tested for phagocytic function, secretory profile, gene expression patterns, and bioenergetic properties. Contrary to previous reports, we observed a mixed M1/M2 phenotype in reprogrammed M2 cells when considering the broader range of functional readouts. In addition, we determined that DEP exposure dampens phagocytic function in all polarization states while modifying bioenergetic properties in M1 macrophages preferentially. Together, these data suggest that DEP exposure of reprogrammed M2 macrophages results in a highly inflammatory, highly energetic subpopulation of macrophages that may contribute to the poor health outcomes following PM exposure during respiratory infections.NEW & NOTEWORTHY We determined that reprogramming M2 macrophages in the presence of diesel exhaust particles (DEP) results in a highly inflammatory mixed M1/M2 phenotype. We also demonstrated that M1 macrophages are particularly vulnerable to particulate matter (PM) exposure as seen by dampened phagocytic function and modified bioenergetics. Our study suggests that PM causes reprogrammed M2 macrophages to become a highly energetic, highly secretory subpopulation of macrophages that may contribute to negative health outcomes observed in humans after PM exposure.
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Affiliation(s)
- Timothy Smyth
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Ilona Jaspers
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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6
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Ranjbar H, Farajollahi A, Rostami M. Targeted drug delivery in pulmonary therapy based on adhesion and transmission of nanocarriers designed with a metal-organic framework. Biomech Model Mechanobiol 2023; 22:2153-2170. [PMID: 37624467 DOI: 10.1007/s10237-023-01756-9] [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: 03/23/2023] [Accepted: 07/22/2023] [Indexed: 08/26/2023]
Abstract
With the recent increase in lung diseases, especially with the onset of the coronavirus pandemic, the design of a highly efficient and optimal targeted drug delivery system for the lungs is crucial in inhaler-based delivery systems. This study aimed to design a magnetic field-assisted targeted drug delivery system to the lungs using three types of metal-organic frameworks (MOFs) and nanoliposomes. The optimization of the system was based on three main parameters: the surface density of the nanocarriers' (NCs) adherence to each of the lung branches, the amount of drug transferred to each branch, and the toxicity based on the rate of nanocarrier delivery to the branches. The study investigated the effect of increasing the diameter of the drug carriers and the amount of drug loaded onto the NCs in improving drug delivery to targeted areas of the lung. Results showed that the presence of a magnetic field significantly increased the adhesion of NCs to the targeted branches. The application of a magnetic field and the type of drug carrier had a significant effect on drug delivery downstream of the lung and reduced drug toxicity. The study found that Fe3O4@UiO-66 (iron-oxide nanoparticle attached to the surface of UiO-66, a type of MOF) and Fe3O4@PAA/AuNCs/ZIF-8 carriers, (iron-oxide nanoparticle attached to a hybrid structure composed of three different materials: poly (acrylic acid) (PAA), gold nanoclusters (AuNCs), and zeolitic imidazolate framework-8 (ZIF-8)), had the greatest drug delivery rate in diameters above 200 nm and less than 200 nm, respectively.
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Affiliation(s)
- Hamed Ranjbar
- School of Mechanical Engineering, University of Tabriz, Tabriz, Iran
| | | | - Mohsen Rostami
- Department of Engineering, University of Imam Ali, Tehran, Iran
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Ghio AJ, Stewart M, Sangani RG, Pavlisko EN, Roggli VL. Asbestos and Iron. Int J Mol Sci 2023; 24:12390. [PMID: 37569765 PMCID: PMC10419076 DOI: 10.3390/ijms241512390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Theories of disease pathogenesis following asbestos exposure have focused on the participation of iron. After exposure, an open network of negatively charged functional groups on the fiber surface complexes host metals with a preference for iron. Competition for iron between the host and the asbestos results in a functional metal deficiency. The homeostasis of iron in the host is modified by the cell response, including increased import to correct the loss of the metal to the fiber surface. The biological effects of asbestos develop in response to and are associated with the disruption of iron homeostasis. Cell iron deficiency in the host following fiber exposure activates kinases and transcription factors, which are associated with the release of mediators coordinating both inflammatory and fibrotic responses. Relative to serpentine chrysotile, the clearance of amphiboles is incomplete, resulting in translocation to the mesothelial surface of the pleura. Since the biological effect of asbestos is dependent on retention of the fiber, the sequestration of iron by the surface, and functional iron deficiency in the cell, the greater clearance (i.e., decreased persistence) of chrysotile results in its diminished impact. An inability to clear asbestos from the lower respiratory tract initiates a host process of iron biomineralization (i.e., asbestos body formation). Host cells attempt to mobilize the metal sequestered by the fiber surface by producing superoxide at the phagosome membrane. The subsequent ferrous cation is oxidized and undergoes hydrolysis, creating poorly crystalline iron oxyhydroxide (i.e., ferrihydrite) included in the coat of the asbestos body.
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Affiliation(s)
- Andrew J. Ghio
- US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Matthew Stewart
- Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Rahul G. Sangani
- Department of Medicine, West Virginia University, Morgantown, WV 26506, USA;
| | - Elizabeth N. Pavlisko
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (E.N.P.); (V.L.R.)
| | - Victor L. Roggli
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (E.N.P.); (V.L.R.)
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Makrufardi F, Bai KJ, Suk CW, Rusmawatiningtyas D, Chung KF, Chuang HC. Alveolar deposition of inhaled fine particulate matter increased risk of severity of pulmonary tuberculosis in the upper and middle lobes. ERJ Open Res 2023; 9:00064-2023. [PMID: 37404847 PMCID: PMC10316043 DOI: 10.1183/23120541.00064-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/04/2023] [Indexed: 07/06/2023] Open
Abstract
Inhaled PM2.5 associated with pulmonary tuberculosis https://bit.ly/3VXAKfq.
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Affiliation(s)
- Firdian Makrufardi
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta, Indonesia
- These authors contributed equally
| | - Kuan-Jen Bai
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- These authors contributed equally
| | - Chi-Won Suk
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Desy Rusmawatiningtyas
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- National Heart and Lung Institute, Imperial College London, London, UK
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Rajaraman PK, Choi J, Babiskin A, Walenga R, Lin CL. Transport and deposition of beclomethasone dipropionate drug aerosols with varying ethanol concentration in severe asthmatic subjects. Int J Pharm 2023; 636:122805. [PMID: 36898619 DOI: 10.1016/j.ijpharm.2023.122805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
This study aims to assess the effects of varying an ethanol co-solvent on the deposition of drug particles in severe asthmatic subjects with distinct airway structures and lung functions using computational fluid dynamics. The subjects were selected from two quantitative computed tomography imaging-based severe asthmatic clusters, differentiated by airway constriction in the left lower lobe. Drug aerosols were assumed to be generated from a pressurized metered-dose inhaler (MDI). The aerosolized droplet sizes were varied by increasing the ethanol co-solvent concentration in the MDI solution. The MDI formulation consists of 1,1,2,2-tetrafluoroethane (HFA-134a), ethanol, and beclomethasone dipropionate (BDP) as the active pharmaceutical ingredient. Since HFA-134a and ethanol are volatile, both substances evaporate rapidly under ambient conditions and trigger condensation of water vapor, increasing the size of aerosols that are predominantly composed of water and BDP. The average deposition fraction in intra-thoracic airways for severe asthmatic subjects with (or without) airway constriction increased from 37%±12 to 53.2%±9.4 (or from 20.7%± 4.6 to 34.7%±6.6) when the ethanol concentration was increased from 1 to 10%wt/wt. However, when the ethanol concentration was further increased from 10 to 20%wt/wt, the deposition fraction decreased. This indicates the importance of selecting appropriate co-solvent amounts during drug formulation development for the treatment of patients with narrowed airway disease. For severe asthmatic subjects with airway narrowing, the inhaled aerosol may benefit from a low hygroscopic effect by reducing ethanol concentration to penetrate the peripheral region effectively. These results could potentially inform the selection of co-solvent amounts for inhalation therapies in a cluster-specific manner.
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Affiliation(s)
- Prathish K Rajaraman
- Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA; IIHR-Hydroscience and Engineering, University of Iowa, Iowa City, IA, USA
| | - Jiwoong Choi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Andrew Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ross Walenga
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ching-Long Lin
- Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA; IIHR-Hydroscience and Engineering, University of Iowa, Iowa City, IA, USA.
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Wedel J, Steinmann P, Štrakl M, Hriberšek M, Cui Y, Ravnik J. Anatomy matters: The role of the subject-specific respiratory tract on aerosol deposition - A CFD study. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2022; 401:115372. [PMID: 35919629 PMCID: PMC9333481 DOI: 10.1016/j.cma.2022.115372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The COVID-19 pandemic is one of the greatest challenges to humanity nowadays. COVID-19 virus can replicate in the host's larynx region, which is in contrast to other viruses that replicate in lungs only, i.e. SARS. This is conjectured to support a fast spread of COVID-19. However, there is sparse research in this field about quantitative comparison of virus load in the larynx for varying susceptible individuals. In this regard the lung geometry itself could influence the risk of reproducing more pathogens and consequently exhaling more virus. Disadvantageously, there are only sparse lung geometries available. To still be able to investigate realistic geometrical deviations we employ three different digital replicas of human airways up to the 7 th level of bifurcation, representing two realistic lungs (male and female) as well as a more simplified experimental model. Our aim is to investigate the influence of breathing scenarios on aerosol deposition in anatomically different, realistic human airways. In this context, we employ three levels of cardiovascular activity as well as reported experimental particle size distributions by means of Computational Fluid Dynamics (CFD) with special focus on the larynx region to enable new insights into the local virus loads in human respiratory tracts. In addition, the influence of more realistic boundary conditions is investigated by performing transient simulations of a complete respiratory cycle in the upper lung regions of the considered respiratory models, focusing in particular on deposition in the oral cavity, the laryngeal region, and trachea, while simplifying the tracheobronchial tree. The aerosol deposition is modeled via OpenFOAM\protect \relax \special {t4ht=®} by employing an Euler-Lagrangian frame including steady and unsteady Reynolds Averaged Navier-Stokes (RANS) resolved turbulent flow using the k- ω -SST and k- ω -SST DES turbulence models. We observed that the respiratory geometry altered the local deposition patterns, especially in the laryngeal region. Despite the larynx region, the effects of varying flow rate for the airway geometries considered were found to be similar in the majority of respiratory tract regions. For all particle size distributions considered, localized particle accumulation occurred in the larynx of all considered lung models, which were more pronounced for larger particle size distributions. Moreover, it was found, that employing transient simulations instead of steady-state analysis, the overall particle deposition pattern is maintained, however with a stronger intensity in the transient cases.
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Affiliation(s)
- Jana Wedel
- Institute of Applied Mechanics, Universität Erlangen-Nürnberg, Germany
| | - Paul Steinmann
- Institute of Applied Mechanics, Universität Erlangen-Nürnberg, Germany
- Glasgow Computational Engineering Center, University of Glasgow, United Kingdom
| | - Mitja Štrakl
- Faculty of Mechanical Engineering, University of Maribor, Slovenia
| | - Matjaž Hriberšek
- Faculty of Mechanical Engineering, University of Maribor, Slovenia
| | - Yan Cui
- Huazhong University of Science and Technology, Wuhan, China
| | - Jure Ravnik
- Faculty of Mechanical Engineering, University of Maribor, Slovenia
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Fate of inhaled aerosols under the influence of glottal motion in a realistic insilico human tracheobronchial tree model. Eur J Pharm Sci 2022; 173:106172. [DOI: 10.1016/j.ejps.2022.106172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/23/2022] [Accepted: 03/20/2022] [Indexed: 11/17/2022]
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12
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Zhikhoreva AA, Belashov AV, Ignatov ES, Gelfond ML, Semenova IV, Vasyutinskii OS. Singlet oxygen generation in aerosol jet and on biological surfaces. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 228:112395. [PMID: 35123161 DOI: 10.1016/j.jphotobiol.2022.112395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/25/2021] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
Abstract
The paper presents steady-state and time-resolved experiments on photophysical processes associated with photodynamic inactivation of infections provided by nebulization of Radachlorin photosensitizer solution. As models of surfaces subjected to photodynamic inactivation we used glass, plant leaf, mushroom cap peel and superficial fascia of chicken and salmon skin flaps. The oxygen content in the photosensitizer solution was varied by blowing with atmospheric air and with pure oxygen. It was shown that singlet oxygen was generated efficiently in the aerosol jet and that its amount increased noticeably at higher oxygen concentrations. The kinetics of photosensitizer photobleaching on different surfaces were found to be significantly different with characteristic decay times varying from seconds for leaf and glass to minutes for fascial flaps. This observation was attributed to much faster oxygen depletion on rough crumbly surfaces of biological samples due to effective oxidation reactions occurred. The singlet oxygen generation and degradation times, and the relative quantum yield were determined on different surfaces by recording time-resolved phosphorescence at about 1270 nm under normoxic and hyperoxic conditions and analyzed on the basis of the set of master equations. The results obtained provide reference marks for choosing optimal irradiation durations for photodynamic inactivation of pathogenic infectious agents (bacteria, mycobacteria, fungi, viruses) on mucous membranes, including the tracheobronchial tree.
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Affiliation(s)
- A A Zhikhoreva
- Ioffe Institute, Russian Academy of Sciences, St. Petersburg, Russia
| | - A V Belashov
- Ioffe Institute, Russian Academy of Sciences, St. Petersburg, Russia
| | - E S Ignatov
- Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russia
| | - M L Gelfond
- N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia, St. Petersburg, Russia
| | - I V Semenova
- Ioffe Institute, Russian Academy of Sciences, St. Petersburg, Russia.
| | - O S Vasyutinskii
- Ioffe Institute, Russian Academy of Sciences, St. Petersburg, Russia
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13
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Assessment of the predictive capability of modelling and simulation to determine bioequivalence of inhaled drugs: A systematic review. Daru 2022; 30:229-243. [PMID: 35094370 PMCID: PMC9114201 DOI: 10.1007/s40199-021-00423-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/18/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES There are a multitude of different modelling techniques that have been used for inhaled drugs. The main objective of this review was to conduct an exhaustive survey of published mathematical models in the area of asthma and chronic obstructive pulmonary disease (COPD) for inhalation drugs. Additionally, this review will attempt to assess the applicability of these models to assess bioequivalence (BE) of orally inhaled products (OIPs). EVIDENCE ACQUISITION PubMed, Science Direct, Web of Science, and Scopus databases were searched from 1996 to 2020, to find studies that described mathematical models used for inhaled drugs in asthma/COPD. RESULTS 50 articles were finally included in this systematic review. This research identified 22 articles on in silico aerosol deposition models, 20 articles related to population pharmacokinetics and 8 articles on physiologically based pharmacokinetic modelling (PBPK) modelling for inhaled drugs in asthma/COPD. Among all the aerosol deposition models, computational fluid dynamics (CFD) simulations are more likely to predict regional aerosol deposition pattern in human respiratory tracts. Across the population PK articles, body weight, gender, age and smoking status were the most common covariates that were found to be significant. Further, limited published PBPK models reported approximately 29 parameters relevant for absorption and distribution of inhaled drugs. The strengths and weaknesses of each modelling technique has also been reviewed. CONCLUSION Overall, while there are different modelling techniques that have been used for inhaled drugs in asthma and COPD, there is very limited application of these models for assessment of bioequivalence of OIPs. This review also provides a ready reference of various parameters that have been considered in various models which will aid in evaluation if one model or hybrid in silico models need to be considered when assessing bioequivalence of OIPs.
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14
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Effect of patient inhalation profile and airway structure on drug deposition in image-based models with particle-particle interactions. Int J Pharm 2022; 612:121321. [PMID: 34875355 DOI: 10.1016/j.ijpharm.2021.121321] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022]
Abstract
For many of the one billion sufferers of respiratory diseases worldwide, managing their disease with inhalers improves their ability to breathe. Poor disease management and rising pollution can trigger exacerbations that require urgent relief. Higher drug deposition in the throat instead of the lungs limits the impact on patient symptoms. To optimise delivery to the lung, patient-specific computational studies of aerosol inhalation can be used. However in many studies, inhalation modelling does not represent situations when the breathing is impaired, such as in recovery from an exacerbation, where the patient's inhalation is much faster and shorter. Here we compare differences in deposition of inhaler particles (10, 4 μm) in the airways of three patients. We aimed to evaluate deposition differences between healthy and impaired breathing with image-based healthy and diseased patient models. We found that the ratio of drug in the lower to upper lobes was 35% larger with a healthy inhalation. For smaller particles the upper airway deposition was similar in all patients, but local deposition hotspots differed in size, location and intensity. Our results identify that image-based airways must be used in respiratory modelling. Various inhalation profiles should be tested for optimal prediction of inhaler deposition.
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15
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Ghio AJ, Pavlisko EN, Roggli VL, Todd NW, Sangani RG. Cigarette Smoke Particle-Induced Lung Injury and Iron Homeostasis. Int J Chron Obstruct Pulmon Dis 2022; 17:117-140. [PMID: 35046648 PMCID: PMC8763205 DOI: 10.2147/copd.s337354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022] Open
Abstract
It is proposed that the mechanistic basis for non-neoplastic lung injury with cigarette smoking is a disruption of iron homeostasis in cells after exposure to cigarette smoke particle (CSP). Following the complexation and sequestration of intracellular iron by CSP, the host response (eg, inflammation, mucus production, and fibrosis) attempts to reverse a functional metal deficiency. Clinical manifestations of this response can present as respiratory bronchiolitis, desquamative interstitial pneumonitis, pulmonary Langerhans’ cell histiocytosis, asthma, pulmonary hypertension, chronic bronchitis, and pulmonary fibrosis. If the response is unsuccessful, the functional deficiency of iron progresses to irreversible cell death evident in emphysema and bronchiectasis. The subsequent clinical and pathological presentation is a continuum of lung injuries, which overlap and coexist with one another. Designating these non-neoplastic lung injuries after smoking as distinct disease processes fails to recognize shared relationships to each other and ultimately to CSP, as well as the common mechanistic pathway (ie, disruption of iron homeostasis).
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Affiliation(s)
- Andrew J Ghio
- Human Studies Facility, US Environmental Protection Agency, Chapel Hill, NC, 27514, USA
- Correspondence: Andrew J Ghio Human Studies Facility, US Environmental Protection Agency, 104 Mason Farm Road, Chapel Hill, NC, USA Email
| | | | | | - Nevins W Todd
- Department of Medicine, University of Maryland, Baltimore, MD, 21201, USA
| | - Rahul G Sangani
- Department of Medicine, West Virginia University, Morgantown, WV, USA
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16
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Tung NT, Ho SC, Lu YH, Chen TT, Lee KY, Chen KY, Wu CD, Chung KF, Kuo HP, Thao HNX, Dung HB, Thuy TPC, Wu SM, Kou HY, Lee YL, Chuang HC. Higher alveolar deposition of particulate matter in emphysematous lobes of COPD. ERJ Open Res 2021; 7:00324-2021. [PMID: 34476255 PMCID: PMC8405879 DOI: 10.1183/23120541.00324-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/27/2021] [Indexed: 11/24/2022] Open
Abstract
Emphysema can be examined quantitatively on high-resolution computed tomography (HRCT) by measuring the low-attenuation areas of the lung and has been associated with decrease in lung function in patients with COPD [1]. Previous studies have associated levels of air pollution with emphysema severity of the total lung [2, 3]. However, the relationship between inhaled particulate matter (PM) deposition in the lungs and the degree of emphysema at the lung lobar level remains poorly understood. We examined the association of lung lobe-deposited doses of PM2.5 (particles with a 50% cut-off aerodynamic diameter of 2.5 μm) with the extent of emphysema in different lung lobes of COPD subjects. The novelty of this study is that it identified the associations between PM2.5 deposition in the lung and the degree of emphysema in different lung lobes of COPD patients, especially in the right middle lobe and both upper lobeshttps://bit.ly/3k21ri0
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Affiliation(s)
- Nguyen Thanh Tung
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Otorhinolaryngology Dept, Cho Ray Hospital, Ho Chi Minh City, Vietnam.,These authors contributed equally
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,These authors contributed equally
| | - Yueh-Hsun Lu
- Dept of Radiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Dept of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Dept of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Dept of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Dept of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Dept of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chih-Da Wu
- Dept of Geomatics, National Cheng Kung University, Tainan, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Dept of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Hoang Ba Dung
- Otorhinolaryngology Dept, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Tran Phan Chung Thuy
- Otorhinolaryngology Dept, Faculty of Medicine, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Dept of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Dept of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yun Kou
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Dept of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Dept of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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17
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Talaat M, Si XA, Dong H, Xi J. Leveraging statistical shape modeling in computational respiratory dynamics: Nanomedicine delivery in remodeled airways. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 204:106079. [PMID: 33831725 DOI: 10.1016/j.cmpb.2021.106079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Accurate knowledge of the delivered doses to the diseased site in the respiratory tract is crucial to elicit desired therapeutic outcomes. However, such information is still difficult to obtain due to inaccessibility for measurement or visualization, complex network structure, and challenges in reconstructing lung geometries with disease-invoked airway remodeling. This study presents a novel method to simulate the airway remodeling in a mouth-lung geometry extending to G9. METHODS Statistical shape modeling was used to extract morphological features from a lung geometry database and four new models (i.e., M1-M4) were generated with parameter-controlled dilated/constricted bronchioles in the left-lower (LL) lung. The variations in airflow and particle deposition due to the airway remodeling were simulated using a well-tested k-ω turbulence model and a Lagrangian tracking approach. RESULTS Significant variations in flow partitions between the lower and upper lobes of the left lung, as well as between the left and right lungs. The flow partition into the LL lobe varied by 10-fold between the most dilated and constricted models in this study. Significantly lower doses were also predicted on the surface of the constricted LL bronchioles G4-G9, as well as into the peripheral airways beyond G9. However, the total dosimetry in the mouth-lung geometry (up to G9) exhibited low sensitivity to the LL lobar remodeling. Results in this study suggest that the optimal nanomedicine should be 2-10 nm in diameter if targeted at the constricted bronchioles G4-G9 as in topical inhalation therapy but should be larger than 20 nm if targeted at the alveolar region as in systemic therapy. CONCLUSIONS This study highlights the large dose variability from local airway remodeling and the need to consider these variations in the treatment planning for pneumonia and other obstructive respiratory diseases.
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Affiliation(s)
- Mohamed Talaat
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA, U.S.A.
| | - Xiuhua April Si
- Department of Aerospace, Industrial, and Mechanical Engineering, California Baptist University, Riverside, CA, U.S.A.
| | - Haibo Dong
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, U.S.A.
| | - Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA, U.S.A.
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18
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Si XA, Talaat M, Su WC, Xi J. Inhalation dosimetry of nasally inhaled respiratory aerosols in the human respiratory tract with locally remodeled conducting lungs. Inhal Toxicol 2021; 33:143-159. [PMID: 33870835 DOI: 10.1080/08958378.2021.1912860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: Respiratory diseases are often accompanied by alterations to airway morphology. However, inhalation dosimetry data in remodeled airways are scarce due to the challenges in reconstructing diseased respiratory morphologies. This study aims to study the airway remodeling effects on the inhalation dosimetry of nasally inhaled nanoparticles in a nose-lung geometry that extends to G9 (ninth generation).Materials and methods: Statistical shape modeling was used to develop four diseased lung models with varying levels of bronchiolar dilation/constriction in the left-lower (LL) lobe (i.e. M1-M4). Respiratory airflow and particle deposition were simulated using a low Reynolds number k-ω turbulence model and a Lagrangian tracking approach.Results: Significant discrepancies were observed in the flow partitions between the left and right lungs, as well as between the lower and upper lobes of the left lung, which changed by 10-fold between the most dilated and constricted models.Much lower doses were predicted on the surface of the constricted LL bronchioles G4-G9, as well as into the peripheral airways beyond G9 of the LL lung. However, the LL lobar remodeling had little effect on the dosimetry in the nasopharynx, as well as on the total dosimetry in the nose-lung geometry (up to G9).Conclusion: It is suggested that airway remodeling may pose a higher viral infection risk to the host by redistributing the inhaled viruses to healthy lung lobes. Airway remodeling effects should also be considered in the treatment planning of inhalation therapies, not only because of the dosimetry variation from altered lung morphology but also its evolution as the disease progresses.
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Affiliation(s)
- Xiuhua April Si
- Department of Mechanical Engineering, California Baptist University, Riverside, CA, USA
| | - Mohamed Talaat
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA, USA
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA, USA
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19
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Corcoran T. Carrier Gases and Their Effects on Aerosol Drug Delivery. J Aerosol Med Pulm Drug Deliv 2021; 34:71-78. [PMID: 33691471 DOI: 10.1089/jamp.2021.29035.tc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Carrier gases provide the medium for delivery of inhaled aerosol therapies. The physical properties of these gases substantially affect both fluid and aerosol mechanics in the lung. Gas density affects both the pressure/flow relationship in the airways and the extent of turbulence within the flow. These physical properties also affect the operation of some components of respiratory and aerosol drug delivery equipment. The lower resistance associated with breathing low density gases has prompted many studies of therapeutic applications. This includes the respiration of helium-oxygen gas mixtures to improve oxygenation and carbon dioxide removal, and the use of these gases to improve the delivery of inhaled medications. Results of these studies have been mixed but meta-analyses indicate a benefit of helium-oxygen respiration for croup and bronchiolitis and for bronchodilator delivery in obstructive disease. Some of the variability demonstrated in these studies is likely associated with specific technical aspects of how the gases are delivered. The utility of alternate carrier gases for aerosol delivery would be facilitated by simultaneous assessment of both aerosol deposition and clinical effect during studies. Previous successful applications may offer a basis for improved delivery system designs that fully realize the effects that might be available with these gases.
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Affiliation(s)
- Tim Corcoran
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania USA
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20
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Bass K, Farkas D, Hassan A, Bonasera S, Hindle M, Longest PW. High-Efficiency Dry Powder Aerosol Delivery to Children: Review and Application of New Technologies. JOURNAL OF AEROSOL SCIENCE 2021; 153:105692. [PMID: 33716317 PMCID: PMC7945982 DOI: 10.1016/j.jaerosci.2020.105692] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
While dry powder aerosol formulations offer a number of advantages, their use in children is often limited due to poor lung delivery efficiency and difficulties with consistent dry powder inhaler (DPI) usage. Both of these challenges can be attributed to the typical use of adult devices in pediatric subjects and a lack of pediatric-specific DPI development. In contrast, a number of technologies have recently been developed or progressed that can substantially improve the efficiency and reproducibility of DPI use in children including: (i) nose-to-lung administration with small particles, (ii) active positive-pressure devices, (iii) structures to reduce turbulence and jet momentum, and (iv) highly dispersible excipient enhanced growth particle formulations. In this study, these technologies and their recent development are first reviewed in depth. A case study is then considered in which these technologies are simultaneously applied in order to enable the nose-to-lung administration of dry powder aerosol to children with cystic fibrosis (CF). Using a combination of computational fluid dynamics (CFD) analysis and realistic in vitro experiments, device performance, aerosol size increases and lung delivery efficiency are considered for pediatric-CF subjects in the age ranges of 2-3, 5-6 and 9-10 years old. Results indicate that a new 3D rod array structure significantly improves performance of a nasal cannula reducing interface loss by a factor of 1.5-fold and produces a device emitted mass median aerodynamic diameter (MMAD) of 1.67 μm. For all ages considered, approximately 70% of the loaded dose reaches the lower lung beyond the lobar bronchi. Moreover, significant and rapid size increase of the aerosol is observed beyond the larynx and illustrates the potential for targeting lower airway deposition. In conclusion, concurrent CFD and realistic in vitro analysis indicates that a combination of multiple new technologies can be implemented to overcome obstacles that currently limit the use of DPIs in children as young as two years of age.
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Affiliation(s)
- Karl Bass
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
| | - Dale Farkas
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
| | - Amr Hassan
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - Serena Bonasera
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - P. Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
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21
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Huang F, Zhu Q, Zhou X, Gou D, Yu J, Li R, Tong Z, Yang R. Role of CFD based in silico modelling in establishing an in vitro-in vivo correlation of aerosol deposition in the respiratory tract. Adv Drug Deliv Rev 2021; 170:369-385. [PMID: 32971228 DOI: 10.1016/j.addr.2020.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/02/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
Effective evaluation and prediction of aerosol transport deposition in the human respiratory tracts are critical to aerosol drug delivery and evaluation of inhalation products. Establishment of an in vitro-in vivo correlation (IVIVC) requires the understanding of flow and aerosol behaviour and underlying mechanisms at the microscopic scale. The achievement of the aim can be facilitated via computational fluid dynamics (CFD) based in silico modelling which treats the aerosol delivery as a two-phase flow. CFD modelling research, in particular coupling with discrete phase model (DPM) and discrete element method (DEM) approaches, has been rapidly developed in the past two decades. This paper reviews the recent development in this area. The paper covers the following aspects: geometric models of the respiratory tract, CFD turbulence models for gas phase and its coupling with DPM/DEM for aerosols, and CFD investigation of the effects of key factors associated with geometric variations, flow and powder characteristics. The review showed that in silico study based on CFD models can effectively evaluate and predict aerosol deposition pattern in human respiratory tracts. The review concludes with recommendations on future research to improve in silico prediction to achieve better IVIVC.
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Affiliation(s)
- Fen Huang
- School of Energy and Environment, Southeast University, Nanjing 210096, China; Department of Chemical Engineering, Monash University, Clayton, Vic 3800, Australia
| | - Qixuan Zhu
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Xudong Zhou
- Department of Chemical Engineering, Monash University, Clayton, Vic 3800, Australia
| | - Dazhao Gou
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jiaqi Yu
- Institute for Process Modelling and Optimization, JITRI, Suzhou 215000, China
| | - Renjie Li
- Institute for Process Modelling and Optimization, JITRI, Suzhou 215000, China
| | - Zhenbo Tong
- School of Energy and Environment, Southeast University, Nanjing 210096, China.
| | - Runyu Yang
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia.
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22
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Atzeni C, Lesma G, Dubini G, Masi M, Rossi F, Bianchi E. Computational fluid dynamic models as tools to predict aerosol distribution in tracheobronchial airways. Sci Rep 2021; 11:1109. [PMID: 33441807 PMCID: PMC7806585 DOI: 10.1038/s41598-020-80241-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
Aerosol and pollutants, in form of particulates 5-8 μm in main size face every day our respiratory system as natural suspension in air or forced to be inhaled as a coadjutant in a medical therapy for respiratory diseases. This inhalation happens in children to elderly, women and men, healthy or sick and disable people. In this paper we analyzed the inhalation of aerosol in conditions assimilable to the thermal therapy. We use a computational fluid dynamic 3D model to compute and visualize the trajectories of aerosol (3-7-10-25 µm) down to the sixth generation of bronchi, in a steady and dynamic condition (7 µm) set as breath cycle at rest. Results, compared to a set of milestone experimental studies published in literature, allow the comprehension of particles behavior during the inhalation from mouth to bronchi sixth generation, the visualization of jet at larynx constriction and vortices, in an averaged characteristic rigorous geometrical model including tracheal rings. Results on trajectories and deposition show the importance of the including transient physiological breath cycle on aerosol deposition analyses. Numerical and graphical results, may enable the design of medical devices and protocols to make the inhalations more effective in all the users' population.
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Affiliation(s)
- Claudia Atzeni
- grid.4643.50000 0004 1937 0327Laboratory of Biological Structures Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Gianluca Lesma
- grid.4643.50000 0004 1937 0327Laboratory of Biological Structures Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Gabriele Dubini
- grid.4643.50000 0004 1937 0327Laboratory of Biological Structures Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Maurizio Masi
- grid.4643.50000 0004 1937 0327Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Filippo Rossi
- grid.4643.50000 0004 1937 0327Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Elena Bianchi
- grid.4643.50000 0004 1937 0327Laboratory of Biological Structures Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico Di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
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23
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Dhanani JA, Goodman S, Ahern B, Cohen J, Fraser JF, Barnett A, Diab S, Bhatt M, Roberts JA. Comparative lung distribution of radiolabeled tobramycin between nebulized and intravenous administration in a mechanically-ventilated ovine model, an observational study. Int J Antimicrob Agents 2020; 57:106232. [PMID: 33232733 DOI: 10.1016/j.ijantimicag.2020.106232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/15/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Ventilator-associated pneumonia is common and is treated using nebulized antibiotics. Although adequate pulmonary biodistribution is important for antibiotic effect, there is a lack of data for both intravenous (IV) and nebulized antibiotic administration during mechanical ventilation. OBJECTIVE To describe the comparative pulmonary regional distribution of IV and nebulized technetium-99m-labeled tobramycin (99mTc-tobramycin) 400 mg in a mechanically-ventilated ovine model. METHODS The study was performed in a mechanically-ventilated ovine model. 99mTc-tobramycin 400 mg was obtained using a radiolabeling process. Computed tomography (CT) was performed. Ten sheep were given 99mTc-tobramycin 400 mg via either an IV (five sheep) or nebulized (five sheep) route. Planar images (dorsal, ventral, left lateral and right lateral) were obtained using a gamma camera. Blood samples were obtained every 15 min for 1 h (4 time points) and lung, liver, both kidney, and urine samples were obtained post-mortem. RESULTS Ten sheep were anesthetized and mechanically ventilated. Whole-lung deposition of nebulized 99mTc-tobramycin 400 mg was significantly lower than with IV (8.8% vs. 57.1%, P<0.001). For both administration routes, there was significantly lower deposition in upper lung zones compared with the rest of the lungs. Dorsal deposition was significantly higher with nebulized 99mTc-tobramycin 400 mg compared with IV (68.9% vs. 58.9%, P=0.003). Lung concentrations of 99mTc-tobramycin were higher with IV compared with nebulized administration. There were significantly higher concentrations of 99mTc-tobramycin in blood, liver and urine with IV administration compared with nebulized. CONCLUSIONS Nebulization resulted in lower whole and regional lung deposition of 99mTc-tobramycin compared with IV administration and appeared to be associated with low blood and extra-pulmonary organ concentrations.
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Affiliation(s)
- Jayesh A Dhanani
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia; Critical Care Research Group, The University of Queensland, Brisbane, Australia.
| | - Steven Goodman
- Department of Nuclear Medicine and Specialised PET Services Queensland, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Benjamin Ahern
- School of Veterinary Science, Faculty of Science, University of Queensland, Gatton, Australia
| | - Jeremy Cohen
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - John F Fraser
- Critical Care Research Group, The University of Queensland, Brisbane, Australia
| | - Adrian Barnett
- Institute of Health and Biomedical Innovation & School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Sara Diab
- Critical Care Research Group, The University of Queensland, Brisbane, Australia
| | - Manoj Bhatt
- Department of Nuclear Medicine and Specialised PET Services Queensland, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jason A Roberts
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia; Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Australia; Department of Pharmacy, Royal Brisbane & Women's Hospital, Brisbane, Australia
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24
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Rajaraman PK, Choi J, Hoffman EA, O'Shaughnessy PT, Choi S, Delvadia R, Babiskin A, Walenga R, Lin CL. Transport and deposition of hygroscopic particles in asthmatic subjects with and without airway narrowing. JOURNAL OF AEROSOL SCIENCE 2020; 146:105581. [PMID: 32346183 PMCID: PMC7187883 DOI: 10.1016/j.jaerosci.2020.105581] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 05/30/2023]
Abstract
This study numerically investigates the effect of hygroscopicity on transport and deposition of particles in severe asthmatic lungs with distinct airway structures. The study human subjects were selected from two imaging-based severe asthmatic clusters with one characterized by non-constricted airways and the other by constricted airways in the lower left lobe (LLL). We compared the deposition fractions of sodium chloride (NaCl) particles with a range of aerodynamic diameters (1-8 μm) in cluster archetypes under conditions with and without hygroscopic growth. The temperature and water vapor distributions in the airways were simulated with an airway wall boundary condition that accounts for variable temperature and water vapor evaporation at the interface between the lumen and the airway surface liquid layer. On average, the deposition fraction increased by about 6% due to hygroscopic particle growth in the cluster subjects with constricted airways, while it increased by only about 0.5% in those with non-constricted airways. The effect of particle growth was most significant for particles with an initial diameter of 2 μm in the cluster subjects with constricted airways. The effect diminished with increasing particle size, especially for particles with an initial diameter larger than 4 μm. This suggests the necessity to differentiate asthmatic subjects by cluster in engineering the aerosol size for tailored treatment. Specifically, the treatment of severe asthmatic subjects who have constricted airways with inhalation aerosols may need submicron-sized hygroscopic particles to compensate for particle growth, if one targets for delivering to the peripheral region. These results could potentially inform the choice of particle size for inhalational drug delivery in a cluster-specific manner.
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Affiliation(s)
- Prathish K. Rajaraman
- Department of Mechanical Engineering, The University of Iowa, Iowa City, IA, USA
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA, USA
| | - Jiwoong Choi
- Department of Mechanical Engineering, The University of Iowa, Iowa City, IA, USA
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA, USA
| | - Eric A. Hoffman
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
| | | | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Renishkumar Delvadia
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Andrew Babiskin
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ross Walenga
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ching-Long Lin
- Department of Mechanical Engineering, The University of Iowa, Iowa City, IA, USA
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA, USA
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Kim T, Cho HB, Kim WJ, Lee CH, Chae KJ, Choi SH, Lee KE, Bak SH, Kwon SO, Jin GY, Choi J, Park EK, Lin CL, Hoffman EA, Choi S. Quantitative CT-based structural alterations of segmental airways in cement dust-exposed subjects. Respir Res 2020; 21:133. [PMID: 32471435 PMCID: PMC7260806 DOI: 10.1186/s12931-020-01399-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure. Methods To reduce confounding factors, subjects with normal spirometry without fibrosis, asthma and pneumonia histories were only selected, and a propensity score matching was applied to match age, sex, height, smoking status, and pack-years. Thus, from a larger data set (N = 609), only 41 cement dust-exposed subjects were compared with 164 non-cement dust-exposed subjects. QCT imaging metrics of airway hydraulic diameter (Dh), wall thickness (WT), and bifurcation angle (θ) were extracted at total lung capacity (TLC) and functional residual capacity (FRC), along with their deformation ratios between TLC and FRC. Results In TLC scan, dust-exposed subjects showed a decrease of Dh (airway narrowing) especially at lower-lobes (p < 0.05), an increase of WT (wall thickening) at all segmental airways (p < 0.05), and an alteration of θ at most of the central airways (p < 0.001) compared with non-dust-exposed subjects. Furthermore, dust-exposed subjects had smaller deformation ratios of WT at the segmental airways (p < 0.05) and θ at the right main bronchi and left main bronchi (p < 0.01), indicating airway stiffness. Conclusions Dust-exposed subjects with normal spirometry demonstrated airway narrowing at lower-lobes, wall thickening at all segmental airways, a different bifurcation angle at central airways, and a loss of airway wall elasticity at lower-lobes. The airway structural alterations may indicate different airway pathophysiology due to cement dusts.
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Affiliation(s)
- Taewoo Kim
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea
| | - Hyun Bin Cho
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Chang Hyun Lee
- Department of Radiology, College of Medicine, Seoul National University, Seoul, South Korea.,Department of Radiology, College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Kum Ju Chae
- Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - So-Hyun Choi
- Department of Statistics, Kyungpook National University, Daegu, South Korea
| | - Kyeong Eun Lee
- Department of Statistics, Kyungpook National University, Daegu, South Korea
| | - So Hyeon Bak
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Sung Ok Kwon
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Gong Yong Jin
- Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Jiwoong Choi
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
| | - Ching-Long Lin
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Eric A Hoffman
- Department of Radiology, College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea.
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Elsayed K, Parvaz F, Hosseini SH, Ahmadi G. Influence of the dipleg and dustbin dimensions on performance of gas cyclones: An optimization study. Sep Purif Technol 2020. [DOI: 10.1016/j.seppur.2020.116553] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Ahookhosh K, Pourmehran O, Aminfar H, Mohammadpourfard M, Sarafraz MM, Hamishehkar H. Development of human respiratory airway models: A review. Eur J Pharm Sci 2020; 145:105233. [DOI: 10.1016/j.ejps.2020.105233] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/11/2020] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
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Haghnegahdar A, Zhao J, Feng Y. Lung Aerosol Dynamics of Airborne Influenza A Virus-Laden Droplets and the Resultant Immune System Responses: An In Silico Study. JOURNAL OF AEROSOL SCIENCE 2019; 134:34-55. [PMID: 31983771 PMCID: PMC6980466 DOI: 10.1016/j.jaerosci.2019.04.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Influenza A Virus (IAV) replications start from the deposition of inhaled virus-laden droplets on the epithelial cells in the pulmonary tracts. In order to understand the local deposition patterns and within-host dynamics of infectious aerosols, accurate information of high-resolution imaging capabilities, as well as real-time flow cytometry analysis, are required for tracking infected cells, virus agents, and immune system responses. However, clinical and animal studies are in deficit to meet the above-mentioned demands, due to their limited operational flexibility and imaging resolution. Therefore, this study developed an experimentally validated multiscale epidemiological computational model, i.e., the Computational Fluid-Particle Dynamics (CFPD) plus Host Cell Dynamics (HCD) model, to predict the transport and deposition of the low-strain IAV-laden droplets, as well as the resultant regional immune system responses. The hygroscopic growth and shrinkage of IAV-laden droplets were accurately modeled. The subject-specific respiratory system was discretized by generating the new polyhedral-core mesh. By simulating both mouth and nasal breathing scenarios, the inhalations of isotonic IAV-laden droplets with three different compositions were achieved. It is the first time that parametric analysis was performed using the multiscale model on how different exposure conditions can influence the virus aerodynamics in the lung and the subsequent immune system responses. Numerical results show a higher viral accretion followed by a faster immune system response in the supraglottic region when droplets with the higher salt concentration were inhaled. Consequently, more severe symptoms and longer recovery are expected at the pharynx. Furthermore, local deposition maps of IAV-laden droplets and post-deposition infection dynamics provide informative and direct evidence which significantly enhance the fundamental understanding of the underlying mechanisms for upper airway and lower airway infections.
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Affiliation(s)
| | - Jianan Zhao
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK, 74078
| | - Yu Feng
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK, 74078
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Choi J, LeBlanc LJ, Choi S, Haghighi B, Hoffman EA, O'Shaughnessy P, Wenzel SE, Castro M, Fain S, Jarjour N, Schiebler ML, Denlinger L, Delvadia R, Walenga R, Babiskin A, Lin CL. Differences in Particle Deposition Between Members of Imaging-Based Asthma Clusters. J Aerosol Med Pulm Drug Deliv 2019; 32:213-223. [PMID: 30888242 PMCID: PMC6685197 DOI: 10.1089/jamp.2018.1487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 01/12/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Four computed tomography (CT) imaging-based clusters have been identified in a study of the Severe Asthma Research Program (SARP) cohort and have been significantly correlated with clinical and demographic metrics (J Allergy Clin Immunol 2017; 140:690-700.e8). We used a computational fluid dynamics (CFD) model to investigate air flow and aerosol deposition within imaging archetypes representative of the four clusters. Methods: CFD simulations for air flow and 1-8 μm particle transport were performed using CT-based airway models from two healthy subjects and eight asthma subjects. The subject selection criterion was based on the discriminant imaging-based flow-related variables of J(Total) (average local volume expansion in the total lung) and Dh*(sLLL) (normalized airway hydraulic diameter in the left lower lobe), where reduced J(Total) and Dh*(sLLL) indicate reduced regional ventilation and airway constriction, respectively. The analysis focused on the comparisons between all clusters with respect to healthy subjects, between cluster 2 and cluster 4 (nonsevere and severe asthma clusters with airway constriction) and between cluster 3 and cluster 4 (two severe asthma clusters characterized by normal and constricted airways, respectively). Results: Nonsevere asthma cluster 2 and severe asthma cluster 4 subjects characterized by airway constriction had an increase in the deposition fraction (DF) in the left lower lobe. Constricted flows impinged on distal bifurcations resulting in large depositions. Although both cluster 3 (without constriction) and cluster 4 (with constriction) were severe asthma, they exhibited different particle deposition patterns with increasing particle size. The statistical analysis showed that Dh*(sLLL) plays a more important role in particle deposition than J(Total), and regional flow fraction is correlated with DF among lobes for smaller particles. Conclusions: We demonstrated particle deposition characteristics associated with cluster-specific imaging-based metrics such as airway constriction, which could pertain to the design of future drug delivery improvements.
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Affiliation(s)
- Jiwoong Choi
- Department of Mechanical Engineering, The University of Iowa, Iowa City, Iowa
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Lawrence J. LeBlanc
- Department of Mechanical Engineering, The University of Iowa, Iowa City, Iowa
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Babak Haghighi
- Department of Mechanical Engineering, The University of Iowa, Iowa City, Iowa
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Eric A. Hoffman
- Department of Radiology, The University of Iowa, Iowa City, Iowa
| | - Patrick O'Shaughnessy
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa
| | - Sally E. Wenzel
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mario Castro
- Departments of Internal Medicine and Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Sean Fain
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Nizar Jarjour
- Division of Pulmonary Medicine and Critical Care, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Mark L. Schiebler
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Loren Denlinger
- Division of Pulmonary Medicine and Critical Care, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Renishkumar Delvadia
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Ross Walenga
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Andrew Babiskin
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Ching-Long Lin
- Department of Mechanical Engineering, The University of Iowa, Iowa City, Iowa
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
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In Vitro Study of Particle Transport in Successively Bifurcating Vessels. Ann Biomed Eng 2019; 47:2271-2283. [PMID: 31165293 DOI: 10.1007/s10439-019-02293-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/20/2019] [Indexed: 12/24/2022]
Abstract
To reach a predictive understanding of how particles travel through bifurcating vessels is of paramount importance in many biomedical settings, including embolization, thromboembolism, and drug delivery. Here we utilize an in vitro model in which solid particles are injected through a rigid vessel that symmetrically bifurcates in successive branching generations. The geometric proportion and fluid dynamics parameters are relevant to the liver embolization. The volumetric flow field is reconstructed via phase-contrast magnetic resonance imaging, from which the particle trajectories are calculated for a range of size and density using the particle equation of motion. The method is validated by directly tracking the injected particles via optical imaging. The results indicate that, opposite to the common assumption, the particles distribution is fundamentally different from the volumetric flow partition. In fact, the amount of delivered particles vary substantially between adjacent branches even when the flow is uniformly distributed. This is not due to the inertia of the particles, nor to gravity. The particle distribution is rather rooted in their different pathways, which in turn are linked to their release origin along the main vessel cross-section. Therefore, the tree geometry and the associated flow streamlines are the prime determinant of the particle fate, while local changes of volumetric flow rate to selected branches do not generally produce proportional changes of particle delivery.
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31
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Van de Moortele T, Goerke U, Wendt CH, Coletti F. Airway morphology and inspiratory flow features in the early stages of Chronic Obstructive Pulmonary Disease. Clin Biomech (Bristol, Avon) 2019; 66:60-65. [PMID: 29169684 PMCID: PMC5955793 DOI: 10.1016/j.clinbiomech.2017.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of death worldwide. Inhaled pollutants are the prime risk factor, but the pathogenesis and progression of the diseased is poorly understood. Most studies on the disease onset and trajectory have focused on genetic and molecular biomarkers. Here we investigate the role of the airway anatomy and the consequent respiratory fluid mechanics on the development of COPD. METHODS We segmented CT scans from a five-year longitudinal study in three groups of smokers (18 subjects each) having: (i) minimal/mild obstruction at baseline with declining lung function at year five; (ii) minimal/mild obstruction at baseline with stable function, and (iii) normal and stable lung function over the five year period. We reconstructed the bronchial trees up to the 7th generation, and for one subject in each group we performed MRI velocimetry in 3D printed models. FINDINGS The subjects with airflow obstruction at baseline have smaller airway diameters, smaller child-to-parent diameter ratios, larger length-to-diameter ratios, and smaller fractal dimensions. The differences are more significant for subjects that develop severe decline in pulmonary function. The secondary flows that characterize lateral dispersion along the airways are found to be less intense in the subjects with airflow obstruction. INTERPRETATION These results indicate that morphology of the conducting airways and inspiratory flow features are correlated with the status and progression of COPD already at an early stage of the disease. This suggests that imaging-based biomarkers may allow a pre-symptomatic diagnosis of disease progression.
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Affiliation(s)
- Tristan Van de Moortele
- Department of Aerospace Engineering & Mechanics, University of Minnesota, Minneapolis, MN, USA
| | - Ute Goerke
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Chris H. Wendt
- Department of Medicine, VA Medical Center, University of Minnesota, Minneapolis, MN, USA
| | - Filippo Coletti
- Department of Aerospace Engineering & Mechanics, University of Minnesota, Minneapolis, MN, USA
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32
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Ahookhosh K, Yaqoubi S, Mohammadpourfard M, Hamishehkar H, Aminfar H. Experimental investigation of aerosol deposition through a realistic respiratory airway replica: An evaluation for MDI and DPI performance. Int J Pharm 2019; 566:157-172. [PMID: 31129343 DOI: 10.1016/j.ijpharm.2019.05.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/15/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE In the present work, a comparison between MDI and DPI for evaluating performance of the devices were carried out by experimentally investigating the deposition parameters through a realistic airway replica. METHODS Computed tomography (CT) images of the respiratory airway of a healthy subject were used to develop the realistic model. The airway replica was included extrathoracic, trachea, and tracheobronchial tree up to fourth generations which was fabricated by rapid prototyping. Afterward, in vitro experiments were performed to validate the airway model by comparing the total deposition (G0 to G3) of present replica with available data in the literature. Drug deposition (Salbutamol) in the model was measured by determining concentration of the segments sample by High Performance Liquid Chromatography (HPLC) assay. RESULTS Deposition parameters were used for investigating the deposition patterns of the inhaled particles. Results showed that inertial impaction is the dominant mechanism in the most regions of the replica. It was found that the MDI delivered more drug to the tracheobronchial tree compared to the DPI for three different flow rate. CONCLUSION The developed realistic respiratory airways model provided an opportunity to more accurately evaluate the performance of drug delivery devices and studying mechanisms of the drug deposition.
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Affiliation(s)
- Kaveh Ahookhosh
- Faculty of Mechanical Engineering, University of Tabriz, Tabriz, Iran
| | - Shadi Yaqoubi
- Biotechnology Research Center, Student Research Committee, and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Habib Aminfar
- Faculty of Mechanical Engineering, University of Tabriz, Tabriz, Iran.
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Watanabe J, Watanabe M. Anatomical factors of human respiratory tract influencing volume flow rate and number of particles arriving at each bronchus. Biocybern Biomed Eng 2019. [DOI: 10.1016/j.bbe.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Longest PW, Bass K, Dutta R, Rani V, Thomas ML, El-Achwah A, Hindle M. Use of computational fluid dynamics deposition modeling in respiratory drug delivery. Expert Opin Drug Deliv 2019; 16:7-26. [PMID: 30463458 PMCID: PMC6529297 DOI: 10.1080/17425247.2019.1551875] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Respiratory drug delivery is a surprisingly complex process with a number of physical and biological challenges. Computational fluid dynamics (CFD) is a scientific simulation technique that is capable of providing spatially and temporally resolved predictions of many aspects related to respiratory drug delivery from initial aerosol formation through respiratory cellular drug absorption. AREAS COVERED This review article focuses on CFD-based deposition modeling applied to pharmaceutical aerosols. Areas covered include the development of new complete-airway CFD deposition models and the application of these models to develop a next-generation of respiratory drug delivery strategies. EXPERT OPINION Complete-airway deposition modeling is a valuable research tool that can improve our understanding of pharmaceutical aerosol delivery and is already supporting medical hypotheses, such as the expected under-treatment of the small airways in asthma. These complete-airway models are also being used to advance next-generation aerosol delivery strategies, like controlled condensational growth. We envision future applications of CFD deposition modeling to reduce the need for human subject testing in developing new devices and formulations, to help establish bioequivalence for the accelerated approval of generic inhalers, and to provide valuable new insights related to drug dissolution and clearance leading to microdosimetry maps of drug absorption.
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Affiliation(s)
- P. Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | - Karl Bass
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rabijit Dutta
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Vijaya Rani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Morgan L. Thomas
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Ahmad El-Achwah
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
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Das P, Nof E, Amirav I, Kassinos SC, Sznitman J. Targeting inhaled aerosol delivery to upper airways in children: Insight from computational fluid dynamics (CFD). PLoS One 2018; 13:e0207711. [PMID: 30458054 PMCID: PMC6245749 DOI: 10.1371/journal.pone.0207711] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/03/2018] [Indexed: 11/28/2022] Open
Abstract
Despite the prevalence of inhalation therapy in the treatment of pediatric respiratory disorders, most prominently asthma, the fraction of inhaled drugs reaching the lungs for maximal efficacy remains adversely low. By and large drug delivery devices and their inhalation guidelines are typically derived from adult studies with child dosages adapted according to body weight. While it has long been recognized that physiological (e.g. airway sizes, breathing maneuvers) and physical transport (e.g. aerosol dynamics) characteristics are critical in governing deposition outcomes, such knowledge has yet to be extensively adapted to younger populations. Motivated by such shortcomings, the present work leverages in a first step in silico computational fluid dynamics (CFD) to explore opportunities for augmenting aerosol deposition in children based on respiratory physiological and physical transport determinants. Using an idealized, anatomically-faithful upper airway geometry, airflow and aerosol motion are simulated as a function of age, spanning a five year old to an adult. Breathing conditions mimic realistic age-specific inhalation maneuvers representative of Dry Powder Inhalers (DPI) and nebulizer inhalation. Our findings point to the existence of a single dimensionless curve governing deposition in the conductive airways via the dimensionless Stokes number (Stk). Most significantly, we uncover the existence of a distinct deposition peak irrespective of age. For the DPI simulations, this peak (∼ 80%) occurs at Stk ≈ 0.06 whereas for nebulizer simulations, the corresponding peak (∼ 45%) occurs in the range of Stk between 0.03-0.04. Such dimensionless findings hence translate to an optimal window of micron-sized aerosols that evolves with age and varies with inhalation device. The existence of such deposition optima advocates revisiting design guidelines for optimizing deposition outcomes in pediatric inhalation therapy.
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Affiliation(s)
- Prashant Das
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Eliram Nof
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Israel Amirav
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Stavros C. Kassinos
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Kallipoleos Avenue 75, Nicosia 1678, Cyprus
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
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Kim M, Collier GJ, Wild JM, Chung YM. Effect of upper airway on tracheobronchial fluid dynamics. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2018; 34:e3112. [PMID: 29856119 DOI: 10.1002/cnm.3112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 05/17/2023]
Abstract
The upper airways play a significant role in the tracheal flow dynamics. Despite many previous studies, however, the effect of the upper airways on the ventilation distribution in distal airways has remained a challenge. The aim of this study is to experimentally and computationally investigate the dynamic behaviour in the intratracheal flow induced by the upper respiratory tract and to assess its influence on the subsequent tributaries. Patient-specific images from 2 different modalities (magnetic resonance imaging of the upper airways and computed tomography of the lower airways) were segmented and combined. An experimental phantom of patient-specific airways (including the oral cavity, larynx, trachea, down to generations 6-8) was generated using 3D printing. The flow velocities in this phantom model were measured by the flow-sensitised phase contrast magnetic resonance imaging technique and compared with the computational fluid dynamics simulations. Both experimental and computational results show a good agreement in the time-averaged velocity fields as well as fluctuating velocity. The flows in the proximal trachea were complex and unsteady under both lower- and higher-flow rate conditions. Computational fluid dynamics simulations were also performed with an airways model without the upper airways. Although the flow near the carina remained unstable only when the inflow rate was high, the influence of the upper airways caused notable changes in distal flow distributions when the 2 airways models were compared with and without the upper airways. The results suggest that the influence of the upper airways should be included in the respiratory flow assessment as the upper airways extensively affect the flows in distal airways and consequent ventilation distribution in the lungs.
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Affiliation(s)
- Minsuok Kim
- School of Engineering, University of Warwick, Coventry, UK
| | - Guilhem J Collier
- Academic Unit of Radiology, Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- Academic Unit of Radiology, Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
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37
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Zhang B, Qi S, Yue Y, Shen J, Li C, Qian W, Wu J. Particle Disposition in the Realistic Airway Tree Models of Subjects with Tracheal Bronchus and COPD. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7428609. [PMID: 30155481 PMCID: PMC6098871 DOI: 10.1155/2018/7428609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/02/2018] [Accepted: 07/18/2018] [Indexed: 12/31/2022]
Abstract
Dispositions of inhalable particles in the human respiratory tract trigger and exacerbate airway inflammatory diseases. However, the particle deposition (PD) in airway of subjects with tracheal bronchus (TB) and chronic obstructive pulmonary diseases (COPD) is unknown. We therefore propose to clarify the disrupted PD associated with TB and COPD using the computational fluid dynamics (CFD) simulation. Totally nine airway tree models are included. Six are extracted from CT images of different individuals (two with TB, two with COPD, and two healthy controls (HC)). The others are the artificially modified models (AMMs) generated by the virtual lesion. Specifically, they are constructed through artificially adding a tracheal bronchus or a stenosis on one HC model. The deposition efficiency (DE) and deposition fraction (DF) in these models are obtained by the Euler-Lagrange approach, analyzed, and compared across models, locations, and particle sizes (0.1-10.0 micrometers). It is found that the PD in models with TB and COPD has been disrupted by the geometrical changes and followed airflow alternations. DE of the tracheal bronchus is higher for TB models. For COPD, the stenosis location determines the effects on DE and DF. Higher DF at the trachea is observed in TB1, TB2, and COPD2 models. DE increases with the particle size, and DE of the terminal bronchi is higher than that of central regions. Combined with AMMs, the CFD simulation using realistic airway models demonstrates disruptions of DP. The methods and findings might help understand the etiology of pulmonary diseases and improve the efficacy of inhaled medicines.
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Affiliation(s)
- Baihua Zhang
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
- Key Laboratory of Medical Image Computing of Northeastern University (Ministry of Education), Shenyang, China
| | - Shouliang Qi
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
- Key Laboratory of Medical Image Computing of Northeastern University (Ministry of Education), Shenyang, China
| | - Yong Yue
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Jing Shen
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Chen Li
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Wei Qian
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
- College of Engineering, University of Texas at El Paso, El Paso, USA
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
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38
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Bass K, Longest PW. Recommendations for Simulating Microparticle Deposition at Conditions Similar to the Upper Airways with Two-Equation Turbulence Models. JOURNAL OF AEROSOL SCIENCE 2018; 119:31-50. [PMID: 30349146 PMCID: PMC6195318 DOI: 10.1016/j.jaerosci.2018.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The development of a CFD model, from initial geometry to experimentally validated result with engineering insight, can be a time-consuming process that often requires several iterations of meshing and solver set-up. Applying a set of guidelines in the early stages can help to streamline the process and improve consistency between different models. The objective of this study was to determine both mesh and CFD solution parameters that enable the accurate simulation of microparticle deposition under flow conditions consistent with the upper respiratory airways including turbulent flow. A 90° bend geometry was used as a characteristic model that occurs throughout the airways and for which high-quality experimental aerosol deposition data is available in the transitional and turbulent flow regimes. Four meshes with varying degrees of near-wall resolution were compared, and key solver settings were applied to determine the parameters that minimize sensitivity to the near-wall (NW) mesh. The Low Reynolds number (LRN) k-ω model was used to resolve the turbulence field, which is a numerically efficient two-equation turbulence model, but has recently been considered overly simplistic. Some recent studies have used more complex turbulence models, such as Large Eddy Simulation (LES), to overcome the perceived weaknesses of two-equation models. Therefore, the secondary objective was to determine whether the more computationally efficient LRN k-ω model was capable of providing deposition results that were comparable to LES. Results show how NW mesh sensitivity is reduced through application of the Green-Gauss Node-based gradient discretization scheme and physically realistic near-wall corrections. Using the newly recommended meshing parameters and solution guidelines gives an excellent match to experimental data. Furthermore, deposition data from the LRN k-ω model compares favorably with LES results for the same characteristic geometry. In summary, this study provides a set of meshing and solution guidelines for simulating aerosol deposition in transitional and turbulent flows found in the upper respiratory airways using the numerically efficient LRN k-ω approach.
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Affiliation(s)
- Karl Bass
- Department of Mechanical Engineering, Virginia Commonwealth University, Richmond, VA
| | - P. Worth Longest
- Department of Mechanical Engineering, Virginia Commonwealth University, Richmond, VA
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
- Dr. P. Worth Longest, PhD (Corresponding author), Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA 23284-3015, Phone: (804)-827-7023, Fax: (804)-827-7030, , Mr. Karl Bass, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA 23284-3015, Phone: (804)-827-7023, Fax: (804)-827-7030,
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Collier GJ, Kim M, Chung Y, Wild JM. 3D phase contrast MRI in models of human airways: Validation of computational fluid dynamics simulations of steady inspiratory flow. J Magn Reson Imaging 2018; 48:1400-1409. [DOI: 10.1002/jmri.26039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Guilhem J. Collier
- POLARIS, Unit of Academic Radiology, Department of Infection; Immunity and Cardiovascular Disease, University of Sheffield; Sheffield UK
| | - Minsuok Kim
- School of Engineering and Centre for Scientific Computing; University of Warwick; Coventry UK
| | - Yongmann Chung
- School of Engineering and Centre for Scientific Computing; University of Warwick; Coventry UK
| | - Jim M. Wild
- POLARIS, Unit of Academic Radiology, Department of Infection; Immunity and Cardiovascular Disease, University of Sheffield; Sheffield UK
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Shang Y, Tian L, Fan Y, Dong J, Inthavong K, Tu J. Effect of morphology on nanoparticle transport and deposition in human upper tracheobronchial airways. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/1757482x18756012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aerosol transport and deposition in human lungs has attracted considerable attention in the past few years, as it has significant value to the study of toxicity consequence as well as therapeutic potential in occupational health and medical applications. In reproducing human tracheobronchial airways, two approaches were frequently taken: (1) anatomical realistic reconstruction through image scans (e.g. CT and MRI) or cadaver casts and (2) mathematical description using simplified models. Strengths and limitations are primarily focused on accuracy, resolution, repeatability, and computational\physical expenses. While both approaches were reported in literature, detailed comparison of aerosol transport and deposition in the two representations were scarcely performed, largely due to the challenge to acquire comprehensive data from the irregular structured airway replicas (approach 1). To fill the gap, the current study performed a numerical comparison of nanoparticle transport and deposition in human upper tracheobronchial airways by using an anatomical realistic reconstruction (through CT scans) and a mathematically simplified airway model. As the first step, the current study was focused on the variation in breathing airflow pattern and the effect towards fate of the inhaled nanoparticles in human upper tracheobronchial airways. The study provided important information to understand geometric sensitivity of nanoparticle modeling in the human tracheobronchial tree and is of significant value to predict the whole lung uptake of inhaled nanoparticles in the human respiratory system.
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Affiliation(s)
- Yidan Shang
- School of Engineering – Mechanical and Automotive, RMIT University, Bundoora, Australia
| | - Lin Tian
- School of Engineering – Mechanical and Automotive, RMIT University, Bundoora, Australia
| | - Yaming Fan
- College of Ecological Environment and Urban Construction, Fujian University of Technology, Fuzhou, China
| | - Jingliang Dong
- School of Engineering – Mechanical and Automotive, RMIT University, Bundoora, Australia
| | - Kiao Inthavong
- School of Engineering – Mechanical and Automotive, RMIT University, Bundoora, Australia
| | - Jiyuan Tu
- School of Engineering – Mechanical and Automotive, RMIT University, Bundoora, Australia
- Key Laboratory of Ministry of Education for Advanced Reactor Engineering and Safety, Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing, China
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41
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Human airway branch variation and chronic obstructive pulmonary disease. Proc Natl Acad Sci U S A 2018; 115:E974-E981. [PMID: 29339516 DOI: 10.1073/pnas.1715564115] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Susceptibility to chronic obstructive pulmonary disease (COPD) beyond cigarette smoking is incompletely understood, although several genetic variants associated with COPD are known to regulate airway branch development. We demonstrate that in vivo central airway branch variants are present in 26.5% of the general population, are unchanged over 10 y, and exhibit strong familial aggregation. The most common airway branch variant is associated with COPD in two cohorts (n = 5,054), with greater central airway bifurcation density, and with emphysema throughout the lung. The second most common airway branch variant is associated with COPD among smokers, with narrower airway lumens in all lobes, and with genetic polymorphisms within the FGF10 gene. We conclude that central airway branch variation, readily detected by computed tomography, is a biomarker of widely altered lung structure with a genetic basis and represents a COPD susceptibility factor.
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Lalas A, Nousias S, Kikidis D, Lalos A, Arvanitis G, Sougles C, Moustakas K, Votis K, Verbanck S, Usmani O, Tzovaras D. Substance deposition assessment in obstructed pulmonary system through numerical characterization of airflow and inhaled particles attributes. BMC Med Inform Decis Mak 2017; 17:173. [PMID: 29297393 PMCID: PMC5751792 DOI: 10.1186/s12911-017-0561-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and asthma are considered as the two most widespread obstructive lung diseases, whereas they affect more than 500 million people worldwide. Unfortunately, the requirement for detailed geometric models of the lungs in combination with the increased computational resources needed for the simulation of the breathing did not allow great progress to be made in the past for the better understanding of inflammatory diseases of the airways through detailed modelling approaches. In this context, computational fluid dynamics (CFD) simulations accompanied by fluid particle tracing (FPT) analysis of the inhaled ambient particles are deemed critical for lung function assessment. Also they enable the understanding of particle depositions on the airways of patients, since these accumulations may affect or lead to inflammations. In this direction, the current study conducts an initial investigation for the better comprehension of particle deposition within the lungs. More specifically, accurate models of the airways obstructions that relate to pulmonary disease are developed and a thorough assessment of the airflow behavior together with identification of the effects of inhaled particle properties, such as size and density, is conducted. Our approach presents a first step towards an effective personalization of pulmonary treatment in regards to the geometric characteristics of the lungs and the in depth understanding of airflows within the airways. METHODS A geometry processing technique involving contraction algorithms is established and used to employ the different respiratory arrangements associated with lung related diseases that exhibit airways obstructions. Apart from the normal lung case, two categories of obstructed cases are examined, i.e. models with obstructions in both lungs and models with narrowings in the right lung only. Precise assumptions regarding airflow and deposition fraction (DF) over various sections of the lungs are drawn by simulating these distinct incidents through the finite volume method (FVM) and particularly the CFD and FPT algorithms. Moreover, a detailed parametric analysis clarifies the effects of the particles size and density in terms of regional deposition upon several parts of the pulmonary system. In this manner, the deposition pattern of various substances can be assessed. RESULTS For the specific case of the unobstructed lung model most particles are detected on the right lung (48.56% of total, when the air flowrate is 12.6 L/min), a fact that is also true when obstructions arise symmetrically in both lungs (51.45% of total, when the air flowrate is 6.06 L/min and obstructions occur after the second generation). In contrast, when narrowings are developed on the right lung only, most particles are pushed on the left section (68.22% of total, when the air flowrate is 11.2 L/min) indicating that inhaled medication is generally deposited away from the areas of inflammation. This observation is useful when designing medical treatment of lung diseases. Furthermore, particles with diameters from 1 μm to 10 μm are shown to be mainly deposited on the lower airways, whereas particles with diameters of 20 μm and 30 μm are mostly accumulated in the upper airways. As a result, the current analysis indicates increased DF levels in the upper airways when the particle diameter is enlarged. Additionally, when the particles density increases from 1000 Kg/m3 to 2000 Kg/m3, the DF is enhanced on every generation and for all cases investigated herein. The results obtained by our simulations provide an accurate and quantitative estimation of all important parameters involved in lung modeling. CONCLUSIONS The treatment of respiratory diseases with inhaled medical substances can be advanced by the clinical use of accurate CFD and FPT simulations and specifically by evaluating the deposition of inhaled particles in a regional oriented perspective in regards to different particle sizes and particle densities. Since a drug with specific characteristics (i.e. particle size and density) exhibits maximum deposition on particular lung areas, the current study provides initial indications to a qualified physician for proper selection of medication.
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Affiliation(s)
- Antonios Lalas
- Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece.
| | - Stavros Nousias
- Department of Electrical and Computer Engineering, University of Patras, Patra, Greece
| | - Dimitrios Kikidis
- Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece
| | - Aris Lalos
- Department of Electrical and Computer Engineering, University of Patras, Patra, Greece
| | - Gerasimos Arvanitis
- Department of Electrical and Computer Engineering, University of Patras, Patra, Greece
| | - Christos Sougles
- Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece
| | | | - Konstantinos Votis
- Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece
| | - Sylvia Verbanck
- Respiratory Division, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Omar Usmani
- National Heart and Lung Institute (NHLI), Imperial College London and Royal Brompton Hospital, London, UK
| | - Dimitrios Tzovaras
- Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece
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Van de Moortele T, Wendt CH, Coletti F. Morphological and functional properties of the conducting human airways investigated by in vivo computed tomography and in vitro MRI. J Appl Physiol (1985) 2017; 124:400-413. [PMID: 29097628 DOI: 10.1152/japplphysiol.00490.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The accurate representation of the human airway anatomy is crucial for understanding and modeling the structure-function relationship in both healthy and diseased lungs. The present knowledge in this area is based on morphometric studies of excised lung casts, partially complemented by in vivo studies in which computed tomography (CT) was used on a small number of subjects. In the present study, we analyzed CT scans of a cohort of healthy subjects and obtained comprehensive morphometric information down to the seventh generation of bronchial branching, including airway diameter, length, branching angle, and rotation angle. Although some of the geometric parameters (such as the child-to-parent branch diameter ratio) are found to be in line with accepted values, for others (such as the branch length-to-diameter ratio) our findings challenge the common assumptions. We also evaluated several metrics of self-similarity, including the fractal dimension of the airway tree. Additionally, we used phase-contrast magnetic resonance imaging (MRI) to obtain the volumetric flow field in the three-dimensional-printed airway model of one of the subjects during steady inhalation. This is used to relate structural and functional parameters and, in particular, to close the power-law relationship between branch flow rate and diameter. The diameter exponent is found to be significantly lower than in the usually assumed Poiseuille regime, which we attribute to the strong secondary (i.e., transverse) velocity component. The strength of the secondary velocity with respect to the axial component exceeds the levels found in idealized airway models and persists within the first seven generations. NEW & NOTEWORTHY We performed a comprehensive computed tomography-based study of the conductive airway morphology in normal human subjects, including branch diameter, length, and mutual angles. We found significant departure from classic homothetic relationships. We also carried out MRI measurements of the three-dimensional inspiratory flow in an anatomy-based model and directly assessed structure-function relationships that have so far been assumed. We found that strong secondary flows (i.e., transverse velocity components) persist through the first seven generations of bronchial branching.
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Affiliation(s)
- Tristan Van de Moortele
- Department of Aerospace Engineering and Mechanics, University of Minnesota , Minneapolis, Minnesota
| | - Christine H Wendt
- Department of Medicine, Veterans Affairs Medical Center, University of Minnesota , Minneapolis, Minnesota
| | - Filippo Coletti
- Department of Aerospace Engineering and Mechanics, University of Minnesota , Minneapolis, Minnesota
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44
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Yousefi M, Inthavong K, Tu J. Effect of Pressurized Metered Dose Inhaler Spray Characteristics and Particle Size Distribution on Drug Delivery Efficiency. J Aerosol Med Pulm Drug Deliv 2017; 30:359-372. [DOI: 10.1089/jamp.2016.1299] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | - Kiao Inthavong
- School of Engineering, RMIT University, Bundoora, Australia
| | - Jiyuan Tu
- School of Engineering, RMIT University, Bundoora, Australia
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45
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Koullapis P, Kassinos SC, Muela J, Perez-Segarra C, Rigola J, Lehmkuhl O, Cui Y, Sommerfeld M, Elcner J, Jicha M, Saveljic I, Filipovic N, Lizal F, Nicolaou L. Regional aerosol deposition in the human airways: The SimInhale benchmark case and a critical assessment of in silico methods. Eur J Pharm Sci 2017; 113:77-94. [PMID: 28890203 DOI: 10.1016/j.ejps.2017.09.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/01/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
Regional deposition effects are important in the pulmonary delivery of drugs intended for the topical treatment of respiratory ailments. They also play a critical role in the systemic delivery of drugs with limited lung bioavailability. In recent years, significant improvements in the quality of pulmonary imaging have taken place, however the resolution of current imaging modalities remains inadequate for quantifying regional deposition. Computational Fluid-Particle Dynamics (CFPD) can fill this gap by providing detailed information about regional deposition in the extrathoracic and conducting airways. It is therefore not surprising that the last 15years have seen an exponential growth in the application of CFPD methods in this area. Survey of the recent literature however, reveals a wide variability in the range of modelling approaches used and in the assumptions made about important physical processes taking place during aerosol inhalation. The purpose of this work is to provide a concise critical review of the computational approaches used to date, and to present a benchmark case for validation of future studies in the upper airways. In the spirit of providing the wider community with a reference for quality assurance of CFPD studies, in vitro deposition measurements have been conducted in a human-based model of the upper airways, and several groups within MP1404 SimInhale have computed the same case using a variety of simulation and discretization approaches. Here, we report the results of this collaborative effort and provide a critical discussion of the performance of the various simulation methods. The benchmark case, in vitro deposition data and in silico results will be published online and made available to the wider community. Particle image velocimetry measurements of the flow, as well as additional numerical results from the community, will be appended to the online database as they become available in the future.
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Affiliation(s)
- P Koullapis
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - S C Kassinos
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - J Muela
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - C Perez-Segarra
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - J Rigola
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - O Lehmkuhl
- Barcelona Supercomputing Center, Barcelona, Spain
| | - Y Cui
- Chair of Applied Mechanics, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - M Sommerfeld
- Institute of Process Engineering, Otto von Guericke-University Magdeburg, Halle, Germany
| | - J Elcner
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - M Jicha
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - I Saveljic
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - N Filipovic
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - F Lizal
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - L Nicolaou
- Department of Mechanical Engineering, Imperial College London, London, UK.
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Yousefi M, Pourmehran O, Gorji-Bandpy M, Inthavong K, Yeo L, Tu J. CFD simulation of aerosol delivery to a human lung via surface acoustic wave nebulization. Biomech Model Mechanobiol 2017; 16:2035-2050. [DOI: 10.1007/s10237-017-0936-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022]
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47
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Current and future approaches to large airways imaging in adults and children. Clin Radiol 2017; 72:356-374. [DOI: 10.1016/j.crad.2017.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/07/2017] [Accepted: 01/23/2017] [Indexed: 01/04/2023]
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48
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On the enhancement of particle deposition in turbulent channel airflow by a ribbed wall. ADV POWDER TECHNOL 2017. [DOI: 10.1016/j.apt.2016.12.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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49
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Silva MC, Silva AS, Fernandez-Lodeiro J, Casimiro T, Lodeiro C, Aguiar-Ricardo A. Supercritical CO₂-Assisted Spray Drying of Strawberry-Like Gold-Coated Magnetite Nanocomposites in Chitosan Powders for Inhalation. MATERIALS (BASEL, SWITZERLAND) 2017; 10:E74. [PMID: 28772434 PMCID: PMC5344610 DOI: 10.3390/ma10010074] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/21/2016] [Accepted: 01/11/2017] [Indexed: 01/03/2023]
Abstract
Lung cancer is one of the leading causes of death worldwide. Therefore, it is of extreme importance to develop new systems that can deliver anticancer drugs into the site of action when initiating a treatment. Recently, the use of nanotechnology and particle engineering has enabled the development of new drug delivery platforms for pulmonary delivery. In this work, POXylated strawberry-like gold-coated magnetite nanocomposites and ibuprofen (IBP) were encapsulated into a chitosan matrix using Supercritical Assisted Spray Drying (SASD). The dry powder formulations showed adequate morphology and aerodynamic performances (fine particle fraction 48%-55% and aerodynamic diameter of 2.6-2.8 µm) for deep lung deposition through the pulmonary route. Moreover, the release kinetics of IBP was also investigated showing a faster release of the drug at pH 6.8, the pH of lung cancer. POXylated strawberry-like gold-coated magnetite nanocomposites proved to have suitable sizes for cellular internalization and their fluorescent capabilities enable their future use in in vitro cell based assays. As a proof-of-concept, the reported results show that these nano-in-micro formulations could be potential drug vehicles for pulmonary administration.
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Affiliation(s)
- Marta C Silva
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus de Caparica, Caparica 2829-516, Portugal.
- BIOSCOPE Research Group, UCIBIO@REQUIMTE, Chemistry Department, Faculty of Science and Technology, University NOVA of Lisbon, Caparica Campus, Caparica 2829-516, Portugal.
| | - Ana Sofia Silva
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus de Caparica, Caparica 2829-516, Portugal.
- CICS-UBI, Health Sciences Research Center, Faculdade de Ciências da Saúde, Universidade da Beira Interior, Av. Infante D. Henrique, Covilhã 6200-506, Portugal.
| | - Javier Fernandez-Lodeiro
- BIOSCOPE Research Group, UCIBIO@REQUIMTE, Chemistry Department, Faculty of Science and Technology, University NOVA of Lisbon, Caparica Campus, Caparica 2829-516, Portugal.
- PROTEOMASS Scientific Society, Rua dos Inventores, Madam Parque, Caparica Campus, Caparica 2829-516, Portugal.
| | - Teresa Casimiro
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus de Caparica, Caparica 2829-516, Portugal.
| | - Carlos Lodeiro
- BIOSCOPE Research Group, UCIBIO@REQUIMTE, Chemistry Department, Faculty of Science and Technology, University NOVA of Lisbon, Caparica Campus, Caparica 2829-516, Portugal.
- PROTEOMASS Scientific Society, Rua dos Inventores, Madam Parque, Caparica Campus, Caparica 2829-516, Portugal.
| | - Ana Aguiar-Ricardo
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus de Caparica, Caparica 2829-516, Portugal.
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50
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Verbanck S, Ghorbaniasl G, Biddiscombe MF, Dragojlovic D, Ricks N, Lacor C, Ilsen B, de Mey J, Schuermans D, Underwood SR, Barnes PJ, Vincken W, Usmani OS. Inhaled Aerosol Distribution in Human Airways: A Scintigraphy-Guided Study in a 3D Printed Model. J Aerosol Med Pulm Drug Deliv 2016; 29:525-533. [DOI: 10.1089/jamp.2016.1291] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sylvia Verbanck
- Respiratory Division, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ghader Ghorbaniasl
- Research Group Fluid Mechanics and Thermodynamics, Department of Mechanical Engineering, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martyn F. Biddiscombe
- Airway Disease Section, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom
- Nuclear Medicine Department, Royal Brompton Hospital, London, United Kingdom
| | - Dusica Dragojlovic
- Research Group Fluid Mechanics and Thermodynamics, Department of Mechanical Engineering, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nathan Ricks
- Research Group Fluid Mechanics and Thermodynamics, Department of Mechanical Engineering, Vrije Universiteit Brussel, Brussels, Belgium
| | - Chris Lacor
- Research Group Fluid Mechanics and Thermodynamics, Department of Mechanical Engineering, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Ilsen
- Radiology Department, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan de Mey
- Radiology Department, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Daniel Schuermans
- Respiratory Division, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Peter J. Barnes
- Airway Disease Section, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom
| | - Walter Vincken
- Respiratory Division, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Omar S. Usmani
- Airway Disease Section, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom
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