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Seifelnasr A, Zare F, Si XA, Xi J. Optimized gravity-driven intranasal drop administration delivers significant doses to the ostiomeatal complex and maxillary sinus. Drug Deliv Transl Res 2024; 14:1839-1859. [PMID: 38044376 DOI: 10.1007/s13346-023-01488-4] [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] [Accepted: 11/23/2023] [Indexed: 12/05/2023]
Abstract
Chronic and allergic rhinosinusitis impacts approximately 12% of the global population. Challenges in rhinosinusitis treatment include paranasal sinus inaccessibility and variability in delivery efficiency among individuals. This study addresses these challenges of drug delivery by developing a high-efficiency, low-variability protocol for nasal drop delivery to the ostiomeatal complex (OMC) and maxillary sinus. Patient-specific nasal casts were dissected to reveal the configurations of conchae and meatus, providing insights into anatomical features amendable for sinus delivery. Fluorescent dye-enhanced videos visualized the dynamic liquid translocation in transparent nasal casts, allowing real-time assessment and quick adjustment to delivery parameters. Dosimetry to the OMC and maxillary sinus were quantified as drop count and mass using a precision scale. Key delivery factors, including the device type, formulation, and head-chin orientation, were systematically investigated in a cohort of ten nasal casts. Results show that both the squeeze bottle and soft-mist nasal pump yielded notably low doses to the OMC with high variability, and no dose from these two devices was detected within the maxillary sinuses. In contrast, the proposed approach, which included a curved nozzle surpassing the nasal valve and leveraged gravity-driven liquid translocation along the lateral nasal wall, delivered significant doses to the OMC and maxillary sinus. Iterative experimentations identified the optimal head tilt to be 40° and chin tilt to be° from the lateral recumbent position. Statistical analyses established the drop count required for effective OMC/sinus delivery. The proposed delivery protocol holds the potential to enhance chronic rhinosinusitis treatment outcomes with low variability. The dual role of nasal anatomy in posing challenges and offering opportunities highlights the need for future investigations using diverse formulations in a larger cohort of nasal models.
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Affiliation(s)
- Amr Seifelnasr
- Department of Biomedical Engineering, University of Massachusetts, 1 University Ave., Falmouth Hall 302I, Lowell, MA, 01854, USA
| | - Farhad Zare
- Department of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Xiuhua April Si
- Department of Mechanical Engineering, California Baptist University, Riverside, CA, USA
| | - Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, 1 University Ave., Falmouth Hall 302I, Lowell, MA, 01854, USA.
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2
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Hu Z, Cheng S, Sun S, Wang Y, Lou M, Ma R, Gong M, Yang F, Zheng G, Zhang Y, Dong J. Numerical and experimental evaluation of nasopharyngeal aerosol administration methods in children with adenoid hypertrophy. Int J Pharm 2024; 653:123906. [PMID: 38365069 DOI: 10.1016/j.ijpharm.2024.123906] [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: 11/13/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
Administering aerosol drugs through the nasal pathway is a common early treatment for children with adenoid hypertrophy (AH). To enhance therapeutic efficacy, a deeper understanding of nasal drug delivery in the nasopharynx is essential. This study uses an integrated experimental, numerical modelling approach to investigate the delivery process of both the aerosol mask delivery system (MDS) and the bi-directional delivery system (BDS) in the pediatric nasal airway with AH. The combined effect of respiratory flow rates and particle size on delivery efficiency was systematically analyzed. The results showed that the nasopharyngeal peak deposition efficiency (DE) for BDS was approximately 2.25-3.73 times higher than that for MDS under low-flow, resting and high-flow respiratory conditions. Overall nasopharyngeal DEs for MDS were at a low level of below 16 %. For each respiratory flow rate, the BDS tended to achieve higher peak DEs (36.36 % vs 9.74 %, 37.80 % vs 14.01 %, 34.58 % vs 15.35 %) at smaller particle sizes (15 µm vs 17 µm, 10 µm vs 14 µm, 6 µm vs 9 µm). An optimal particle size exists for each respiratory flow rate, maximizing the drug delivery efficiency to the nasopharynx. The BDS is more effective in delivering drug aerosols to the nasal cavity and nasopharynx, which is crucial for early intervention in children with AH.
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Affiliation(s)
- Zhenzhen Hu
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; School of Engineering, RMIT University, Bundoora, VIC 3083, Australia; Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC 8001, Australia
| | - Shaokoon Cheng
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Siping Sun
- Zhejiang Cuize Pharmtech Co. Ltd., Hangzhou, Zhejiang 310000, China
| | - Yusheng Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Miao Lou
- Department of Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
| | - Ruiping Ma
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Minjie Gong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Feilun Yang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Guoxi Zheng
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Ya Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
| | - Jingliang Dong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC 8001, Australia; First Year College, Victoria University, Footscray Park Campus, Footscray, VIC 3011, Australia.
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Zhang MX, Verhoeven F, Ravensbergen P, Kooij S, Geoffrion R, Bonn D, van Rijn CJM. Improved Olfactory Deposition of Theophylline Using a Nanotech Soft Mist Nozzle Chip. Pharmaceutics 2023; 16:2. [PMID: 38276480 PMCID: PMC10821129 DOI: 10.3390/pharmaceutics16010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Currently, nasal administration of active pharmaceutical ingredients is most commonly performed using swirl-nozzle-based pump devices or pressurized syringes. However, they lead to limited deposition in the more active regions of the nasal cavity, especially the olfactory region, which is crucial for nose-to-brain drug delivery. This research proposes to improve deposition in the olfactory region by replacing the swirl nozzle with a nanoengineered nozzle chip containing micrometer-sized holes, which generates smaller droplets of 10-50 μm travelling at a lower plume velocity. Two nanotech nozzle chips with different hole sizes were tested at different inhalation flow rates to examine the deposition patterns of theophylline, a hyposmia treatment formulation, using a nasal cavity model. A user study was also conducted and showed that the patient instructions influenced the inhalation flow rate characteristics. Targeted flow rates of between 0 and 25 L/min were used for the in vitro deposition study, yielding 21.5-31.5% olfactory coverage. In contrast, the traditional swirl nozzle provided only 10.8% coverage at a similar flow rate. This work highlights the potential of the nanotech soft mist nozzle for improved intranasal drug delivery, particularly to the olfactory region.
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Affiliation(s)
- Madeline X. Zhang
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, 1098 XH Amsterdam, The Netherlands; (S.K.); (D.B.); (C.J.M.v.R.)
| | - Frank Verhoeven
- Medspray B.V., 7521 PV Enschede, The Netherlands; (F.V.); (P.R.)
| | | | - Stefan Kooij
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, 1098 XH Amsterdam, The Netherlands; (S.K.); (D.B.); (C.J.M.v.R.)
| | | | - Daniel Bonn
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, 1098 XH Amsterdam, The Netherlands; (S.K.); (D.B.); (C.J.M.v.R.)
| | - Cees J. M. van Rijn
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, 1098 XH Amsterdam, The Netherlands; (S.K.); (D.B.); (C.J.M.v.R.)
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4
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Liu Y, Wu D. Bi-directional nasal drug delivery systems: A scoping review of nasal particle deposition patterns and clinical application. Laryngoscope Investig Otolaryngol 2023; 8:1484-1499. [PMID: 38130248 PMCID: PMC10731484 DOI: 10.1002/lio2.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/24/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives To compare the deposition patterns within the nasal cavity between the bi-directional and unilateral nasal delivery systems. And to summarize the clinical application of the bi-directional nasal drug delivery devices. Data source PubMed, Cochrane Library, Embase, and Web of Science databases. Methods A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We included studies exploring patterns and influencing factors of particle depositions within the nasal cavity among patients, healthy controls, and nose cast models using the bi-directional and unilateral nasal delivery system. The clinical application of the bi-directional delivery devices was also summarized. Results A total of 24 studies were included in this review. Bi-directional nasal delivery systems utilize forced exhalation to power the delivery of drugs to deeper areas of the nasal cavity and paranasal sinuses. Unilateral nasal delivery systems included traditional liquid spray pumps, the aerosol mask system, nebulization, and conventional nasal inhalation. Compared with unilateral delivery systems, the bi-directional nasal delivery system provided a more extensive and efficient nasal deposition in the nasal cavity, especially in the olfactory cleft, without lung deposition. Several parameters, including particle size, pulsatile flow, and nasal geometry, could significantly influence nasal deposition. The bi-directional nasal delivery system enables better delivery of steroids or sumatriptan to the sinonasal cavity's high and deep target sites. This bi-directional delivery device demonstrated an effective and well-tolerated treatment that produced high drug utilization, rapid absorption, and sustained symptom improvement among patients with chronic rhinosinusitis (CRS) or migraine. Conclusion The bi-directional nasal drug delivery systems demonstrated significantly higher drug deposition in superior and posterior regions of the nasal cavity than unilateral nasal delivery systems. Further studies should explore its potential role in delivering drugs to the olfactory cleft among patients with olfactory disorders and central nervous system diseases. Level of evidence N/A.
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Affiliation(s)
- Yuxing Liu
- Department of Otolaryngology‐Head and Neck SurgeryPeking University Third HospitalBeijingPR China
- Department of MedicinePeking UniversityBeijingPR China
| | - Dawei Wu
- Department of Otolaryngology‐Head and Neck SurgeryPeking University Third HospitalBeijingPR China
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Doub WH, Suman JM, Copley M, Goodey AP, Hosseini S, Mitchell JP. Laboratory Performance Testing of Aqueous Nasal Inhalation Products for Droplet/Particle Size Distribution: an Assessment from the International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS). AAPS PharmSciTech 2023; 24:208. [PMID: 37817001 DOI: 10.1208/s12249-023-02665-x] [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: 06/09/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
Although nasal inhalation products are becoming more and more important for the delivery of medicines, characterization of these products for quality control and assessment of bioequivalence is complicated. Most of the problems encountered are associated with the assessment of aerodynamic droplet/particle size distribution (APSD). The droplets produced by the various nasal devices are large, and for suspension products, individual droplets may contain multiple drug particles or none at all. Assessment of suspension products is further complicated by the presence of solid excipient particles. These complications make it imperative that the limitations of the instruments used for characterization as well as the underlying assumptions that govern the interpretation of data produced by these instruments are understood. In this paper, we describe various methodologies used to assess APSD for nasal inhalation products and discuss proper use, limitations, and new methodologies on the horizon.
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Affiliation(s)
- William H Doub
- OINDP In Vitro Analysis, 1430 Neffwold Ln, Kirkwood, Missouri, 63122, USA.
| | | | | | | | | | - Jolyon P Mitchell
- Jolyon Mitchell Inhaler Consulting Services Inc, 1154 St. Anthony Road, London, Ontario, N6H2R1, Canada
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Boyuklieva R, Zagorchev P, Pilicheva B. Computational, In Vitro, and In Vivo Models for Nose-to-Brain Drug Delivery Studies. Biomedicines 2023; 11:2198. [PMID: 37626694 PMCID: PMC10452071 DOI: 10.3390/biomedicines11082198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
Direct nose-to-brain drug delivery offers the opportunity to treat central nervous system disorders more effectively due to the possibility of drug molecules reaching the brain without passing through the blood-brain barrier. Such a delivery route allows the desired anatomic site to be reached while ensuring drug effectiveness, minimizing side effects, and limiting drug losses and degradation. However, the absorption of intranasally administered entities is a complex process that considerably depends on the interplay between the characteristics of the drug delivery systems and the nasal mucosa. Various preclinical models (in silico, in vitro, ex vivo, and in vivo) are used to study the transport of drugs after intranasal administration. The present review article attempts to summarize the different computational and experimental models used so far to investigate the direct delivery of therapeutic agents or colloidal carriers from the nasal cavity to the brain tissue. Moreover, it provides a critical evaluation of the data available from different studies and identifies the advantages and disadvantages of each model.
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Affiliation(s)
- Radka Boyuklieva
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Research Institute, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Plamen Zagorchev
- Research Institute, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Department of Medical Physics and Biophysics, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
| | - Bissera Pilicheva
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Research Institute, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
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7
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Xi J, Si XA, Malvè M. Nasal anatomy and sniffing in respiration and olfaction of wild and domestic animals. Front Vet Sci 2023; 10:1172140. [PMID: 37520001 PMCID: PMC10375297 DOI: 10.3389/fvets.2023.1172140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Animals have been widely utilized as surrogate models for humans in exposure testing, infectious disease experiments, and immunology studies. However, respiratory diseases affect both humans and animals. These disorders can spontaneously affect wild and domestic animals, impacting their quality and quantity of life. The origin of such responses can primarily be traced back to the pathogens deposited in the respiratory tract. There is a lack of understanding of the transport and deposition of respirable particulate matter (bio-aerosols or viruses) in either wild or domestic animals. Moreover, local dosimetry is more relevant than the total or regionally averaged doses in assessing exposure risks or therapeutic outcomes. An accurate prediction of the total and local dosimetry is the crucial first step to quantifying the dose-response relationship, which in turn necessitates detailed knowledge of animals' respiratory tract and flow/aerosol dynamics within it. In this review, we examined the nasal anatomy and physiology (i.e., structure-function relationship) of different animals, including the dog, rat, rabbit, deer, rhombus monkey, cat, and other domestic and wild animals. Special attention was paid to the similarities and differences in the vestibular, respiratory, and olfactory regions among different species. The ventilation airflow and behaviors of inhaled aerosols were described as pertinent to the animals' mechanisms for ventilation modulation and olfaction enhancement. In particular, sniffing, a breathing maneuver that animals often practice enhancing olfaction, was examined in detail in different animals. Animal models used in COVID-19 research were discussed. The advances and challenges of using numerical modeling in place of animal studies were discussed. The application of this technique in animals is relevant for bidirectional improvements in animal and human health.
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Affiliation(s)
- Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA, United States
| | - Xiuhua April Si
- Department of Mechanical Engineering, California Baptist University, Riverside, CA, United States
| | - Mauro Malvè
- Department of Engineering, Public University of Navarre, Pamplona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
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8
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Seifelnasr A, Si XA, Xi J. Visualization and Estimation of Nasal Spray Delivery to Olfactory Mucosa in an Image-Based Transparent Nasal Model. Pharmaceutics 2023; 15:1657. [PMID: 37376105 DOI: 10.3390/pharmaceutics15061657] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/25/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Nose-to-brain (N2B) drug delivery offers unique advantages over intravenous methods; however, the delivery efficiency to the olfactory region using conventional nasal devices and protocols is low. This study proposes a new strategy to effectively deliver high doses to the olfactory region while minimizing dose variability and drug losses in other regions of the nasal cavity. Materials and Methods: The effects of delivery variables on the dosimetry of nasal sprays were systematically evaluated in a 3D-printed anatomical model that was generated from a magnetic resonance image of the nasal airway. The nasal model comprised four parts for regional dose quantification. A transparent nasal cast and fluorescent imaging were used for visualization, enabling detailed examination of the transient liquid film translocation, real-time feedback on input effect, and prompt adjustment to delivery variables, which included the head position, nozzle angle, applied dose, inhalation flow, and solution viscosity. Results: The results showed that the conventional vertex-to-floor head position was not optimal for olfactory delivery. Instead, a head position tilting 45-60° backward from the supine position gave a higher olfactory deposition and lower variability. A two-dose application (250 mg) was necessary to mobilize the liquid film that often accumulated in the front nose following the first dose administration. The presence of an inhalation flow reduced the olfactory deposition and redistributed the sprays to the middle meatus. The recommended olfactory delivery variables include a head position ranging 45-60°, a nozzle angle ranging 5-10°, two doses, and no inhalation flow. With these variables, an olfactory deposition fraction of 22.7 ± 3.7% was achieved in this study, with insignificant discrepancies in olfactory delivery between the right and left nasal passages. Conclusions: It is feasible to deliver clinically significant doses of nasal sprays to the olfactory region by leveraging an optimized combination of delivery variables.
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Affiliation(s)
- Amr Seifelnasr
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
| | - Xiuhua April Si
- Department of Mechanical Engineering, California Baptist University, Riverside, CA 92504, USA
| | - Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
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9
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Targeted drug delivery with polydisperse particle transport and deposition in patient-specific upper airway during inhalation and exhalation. Respir Physiol Neurobiol 2023; 308:103986. [PMID: 36396028 DOI: 10.1016/j.resp.2022.103986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
Identifying the deposition pattern of inhaled pharmaceutical aerosols in the human respiratory system and understanding the effective parameters in this process is vital for more efficient drug delivery to this region. This study investigated aerosol deposition in a patient-specific upper respiratory airway and determined the deposition fraction (DF) and pressure drop across the airway. An experimental setup was developed to measure the pressure drop in the same realistic geometry printed from the patient-specific geometry. The unsteady simulations were performed with a flow rate of 15 L/min and different particle diameters ranging from 2 to 30 µm. The results revealed significant flow circulation after the nasal valve in the upper and oropharynx regions, and a maximum local velocity observed in the nasopharynx. Transient cumulative deposition fraction showed that after 2 s of the simulation, all particles deposit or escape the computational domain. About 30 % of the injected large particles (dp ≥ 20 µm) deposited in the first 1 cm away from the nostril and more than 95 % deposited in the nasal airway before entering the oropharynx region. While almost 94 % deposition in trachea was composed of particles smaller than 5 µm. Approximately 20 % of inhaled fine particles (2-5 µm) deposited in the upper airway and the rest deposited in oropharynx, larynx and trachea.
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10
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Seifelnasr A, Talaat M, Ramaswamy P, Si XA, Xi J. A Supine Position and Dual-Dose Applications Enhance Spray Dosing to the Posterior Nose: Paving the Way for Mucosal Immunization. Pharmaceutics 2023; 15:pharmaceutics15020359. [PMID: 36839681 PMCID: PMC9967276 DOI: 10.3390/pharmaceutics15020359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/22/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Delivering vaccines to the posterior nose has been proposed to induce mucosal immunization. However, conventional nasal devices often fail to deliver sufficient doses to the posterior nose. This study aimed to develop a new delivery protocol that can effectively deliver sprays to the caudal turbinate and nasopharynx. High-speed imaging was used to characterize the nasal spray plumes. Three-dimensional-printed transparent nasal casts were used to visualize the spray deposition within the nasal airway, as well as the subsequent liquid film formation and translocation. Influencing variables considered included the device type, delivery mode, release angle, flow rate, head position, and dose number. Apparent liquid film translocation was observed in the nasal cavity. To deliver sprays to the posterior nose, the optimal release angle was found to be 40° for unidirectional delivery and 30° for bidirectional delivery. The flow shear was the key factor that mobilized the liquid film. Both the flow shear and the head position were important in determining the translocation distance. A supine position and dual-dose application significantly improved delivery to the nasopharynx, i.e., 31% vs. 0% with an upright position and one-dose application. It is feasible to effectively deliver medications to the posterior nose by leveraging liquid film translocation for mucosal immunization.
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Affiliation(s)
- Amr Seifelnasr
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
| | - Mohamed Talaat
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
| | - Pranav Ramaswamy
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
| | - Xiuhua April Si
- Department of Mechanical Engineering, California Baptist University, Riverside, CA 92504, USA
| | - Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA
- Correspondence: ; Tel.: +1-978-934-3259
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11
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Perkušić M, Nižić Nodilo L, Ugrina I, Špoljarić D, Jakobušić Brala C, Pepić I, Lovrić J, Matijašić G, Gretić M, Zadravec D, Kalogjera L, Hafner A. Tailoring functional spray-dried powder platform for efficient donepezil nose-to-brain delivery. Int J Pharm 2022; 624:122038. [PMID: 35870666 DOI: 10.1016/j.ijpharm.2022.122038] [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: 04/29/2022] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
Shortcomings of oral donepezil administration in the treatment of Alzheimer's disease have paved the way for ongoing investigations towards more efficient and safe donepezil nose-to-brain delivery. Herein we present the development of advantageous powder platform for donepezil nose-to-brain delivery, coupling careful design of chitosan and mannitol-based carrier matrix with spray-drying technology advantages and early consideration of adequate nasal administration mode, employing QbD approach. Unprecedentedly, ultrasonic nozzle was used to atomise the drying feed in response to size-related requirements for nasal aerosol particles. The optimised spray-drying process resulted in free-flowable dry powder with a great majority of particles larger than 10 µm, ensuring localised nasal deposition upon aerosolization, as evidenced by using 3D-printed nasal cavity model. QbD approach coupling formulation, process and administration parameters enabled optimisation of drug deposition profile reaching tremendously high 65.5 % of the applied dose deposited in the olfactory region. The leading formulation exhibited favourable swelling, mucoadhesion, drug release and permeation-enhancing properties, suiting the needs for efficient brain-targeted delivery. Results of in vitro biocompatibility and physico-chemical stability studies confirmed the leading formulation potential for safe and efficient donepezil nose-to-brain delivery. The obtained results encourage extending the study to an appropriate in vivo model needed for the final proof-of-concept.
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Affiliation(s)
- Mirna Perkušić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Laura Nižić Nodilo
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | | | | | | | - Ivan Pepić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Jasmina Lovrić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Gordana Matijašić
- University of Zagreb, Faculty of Chemical Engineering and Technology, Zagreb, Croatia
| | - Matija Gretić
- Genera, Inc., Part of Dechra Pharmaceuticals PLC Group, Rakov Potok, Croatia
| | - Dijana Zadravec
- Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Center, University of Zagreb, Zagreb, Croatia
| | - Livije Kalogjera
- ENT Department, Zagreb School of Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Anita Hafner
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia.
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12
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Rigaut C, Deruyver L, Goole J, Haut B, Lambert P. Instillation of a Dry Powder in Nasal Casts: Parameters Influencing the Olfactory Deposition With Uni- and Bi-Directional Devices. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 4:924501. [PMID: 35832236 PMCID: PMC9273033 DOI: 10.3389/fmedt.2022.924501] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/26/2022] [Indexed: 01/04/2023] Open
Abstract
Nose-to-brain delivery is a promising way to reach the central nervous system with therapeutic drugs. However, the location of the olfactory region at the top of the nasal cavity complexifies this route of administration. In this study, we used a 3D-printed replica of a nasal cavity (a so-called “nasal cast”) to reproduce in vitro the deposition of a solid powder. We considered two different delivery devices: a unidirectional device generating a classical spray and a bidirectional device that relies on the user expiration. A new artificial mucus also coated the replica. Five parameters were varied to measure their influence on the powder deposition pattern in the olfactory region of the cast: the administration device, the instillation angle and side, the presence of a septum perforation, and the flow rate of possible concomitant inspiration. We found that the unidirectional powder device is more effective in targeting the olfactory zone than the bi-directional device. Also, aiming the spray nozzle directly at the olfactory area is more effective than targeting the center of the nasal valve. Moreover, the choice of the nostril and the presence of a perforation in the septum also significantly influence the olfactory deposition. On the contrary, the inspiratory flow has only a minor effect on the powder outcome. By selecting the more efficient administration device and parameters, 44% of the powder can reach the olfactory region of the nasal cast.
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Affiliation(s)
- Clément Rigaut
- Transfers, Interfaces and Processes (TIPs), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Laura Deruyver
- Laboratoire de Pharmacie Galénique et Biopharmacie, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium
| | - Jonathan Goole
- Laboratoire de Pharmacie Galénique et Biopharmacie, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium
| | - Benoît Haut
- Transfers, Interfaces and Processes (TIPs), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Pierre Lambert
- Transfers, Interfaces and Processes (TIPs), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
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13
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Parvez S, Kaushik M, Ali M, Alam MM, Ali J, Tabassum H, Kaushik P. Dodging blood brain barrier with "nano" warriors: Novel strategy against ischemic stroke. Theranostics 2022; 12:689-719. [PMID: 34976208 PMCID: PMC8692911 DOI: 10.7150/thno.64806] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/14/2021] [Indexed: 12/13/2022] Open
Abstract
Ischemic stroke (IS) is one of the leading causes of death and disability resulting in inevitable burden globally. Ischemic injury initiates cascade of pathological events comprising energy dwindling, failure of ionic gradients, failure of blood brain barrier (BBB), vasogenic edema, calcium over accumulation, excitotoxicity, increased oxidative stress, mitochondrial dysfunction, inflammation and eventually cell death. In spite of such complexity of the disease, the only treatment approved by US Food and Drug Administration (FDA) is tissue plasminogen activator (t-PA). This therapy overcome blood deficiency in the brain along with side effects of reperfusion which are responsible for considerable tissue injury. Therefore, there is urgent need of novel therapeutic perspectives that can protect the integrity of BBB and salvageable brain tissue. Advancement in nanomedicine is empowering new approaches that are potent to improve the understanding and treatment of the IS. Herein, we focus nanomaterial mediated drug delivery systems (DDSs) and their role to bypass and cross BBB especially via intranasal drug delivery. The various nanocarriers used in DDSs are also discussed. In a nut shell, the objective is to provide an overview of use of nanomedicine in the diagnosis and treatment of IS to facilitate the research from benchtop to bedside.
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14
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Farnoud A, Tofighian H, Baumann I, Martin AR, Rashidi MM, Menden MP, Schmid O. Pulsatile Bi-Directional Aerosol Flow Affects Aerosol Delivery to the Intranasal Olfactory Region: A Patient-Specific Computational Study. Front Pharmacol 2021; 12:746420. [PMID: 34887754 PMCID: PMC8650014 DOI: 10.3389/fphar.2021.746420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
The nasal olfactory region is a potential route for non-invasive delivery of drugs directly from the nasal epithelium to the brain, bypassing the often impermeable blood-brain barrier. However, efficient aerosol delivery to the olfactory region is challenging due to its location in the nose. Here we explore aerosol delivery with bi-directional pulsatile flow conditions for targeted drug delivery to the olfactory region using a computational fluid dynamics (CFD) model on the patient-specific nasal geometry. Aerosols with aerodynamic diameter of 1 µm, which is large enough for delivery of large enough drug doses and yet potentially small enough for non-inertial aerosol deposition due to, e.g., particle diffusion and flow oscillations, is inhaled for 1.98 s through one nostril and exhaled through the other one. The bi-directional aerosol delivery with steady flow rate of 4 L/min results in deposition efficiencies (DEs) of 50.9 and 0.48% in the nasal cavity and olfactory region, respectively. Pulsatile flow with average flow rate of 4 L/min (frequency: 45 Hz) reduces these values to 34.4 and 0.12%, respectively, and it mitigates the non-uniformity of right-left deposition in both the cavity (from 1.77- to 1.33-fold) and the olfactory region (from 624- to 53.2-fold). The average drug dose deposited in the nasal cavity and the olfactory epithelium region is very similar in the right nasal cavity independent of pulsation conditions (inhalation side). In contrast, the local aerosol dose in the olfactory region of the left side is at least 100-fold lower than that in the nasal cavity independent of pulsation condition. Hence, while pulsatile flow reduces the right-left (inhalation-exhalation) imbalance, it is not able to overcome it. However, the inhalation side (even with pulsation) allows for relatively high olfactory epithelium drug doses per area reaching the same level as in the total nasal cavity. Due to the relatively low drug deposition in olfactory region on the exhalation side, this allows either very efficient targeting of the inhalation side, or uniform drug delivery by performing bidirectional flow first from the one and then from the other side of the nose.
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Affiliation(s)
- Ali Farnoud
- Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany.,Comprehensive Pneumology Center, Member of the German Center for Lung Research, Munich, Germany.,Institute of Lung Biology and Disease, Helmholtz Zentrum München, Munich, Germany
| | - Hesam Tofighian
- Mechanical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Ingo Baumann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center of Heidelberg University, Heidelberg, Germany
| | - Andrew R Martin
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Mohammad M Rashidi
- Institute of Fundamental and Frontier Sciences, University of Electronics and Technology of China, Chengdu, China
| | - Micheal P Menden
- Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany.,Department of Biology, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Diabetes Research (DZD e.V.), Munich, Germany
| | - Otmar Schmid
- Comprehensive Pneumology Center, Member of the German Center for Lung Research, Munich, Germany.,Institute of Lung Biology and Disease, Helmholtz Zentrum München, Munich, Germany
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15
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Xi J, Lei LR, Zouzas W, April Si X. Nasally inhaled therapeutics and vaccination for COVID-19: Developments and challenges. MedComm (Beijing) 2021; 2:569-586. [PMID: 34977869 PMCID: PMC8706742 DOI: 10.1002/mco2.101] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 12/11/2022] Open
Abstract
The nose is the initial site of viral infection, replication, and transmission in the human body. Nasally inhaled vaccines may act as a promising alternative for COVID-19 management in addition to intramuscular vaccination. In this review, the latest developments of nasal sprays either as repurposed or antiviral formulations were presented. Nasal vaccines based on traditional medicines, such as grapefruit seed extract, algae-isolated carrageenan, and Yogurt-fermenting Lactobacillus, are promising and under active investigations. Inherent challenges that hinder effective intranasal delivery were discussed in detail, which included nasal device issues and human nose physiological complexities. We examined factors related to nasal spray administration, including the nasal angiotensin I converting enzyme 2 (ACE2) locations as the delivery target, nasal devices, medication translocation after application, delivery methods, safety issues, and other nasal delivery options. The effects of human factors on nasal spray efficacy, such as nasal physiology, disease-induced physiological modifications, intersubject variability, and mucociliary clearance, were also examined. Finally, the potential impact of nasal vaccines on COVID-19 management in the developing world was discussed. It is concluded that effective delivery of nasal sprays to ACE2-rich regions is urgently needed, especially in the context that new variants may become unresponsive to current vaccines and more refractory to existing therapies.
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Affiliation(s)
- Jinxiang Xi
- Department of Biomedical EngineeringUniversity of MassachusettsLowellMassachusettsUSA
| | - Lameng Ray Lei
- Amphastar Pharmaceuticals, IncRancho CucamongaCaliforniaUSA
| | - William Zouzas
- Department of Biomedical EngineeringUniversity of MassachusettsLowellMassachusettsUSA
| | - Xiuhua April Si
- Department of AerospaceIndustrial and Mechanical EngineeringCalifornia Baptist UniversityRiversideCaliforniaUSA
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16
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In Vitro Evaluation of Nasal Aerosol Depositions: An Insight for Direct Nose to Brain Drug Delivery. Pharmaceutics 2021; 13:pharmaceutics13071079. [PMID: 34371770 PMCID: PMC8309016 DOI: 10.3390/pharmaceutics13071079] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/25/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022] Open
Abstract
The nasal cavity is an attractive route for both local and systemic drug delivery and holds great potential for access to the brain via the olfactory region, an area where the blood–brain barrier (BBB) is effectively absent. However, the olfactory region is located at the roof of the nasal cavity and only represents ~5–7% of the epithelial surface area, presenting significant challenges for the deposition of drug molecules for nose to brain drug delivery (NTBDD). Aerosolized particles have the potential to be directed to the olfactory region, but their specific deposition within this area is confounded by a complex combination of factors, which include the properties of the formulation, the delivery device and how it is used, and differences in inter-patient physiology. In this review, an in-depth examination of these different factors is provided in relation to both in vitro and in vivo studies and how advances in the fabrication of nasal cast models and analysis of aerosol deposition can be utilized to predict in vivo outcomes more accurately. The challenges faced in assessing the nasal deposition of aerosolized particles within the paediatric population are specifically considered, representing an unmet need for nasal and NTBDD to treat CNS disorders.
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17
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Chen J, Martin AR, Finlay WH. Recent In Vitro and In Silico Advances in the Understanding of Intranasal Drug Delivery. Curr Pharm Des 2021; 27:1482-1497. [PMID: 33183191 DOI: 10.2174/1381612826666201112143230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Many drugs are delivered intranasally for local or systemic effect, typically in the form of droplets or aerosols. Due to the high cost of in vivo studies, drug developers and researchers often turn to in vitro or in silico testing when first evaluating the behavior and properties of intranasal drug delivery devices and formulations. Recent advances in manufacturing and computer technologies have allowed for increasingly realistic and sophisticated in vitro and in silico reconstructions of the human nasal airways. OBJECTIVE The study aims to perform a summary of advances in the understanding of intranasal drug delivery based on recent in vitro and in silico studies. CONCLUSION The turbinates are a common target for local drug delivery applications, and while nasal sprays are able to reach this region, there is currently no broad consensus across the in vitro and in silico literature concerning optimal parameters for device design, formulation properties and patient technique which would maximize turbinate deposition. Nebulizers can more easily target the turbinates, but come with the disadvantage of significant lung deposition. Targeting of the olfactory region of the nasal cavity has been explored for the potential treatment of central nervous system conditions. Conventional intranasal devices, such as nasal sprays and nebulizers, deliver very little dose to the olfactory region. Recent progress in our understanding of intranasal delivery will be useful in the development of the next generation of intranasal drug delivery devices.
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Affiliation(s)
- John Chen
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
| | - Andrew R Martin
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
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18
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A Dry Powder Platform for Nose-to-Brain Delivery of Dexamethasone: Formulation Development and Nasal Deposition Studies. Pharmaceutics 2021; 13:pharmaceutics13060795. [PMID: 34073500 PMCID: PMC8229415 DOI: 10.3390/pharmaceutics13060795] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/26/2022] Open
Abstract
Nasal route of administration offers a unique opportunity of brain targeted drug delivery via olfactory and trigeminal pathway, providing effective CNS concentrations at lower doses and lower risk for adverse reactions compared to systemic drug administration. Therefore, it has been recently proposed as a route of choice for glucocorticoids to control neuroinflammation processes in patients with severe Covid-19. However, appropriate delivery systems tailored to enhance their efficacy yet need to emerge. In this work we present the development of sprayable brain targeting powder delivery platform of dexamethasone sodium phosphate (DSP). DSP-loaded microspheres, optimised employing Quality-by-Design approach, were blended with soluble inert carriers (mannitol or lactose monohydrate). Powder blends were characterized in terms of homogeneity, flow properties, sprayability, in vitro biocompatibility, permeability and mucoadhesion. Nasal deposition studies were performed using 3D printed nasal cavity model. Mannitol provided better powder blend flow properties compared to lactose. Microspheres blended with mannitol retained or enlarged their mucoadhesive properties and enhanced DSP permeability across epithelial model barrier. DSP dose fraction deposited in the olfactory region reached 17.0% revealing the potential of developed powder platform for targeted olfactory delivery. The observed impact of nasal cavity asymmetry highlighted the importance of individual approach when aiming olfactory region.
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19
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In vitro - in vivo correlation of intranasal drug deposition. Adv Drug Deliv Rev 2021; 170:340-352. [PMID: 32918968 DOI: 10.1016/j.addr.2020.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/31/2022]
Abstract
In vitro - in vivo correlation (IVIVC) allows prediction of in vivo drug deposition from a nasally inhaled drug based on in vitro drug measurements. In vitro measurements include physical particle characterization and, more recently, deposition studies using anatomical models. Currently, there is a lack of IVIVC for deposition measurements in anatomical models, especially for deposition patterns in various nasal cavity regions. Therefore, improvement of in vitro and in vivo measurement methods and knowledge about nasal deposition mechanisms should help IVIVC in the future.
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20
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Simulation of patient-specific bi-directional pulsating nasal aerosol dispersion and deposition with clockwise 45° and 90° nosepieces. Comput Biol Med 2020; 123:103816. [DOI: 10.1016/j.compbiomed.2020.103816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 02/06/2023]
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21
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Dong D, Cai F, Huang S, Zhu X, Geng J, Liu J, Lv L, Zhang Y, Zhao Y. Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study. Int Forum Allergy Rhinol 2020; 10:1300-1308. [PMID: 32687694 DOI: 10.1002/alr.22657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/18/2020] [Accepted: 06/29/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Dong Dong
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, China
| | - Fangyu Cai
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuman Huang
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyuan Zhu
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Geng
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jia Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Lv
- College of Information Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yanbing Zhang
- School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, China
| | - Yulin Zhao
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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22
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Hosseini S, Golshahi L. An in vitro evaluation of importance of airway anatomy in sub-regional nasal and paranasal drug delivery with nebulizers using three different anatomical nasal airway replicas of 2-, 5- and 50-Year old human subjects. Int J Pharm 2019; 563:426-436. [DOI: 10.1016/j.ijpharm.2019.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/05/2019] [Accepted: 04/07/2019] [Indexed: 11/30/2022]
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23
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Kiaee M, Wachtel H, Noga ML, Martin AR, Finlay WH. Regional deposition of nasal sprays in adults: A wide ranging computational study. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2018; 34:e2968. [PMID: 29453801 DOI: 10.1002/cnm.2968] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/02/2018] [Accepted: 02/08/2018] [Indexed: 06/08/2023]
Abstract
The present work examines regional deposition within the nose for nasal sprays over a large and wide ranging parameter space by using numerical simulation. A set of 7 realistic adult nasal airway geometries was defined based on computed tomography images. Deposition in 6 regions of each nasal airway geometry (the vestibule, valve, anterior turbinate, posterior turbinate, olfactory, and nasopharynx) was determined for varying particle diameter, spray cone angle, spray release direction, particle injection speed, and particle injection location. Penetration of nasal spray particles through the airway geometries represented unintended lung exposure. Penetration was found to be relatively insensitive to injection velocity, but highly sensitive to particle size. Penetration remained at or above 30% for particles exceeding 10 μm in diameter for several airway geometries studied. Deposition in the turbinates, viewed as desirable for both local and systemic nasal drug delivery, was on average maximized for particles ranging from ~20 to 30 μm in diameter, and for low to zero injection velocity. Similar values of particle diameter and injection velocity were found to maximize deposition in the olfactory region, a potential target for nose-to-brain drug delivery. However, olfactory deposition was highly variable between airway geometries, with maximum olfactory deposition ranging over 2 orders of magnitude between geometries. This variability is an obstacle to overcome if consistent dosing between subjects is to be achieved for nose-to-brain drug delivery.
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Affiliation(s)
- Milad Kiaee
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | | | - Michelle L Noga
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
| | - Andrew R Martin
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
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24
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Xi J, Wang Z, Si XA, Zhou Y. Nasal dilation effects on olfactory deposition in unilateral and bi-directional deliveries: In vitro tests and numerical modeling. Eur J Pharm Sci 2018; 118:113-123. [PMID: 29597042 DOI: 10.1016/j.ejps.2018.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/16/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
The human nose can expand either actively or passively to increase airflow. Nasal dilation may alter drug delivery efficiencies in the nasal airway or olfactory region. However, the dosage enhancement from nasal dilations has not been quantified. The mechanisms underlying the dilation-induced deposition variation are also not clear. This study aims to quantify the nasal dilation effects on drug delivery in the nasal airway and olfactory region using in vitro tests and numerical analysis. Two variants of an existing normal nasal airway model were developed with different levels of airway dilation. Airway dimensions were quantified in terms of hydraulic diameter, cross-sectional area, and surface area to volume ratio. Sectional nose casts were prepared using a 3-D printer for visualizing deposition patterns and quantifying delivered dosages. A well-validated computational fluid-particle dynamics (CFPD) model was utilized to understand the underlying mechanisms in the unilateral and bi-directional deliveries. In vitro tests show that nasal dilation lowered the total dosage in the nose but increased the dosage to the olfactory region in both the unilateral and bi-directional deliveries. Compared to the normal nose with unilateral delivery, nasal dilation enhanced the olfactory deposition by a factor of 2.2, while nasal dilatation with the bi-directional delivery increased by a factor of 4. Complementary numerical analyses revealed the growth of a recirculation zone in the middle meatus of dilated noses, which induced lower pressure and increased ventilation to the upper nose. In bi-directional deliveries, a significantly higher fraction of airflow was ventilated to the upper airway in the outflow side of the nose and contributed to the elevated olfactory dosage. Nasal dilation in combination with the bi-directional delivery is recommended over the conventional unilateral method for olfactory targeting.
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Affiliation(s)
- Jinxiang Xi
- Department of Biomedical Engineering California Baptist University, Riverside, CA, USA.
| | - Zhaoxuan Wang
- Department of Mechanical and Industrial Engineering University of Toronto, Toronto, ON, Canada
| | - Xiuhua April Si
- Department of Aerospace, Industrial, and Mechanical Engineering California Baptist University, Riverside, CA, USA
| | - Yue Zhou
- Aerosol and Respiratory Dosimetry Program, Lovelace Respiratory Research Institute, Albuquerque, NM, USA
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25
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Dong J, Shang Y, Inthavong K, Chan HK, Tu J. Numerical Comparison of Nasal Aerosol Administration Systems for Efficient Nose-to-Brain Drug Delivery. Pharm Res 2017; 35:5. [PMID: 29288465 DOI: 10.1007/s11095-017-2280-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/12/2017] [Indexed: 12/23/2022]
Abstract
PURPOSE Nose-to-brain drug administration along the olfactory and trigeminal nerve pathways offers an alternative route for the treatment of central nervous system (CNS) disorders. The characterization of particle deposition remains difficult to achieve in experiments. Alternative numerical approach is applied to identify suitable aerosol particle size with maximized inhaled doses. METHODS This study numerically compared the drug delivery efficiency in a realistic human nasal cavity between two aerosol drug administration systems targeting the olfactory region: the aerosol mask system and the breath-powered bi-directional system. Steady inhalation and exhalation flow rates were applied to both delivery systems. The discrete phase particle tracking method was employed to capture the aerosol drug transport and deposition behaviours in the nasal cavity. Both overall and regional deposition characteristics were analysed in detail. RESULTS The results demonstrated the breath-powered drug delivery approach can produce superior olfactory deposition with peaking olfactory deposition fractions for diffusive 1 nm particles and inertial 10 μm. While for particles in the range of 10 nm to 2 μm, no significant olfactory deposition can be found, indicating the therapeutic agents should avoid this size range when targeting the olfactory deposition. CONCLUSIONS The breath-powered bi-directional aerosol delivery approach shows better drug delivery performance globally and locally, and improved drug administration doses can be achieved in targeted olfactory region.
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Affiliation(s)
- Jingliang Dong
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Yidan Shang
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Kiao Inthavong
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jiyuan Tu
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia. .,Key Laboratory of Ministry of Education for Advanced Reactor Engineering and Safety, Institute of Nuclear and New Energy Technology, Tsinghua University, PO Box 1021, Beijing, 100086, China.
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