Surfactant Driven Post-Deposition Spreading of Aerosols on Complex Aqueous Subphases. 1: High Deposition Flux Representative of Aerosol Delivery to Large Airways

Interaction of impinging marangoni fields

HYPOTHESIS

Surface tension gradient driven Marangoni flows originating from multiple sources are important to many industrial and medical applications, but the theoretical literature focuses on single surfactant sources. Understanding how two spreading surfactant sources interact allows insights from single source experiments to be applied to multi-source applications. Two key features of multi-source spreading - source translation and source deformation - can be explained by transport modeling of a two-source system.

MODELING

Numerical simulations of two oleic acid disks placed at varying initial separation distances on a glycerol subphase were performed using COMSOL Multiphysics and compared to spreading of a single surfactant source.

FINDINGS

Interaction of two spreading sources can be split into three regimes: the independent regime - where each source is unaffected by the other, the interaction regime - where the presence of a second source alters one or more features of the spreading dynamics, and the quasi-one disk regime - where the two sources merge together. The translation of the sources, manifested as increasing separation distance between disk centers of mass, is driven by the flow fields within the subphase and the resultant surface deformation, while deformation of the sources occurs only once the surfactant fronts of the two sources meet.

Repurposing mucosal delivery devices for live attenuated tuberculosis vaccines

Tuberculosis (TB) remains one of the most lethal infectious diseases globally. The only TB vaccine approved by the World Health Organization, Bacille Calmette-Guérin (BCG), protects children against severe and disseminated TB but provides limited protection against pulmonary TB in adults. Although several vaccine candidates have been developed to prevent TB and are undergoing preclinical and clinical testing, BCG remains the gold standard. Currently, BCG is administered as an intradermal injection, particularly in TB endemic countries. However, mounting evidence from experimental animal and human studies indicates that delivering BCG directly into the lungs provides enhanced immune responses and greater protection against TB. Inhalation therapy using handheld delivery devices is used for some diseases and allows the delivery of drugs or vaccines directly into the human respiratory tract. Whether this mode of delivery could also be applicable for live attenuated bacterial vaccines such as BCG or other TB vaccine candidates remains unknown. Here we discuss how two existing inhalation devices, the mucosal atomization device (MAD) syringe, used for influenza vaccines, and the Respimat® Soft Mist™ inhaler, used for chronic obstructive pulmonary disease (COPD) therapy, could be repurposed for mucosal delivery of live attenuated TB vaccines. We also outline the challenges and outstanding research questions that will require further investigations to ensure usefulness of respiratory delivery devices that are cost-effective and accessible to lower- and middle-income TB endemic countries.

Beyond the Interface: Improved Pulmonary Surfactant-Assisted Drug Delivery through Surface-Associated Structures

Pulmonary surfactant (PS) has been proposed as an efficient drug delivery vehicle for inhaled therapies. Its ability to adsorb and spread interfacially and transport different drugs associated with it has been studied mainly by different surface balance designs, typically interconnecting various compartments by interfacial paper bridges, mimicking in vitro the respiratory air-liquid interface. It has been demonstrated that only a monomolecular surface layer of PS/drug is able to cross this bridge. However, surfactant films are typically organized as multi-layered structures associated with the interface. The aim of this work was to explore the contribution of surface-associated structures to the spreading of PS and the transport of drugs. We have designed a novel vehiculization balance in which donor and recipient compartments are connected by a whole three-dimensional layer of liquid and not only by an interfacial bridge. By combining different surfactant formulations and liposomes with a fluorescent lipid dye and a model hydrophobic drug, budesonide (BUD), we observed that the use of the bridge significantly reduced the transfer of lipids and drug through the air-liquid interface in comparison to what can be spread through a fully open interfacial liquid layer. We conclude that three-dimensional structures connected to the surfactant interfacial film can provide an important additional contribution to interfacial delivery, as they are able to transport significant amounts of lipids and drugs during surfactant spreading.

Effect of a Surfactant Additive on Drug Transport and Distribution Uniformity After Aerosol Delivery to Ex Vivo Lungs

Background: Inhaled drug delivery can be limited by heterogeneous dose distribution. An additive that would disperse drug over the internal surfaces of the lung after aerosol deposition could improve dosing uniformity and increase the treated area. Our previous studies demonstrated that surfactant additives can produce surface tension-driven (Marangoni) flows that effectively dispersed aerosol-delivered drugs over mucus surfaces. Here we sought to determine whether the addition of a surfactant would increase transport of an aerosol between lung regions and also improve dosing uniformity in human lungs. Methods: We compared the deposition and postdeposition dispersion of surfactant (10 mg/mL dipalmitoylphosphatidylcholine; DPPC) and saline-based liquid aerosols, admixed with Technetium 99m (Tc99m) diethylenetriaminepentaacetic acid, using gamma scintigraphy. Deposition images were obtained ex vivo in eight pairs of ventilated human lungs. The trachea was intubated and the mainstem bronchi were alternately clamped so that saline was delivered to one lung and then DPPC to the other (sides alternated). The lungs were continually imaged for 15 minutes during delivery. We assessed transport of the deposited aerosol by quantifying the percentage of Tc99m in each of four lung quadrants over time. We quantified dose uniformity within each lung quadrant by measuring the coefficient of variation (CV = standard deviation of the pixel associated radioactive counts/mean of the counts within each quadrant). Results: There was no change in the percentage of Tc99m in each quadrant over time, indicating no improvement in transport with the addition of the surfactant. The addition of surfactant was associated with a statistically significant decrease in CV in the lower inner lung quadrant at each of the three time points, indicating an improvement in dosing uniformity. Conclusion: These preliminary results indicate the possible utility of adding surfactant to aerosols to improve drug distribution uniformity to lower inner lung regions.

Surfactant spreading on a deep subphase: Coupling of Marangoni flow and capillary waves

HYPOTHESIS

Surfactant-driven Marangoni spreading generates a fluid flow characterized by an outwardly moving "Marangoni ridge". Spreading on thin and/or high viscosity subphases, as most of the prior literature emphasizes, does not allow the formation of capillary waves. On deep, low viscosity subphases, Marangoni stresses may launch capillary waves coupled with the Marangoni ridge, and new dependencies emerge for key spreading characteristics on surfactant thermodynamic and kinetic properties.

EXPERIMENTS AND MODELING

Computational and physical experiments were performed using a broad range of surfactants to report the post-deposition motion of the surfactant front and the deformation of the subphase surface. Modeling coupled the Navier-Stokes and advective diffusion equations with an adsorption model. Separate experiments employed tracer particles or an optical density method to track surfactant front motion or surface deformation, respectively.

FINDINGS

Marangoni stresses on thick subphases induce capillary waves, the slowest of which is co-mingled with the Marangoni ridge. Changing Marangoni stresses by varying the surfactant system alters the surfactant front velocity and the amplitude - but not the velocity - of the slowest capillary wave. As spreading progresses, the surfactant front and its associated surface deformation separate from the slowest moving capillary wave.

Mucosal delivery of tuberculosis vaccines: a review of current approaches and challenges

Introduction: Tuberculosis (TB) remains a major health threat and it is now clear that the current vaccine, BCG, is unable to arrest the global TB epidemic. A new vaccine is needed to either replace or boost BCG so that a better level of protection could be achieved. The route of entry of Mycobacterium tuberculosis, the causative organism, is via inhalation making TB primarily a respiratory disease. There is therefore good reason to hypothesize that a mucosally delivered vaccine against TB could be more effective than one delivered via the systemic route.

Areas covered: This review summarizes the progress that has been made in the area of TB mucosal vaccines in the last few years. It highlights some of the strengths and shortcomings of the published evidence and aims to discuss immunological and practical considerations in the development of mucosal vaccines.

Expert opinion: There is a growing body of evidence that the mucosal approach to vaccination against TB is feasible and should be pursued. However, further key studies are necessary to both improve our understanding of the protective immune mechanisms operating in the mucosa and the technical aspects of aerosolized delivery, before such a vaccine could become a feasible, deployable strategy.

Flow regime transitions and effects on solute transport in surfactant-driven Marangoni flows

HYPOTHESIS

Surfactant-driven Marangoni flow on liquid films is predicted to depend on subphase depth and initial surface tension difference between the subphase and deposited surfactant solution drop. Changes in flow behavior will impact transport of soluble species entrained in the Marangoni flow along the surface. In extreme cases, the subphase film may rupture, limiting transport. Understanding this behavior is important for applications in drug delivery, coatings, and oil spill remediation.

EXPERIMENTS

A trans-illumination optical technique measured the subphase height profiles and drop content transport after drop deposition when varying initial subphase depth, surfactant concentration, and subphase viscosity.

FINDINGS

Three distinct flow regimes were identified depending on the subphase depth and surfactant concentration and mapped onto an operating diagram. These are characterized as a "central depression" bounded by an outwardly traveling ridge, an "annular depression" bounded by a central dome and the traveling ridge, and an "annular dewetting" when the subphase ruptures. Well above the critical micelle concentration, transitions between regimes occur at characteristic ratios of gravitational and initial surface tension gradient stresses; transitions shift when surfactant dilution during spreading weakens the stress before the completion of the spreading event. Drop contents travel with the ridge, but dewetting hinders transport.

Surfactant-induced Marangoni transport of lipids and therapeutics within the lung

Understanding the fundamentals of surface transport on thin viscous films has important application in pulmonary drug delivery. The human lung contains a large-area interface between its complex fluid lining and inhaled air. Marangoni flows driven by surface tension gradients along this interface would promote enhanced distribution of inhaled therapeutics by carrying them from where they are deposited in the upper airways, along the fluid interface to deeper regions of the lung. Motivated by the potential to improve therapies for acute and chronic lung diseases, we review recent progress in modeling and experimental studies of Marangoni transport induced by the deposition of surfactant-containing microliter drops and liquid aerosols (picoliter drops) onto a fluid interface. The roles of key system variables are identified, including surfactant solubility, drop miscibility with the subphase, and the thickness, composition and surface properties of the subphase liquid. Of particular interest is the unanticipated but crucial role of aerosol processing to achieve Marangoni transport via phospholipid vesicle dispersions, which are likely candidates for a biocompatible delivery system. Progress in this field has the potential to not only improve outcomes in patients with chronic and acute lung diseases, but also to further our understanding of surface transport in complex systems.

Aerosolizing Lipid Dispersions Enables Antibiotic Transport Across Mimics of the Lung Airway Surface Even in the Presence of Pre-existing Lipid Monolayers

BACKGROUND

Secondary lung infections are the primary cause of morbidity associated with cystic fibrosis lung disease. Aerosolized antibiotic inhalation is potentially advantageous but has limited effectiveness due to altered airway aerodynamics and deposition patterns that limit drug access to infected regions. One potential strategy to better reach infected areas is to formulate aerosols with surfactants that induce surface tension gradients and drive postdeposition drug dispersal via Marangoni transport along the airway surface liquid (ASL). Since this relies on surfactant-induced surface tension reduction, the presence of endogenous lipid monolayers may hinder drug dispersal performance.

METHODS

Tobramycin solutions were formulated with dipalmitoylphosphatidylcholine (DPPC), a major component of endogenous pulmonary surfactant, to drive postdeposition aerosol dispersal across a model ASL based on a liquid layer or "subphase" of aqueous porcine gastric mucin (PGM) solution with predeposited DPPC monolayers to mimic the endogenous surfactant. In vitro subphase samples were collected from regions outside the aerosol deposition zone and assayed for tobramycin concentration using a closed enzyme donor immunoassay. The motion of a tracking bead across the subphase surface and the corresponding decrease in surface tension on aerosol deposition were tracked both with and without a predeposited DPPC monolayer. The surface tension/area isotherm for DPPC on PGM solution subphase was measured to aid in the interpretation of the tobramycin dispersal behavior.

RESULTS AND CONCLUSIONS

Transport of tobramycin away from the deposition region occurs in aerosols formulated with DPPC whether or not predeposited lipid is present, and tobramycin concentrations are similar in both cases across biologically relevant length scales (∼8 cm). When DPPC is deposited from an aerosol, it induces ultralow surface tensions (<5 mN/m), which drive Marangoni flows, even in the presence of a dense background layer of DPPC. Therefore, aerosolized phospholipids, such as DPPC, will likely be effective spreading agents in the human lung.

Enabling Marangoni flow at air-liquid interfaces through deposition of aerosolized lipid dispersions

It has long been known that deposited drops of surfactant solution induce Marangoni flows at air-liquid interfaces. These surfactant drops create a surface tension gradient, which causes an outward flow at the fluid interface. We show that aqueous phospholipid dispersions may be used for this same purpose. In aqueous dispersions, phospholipids aggregate into vesicles that are not surface-active; therefore, drops of these dispersions do not initiate Marangoni flow. However, aerosolization of these dispersions disrupts the vesicles, allowing access to the surface-active monomers within. These lipid monomers do have the ability to induce Marangoni flow. We hypothesize that monomers released from broken vesicles adsorb on the surfaces of individual aerosol droplets and then create localized surface tension reduction upon droplet deposition. Deposition of lipid monomers via aerosolization produces surface tensions as low as 1mN/m on water. In addition, aerosolized lipid deposition also drives Marangoni flow on entangled polymer solution subphases with low initial surface tensions (∼34mN/m). The fact that aerosolization of phospholipids naturally found within pulmonary surfactant can drive Marangoni flows on low surface tension liquids suggests that aerosolized lipids may be used to promote uniform pulmonary drug delivery without the need for exogenous spreading agents.

Transport of a partially wetted particle at the liquid/vapor interface under the influence of an externally imposed surfactant generated Marangoni stress

Marangoni flows offer an interesting and useful means to transport particles at fluid interfaces with potential applications such as dry powder pulmonary drug delivery. In this article, we investigate the transport of partially wetted particles at a liquid/vapor interface under the influence of Marangoni flows driven by gradients in the surface excess concentration of surfactants. We deposit a microliter drop of soluble (sodium dodecyl sulfate aqueous solution) surfactant solution or pure insoluble liquid (oleic acid) surfactant on a water subphase and observe the transport of a pre-deposited particle. Following the previous observation by Wang et al. [1] that a surfactant front rapidly advances ahead of the deposited drop contact line initiates particle motion but then moves beyond the particle, we now characterize the two dominant, time- and position-dependent forces acting on the moving particle: 1) a surface tension force acting on the three-phase contact line around the particle periphery due to the surface tension gradient at the liquid/vapor interface which always accelerates the particle and 2) a viscous force acting on the immersed surface area of the particle which accelerates or decelerates the particle depending on the difference in the velocities of the liquid and particle. We find that the particle velocity evolves over time in two regimes. In the acceleration regime, the net force on the particle acts in the direction of particle motion, and the particle quickly accelerates and reaches a maximum velocity. In the deceleration regime, the net force on the particle reverses and the particle decelerates gradually and stops. We identify the parameters that affect the two forces acting on the particle, including the initial particle position relative to the surfactant drop, particle diameter, particle wettability, subphase thickness, and surfactant solubility. We systematically vary these parameters and probe the spatial and temporal evolution of the two forces acting on the particle as it moves along its trajectory in both regimes. We find that a larger particle always lags behind the smaller particle when placed at an equal initial distance from the drop. Similarly, particles more deeply engulfed in the subphase lag behind those less deeply engulfed. Further, the extent of particle transport is reduced as the subphase thickness decreases, due to the larger velocity gradients in the subphase recirculation flows.

Influence of the Surfactant Tyloxapol on Mucociliary Clearance in Human Respiratory Cystic Fibrosis Cells

Dehydration of the apical surface of cystic fibrosis (CF) airway epithelia leads to a greatly impaired mucociliary clearance function in CF patients. In an in vitro cell model of human airway epithelia taken from CF patients and cultivated for 60 days, mucociliary clearance was zero. Tyloxapol, a synthetic surfactant, is able to restore the mucociliary clearance of the CF epithelia. The velocity of mucociliary clearance, using polystyrene microbeads as markers, increased within the first minute of tyloxapol treatment from zero to 12 µm/s and reached a maximum of 22 µm/s after 120 min. In conclusion, tyloxapol restores mucociliary clearance in a MucilAir™-CF model and may accordingly be efficient in CF patients to restore mucociliary clearance.

Computational Models of Inhalation Therapy in Early Childhood: Therapeutic Aerosols in the Developing Acinus

BACKGROUND

Inhalation therapy targeted to the deep alveolated regions holds great promise, specifically in pediatric populations. Yet, inhalation devices and medical protocols are overwhelmingly derived from adult guidelines, with very low therapeutic efficiency in young children. During the first years of life, airway remodeling and changing ventilation patterns are anticipated to alter aerosol deposition with underachieving outcomes in infants. As past research is still overwhelmingly focused on adults or limited to models of upper airways, a fundamental understanding of inhaled therapeutic transport and deposition in the acinar regions is needed to shed light on delivering medication to the developing alveoli.

METHODS

Using computational fluid dynamics (CFD), we simulated inhalation maneuvers in anatomically-inspired models of developing acinar airways, covering the distinct phases of lung development, from underdeveloped, saccular pulmonary architectures in infants, to structural changes in toddlers, ultimately mimicking space-filling morphologies of a young child, representing scaled-down adult lungs. We model aerosols whose diameters span the range of sizes acknowledged to reach the alveolar regions and examine the coupling between morphological changes, varying ventilation patterns and particle characteristics on deposition outcomes.

RESULTS

Spatial distributions of deposited particles point to noticeable changes in the patterns of aerosol deposition with age, in particular in the youngest age group examined (3 month). Total deposition efficiency, as well as deposition dispersion, vary not only with the phases of lung development but also and critically with aerosol diameter.

CONCLUSIONS

Given the various challenges when prescribing inhalation therapy to a young infant, our findings underline some mechanistic aspects to consider when targeting medication to the developing alveoli. Not only does the intricate coupling between acinar morphology and ventilation patterns need to be considered, but the physical properties (i.e., aerodynamic size) of therapeutic aerosols also closely affect the anticipated success rates of the inhaled medication.