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Li X, Chen T, Zheng Z, Gao J, Wu Y, Wu X, Jiang T, Zhu Z, Xu RX. Magnetic Liquid Gating Valve Terminal for Patterned Droplet Generation and Transportation of Highly Viscous Bioactive Fluids. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2404952. [PMID: 39380418 DOI: 10.1002/smll.202404952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 09/10/2024] [Indexed: 10/10/2024]
Abstract
As an open microfluidic technology with excellent anti-fouling and energy-saving properties, liquid gating technology can selectively separate or transfer multiphase fluids, which has shown great application value in the field of biomedical engineering. However, no study has demonstrated that liquid gating technology has the ability to transfer high-viscosity fluids and biologically active substances, and current liquid gating valves are unable to realize smart-responsive pulsed-patterned transfer, which severely limits their application scope. In this paper, liquid gating technology is combined with magnetically responsive materials to prepare a liquid-based magnetic porous membrane (LMPM) with excellent magnetostatic deformation capability and antifouling properties. On this basis, a magnetic liquid gating valve terminal (MLGVT) with patterning transfer capability is developed, and the feasibility of liquid gating technology for transferring high-viscosity fluids and hydrogel bioinks is explored. Meanwhile, a flexible MLGVT is prepared and realized for targeted drug delivery. This study expands the potential of liquid gating technology for drug delivery, cellular transport and smart patches.
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Affiliation(s)
- Xin Li
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- Nano Science and Technology Institute, University of Science and Technology of China, Suzhou, 215123, China
| | - Tianao Chen
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- School of Biomedical Engineering, Division of Life Sciences and Medicine, Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangsu, 215123, China
| | - Zhiyuan Zheng
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Jie Gao
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- School of Biomedical Engineering, Division of Life Sciences and Medicine, Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangsu, 215123, China
| | - Yongqi Wu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- School of Biomedical Engineering, Division of Life Sciences and Medicine, Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangsu, 215123, China
| | - Xizhi Wu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- School of Biomedical Engineering, Division of Life Sciences and Medicine, Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangsu, 215123, China
| | - Tao Jiang
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- Nano Science and Technology Institute, University of Science and Technology of China, Suzhou, 215123, China
| | - Zhiqiang Zhu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, 230026, China
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Ronald X Xu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215000, China
- School of Biomedical Engineering, Division of Life Sciences and Medicine, Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangsu, 215123, China
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, 230026, China
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui, 230026, China
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2
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Kim MW, Yu SH, Yang U, Nukiwa R, Cho HJ, Kwon NS, Yong MJ, Kim NH, Lee SH, Lee JH, Lim JH, Kohmura Y, Ishikawa T, Henry FS, Imai Y, Oh SS, Hwang HJ, Tsuda A, Je JH. Alveolar Microdynamics during Tidal Ventilation in Live Animals Imaged by SPring-8 Synchrotron. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306256. [PMID: 38959397 PMCID: PMC11434049 DOI: 10.1002/advs.202306256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 03/10/2024] [Indexed: 07/05/2024]
Abstract
It is self-evident that our chests expand and contract during breathing but, surprisingly, exactly how individual alveoli change shape over the respiratory cycle is still a matter of debate. Some argue that all the alveoli expand and contract rhythmically. Others claim that the lung volume change is due to groups of alveoli collapsing and reopening during ventilation. Although this question might seem to be an insignificant detail for healthy individuals, it might be a matter of life and death for patients with compromised lungs. Past analyses were based on static post-mortem preparations primarily due to technological limitations, and therefore, by definition, incapable of providing dynamic information. In contrast, this study provides the first comprehensive dynamic data on how the shape of the alveoli changes, and, further, provides valuable insights into the optimal lung volume for efficient gas exchange. It is concluded that alveolar micro-dynamics is nonlinear; and at medium lung volume, alveoli expand more than the ducts.
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Affiliation(s)
- Min Woo Kim
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
- Pohang Accelerator Laboratory (PAL), POSTECH, Pohang, 37673, South Korea
| | - Seung Hyeon Yu
- Department of Mathematics, POSTECH, Pohang, 37673, South Korea
| | - Un Yang
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Ryota Nukiwa
- National Institutes of Biomedical Innovation, Health and Nutrition, Infection Medical Information Laboratory, Osaka, 567-0085, Japan
| | - Hyeon Jung Cho
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
| | - Nam Seop Kwon
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
| | - Moon Jung Yong
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Nam Ho Kim
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Sang Hyeon Lee
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Jun Ho Lee
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Jae Hong Lim
- Pohang Accelerator Laboratory (PAL), POSTECH, Pohang, 37673, South Korea
| | | | | | - Frank S Henry
- Department of Mechanical Engineering, Manhattan College, Riverdale, NY, 10471, USA
| | - Yumiko Imai
- National Institutes of Biomedical Innovation, Health and Nutrition, Infection Medical Information Laboratory, Osaka, 567-0085, Japan
| | - Seung Soo Oh
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
| | - Hyung Ju Hwang
- Department of Mathematics, POSTECH, Pohang, 37673, South Korea
- Graduate School of Artificial Intelligence, POSTECH, Pohang, 37673, South Korea
| | - Akira Tsuda
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, 02115, USA
- Tsuda Lung Research, Shrewsbury, MA, 01545, USA
| | - Jung Ho Je
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
- Department of Materials Science and Engineering, POSTECH, Pohang, 37673, South Korea
- Nanoblesse Research Lab., Pohang, 37883, South Korea
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3
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Fallert L, Urigoitia-Asua A, Cipitria A, Jimenez de Aberasturi D. Dynamic 3D in vitro lung models: applications of inorganic nanoparticles for model development and characterization. NANOSCALE 2024; 16:10880-10900. [PMID: 38787741 DOI: 10.1039/d3nr06672j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Being a vital organ exposed to the external environment, the lung is susceptible to a plethora of pathogens and pollutants. This is reflected in high incidences of chronic respiratory diseases, which remain a leading cause of mortality world-wide and pose a persistent global burden. It is thus of paramount importance to improve our understanding of these pathologies and provide better therapeutic options. This necessitates the development of representative and physiologically relevant in vitro models. Advances in bioengineering have enabled the development of sophisticated models that not only capture the three-dimensional architecture of the cellular environment but also incorporate the dynamics of local biophysical stimuli. However, such complex models also require novel approaches that provide reliable characterization. Within this review we explore how 3D bioprinting and nanoparticles can serve as multifaceted tools to develop such dynamic 4D printed in vitro lung models and facilitate their characterization in the context of pulmonary fibrosis and breast cancer lung metastasis.
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Affiliation(s)
- Laura Fallert
- Department of Hybrid Biofunctional Materials, CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramon 194, 20014 Donostia-San Sebastián, Spain.
- Group of Bioengineering in Regeneration and Cancer, Biogipuzkoa Health Research Institute, 20014 Donostia-San Sebastián, Spain
- Department of Applied Chemistry, University of the Basque Country, 20018 Donostia-San Sebastián, Spain
| | - Ane Urigoitia-Asua
- Department of Hybrid Biofunctional Materials, CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramon 194, 20014 Donostia-San Sebastián, Spain.
- Department of Applied Chemistry, University of the Basque Country, 20018 Donostia-San Sebastián, Spain
- POLYMAT, Basque Centre for Macromolecular Design and Engineering, 20018 Donostia-San Sebastián, Spain
| | - Amaia Cipitria
- Group of Bioengineering in Regeneration and Cancer, Biogipuzkoa Health Research Institute, 20014 Donostia-San Sebastián, Spain
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - Dorleta Jimenez de Aberasturi
- Department of Hybrid Biofunctional Materials, CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramon 194, 20014 Donostia-San Sebastián, Spain.
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN, ISCIII), 20014 Donostia-San Sebastián, Spain
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 PMCID: PMC11326136 DOI: 10.1128/cmr.00124-23] [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] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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5
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Chioccioli M, Liu S, Magruder S, Tata A, Borriello L, McDonough JE, Konkimalla A, Kim SH, Nouws J, Gonzalez DG, Traub B, Ye X, Yang T, Entenberg DR, Krishnaswamy S, Hendry CE, Kaminski N, Tata PR, Sauler M. Stem cell migration drives lung repair in living mice. Dev Cell 2024; 59:830-840.e4. [PMID: 38377991 PMCID: PMC11003834 DOI: 10.1016/j.devcel.2024.02.003] [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] [Received: 11/15/2022] [Revised: 06/12/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
Tissue repair requires a highly coordinated cellular response to injury. In the lung, alveolar type 2 cells (AT2s) act as stem cells to replenish both themselves and alveolar type 1 cells (AT1s); however, the complex orchestration of stem cell activity after injury is poorly understood. Here, we establish longitudinal imaging of AT2s in murine intact tissues ex vivo and in vivo in order to track their dynamic behavior over time. We discover that a large fraction of AT2s become motile following injury and provide direct evidence for their migration between alveolar units. High-resolution morphokinetic mapping of AT2s further uncovers the emergence of distinct motile phenotypes. Inhibition of AT2 migration via genetic depletion of ArpC3 leads to impaired regeneration of AT2s and AT1s in vivo. Together, our results establish a requirement for stem cell migration between alveolar units and identify properties of stem cell motility at high cellular resolution.
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Affiliation(s)
- Maurizio Chioccioli
- Department of Genetics and Comparative Medicine, Yale University, New Haven, CT 06519, USA; Department of Comparative Medicine, Yale University, New Haven, CT 06519, USA.
| | - Shuyu Liu
- Department of Cell Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Sumner Magruder
- Department of Computer Science, Yale University, New Haven, CT 06511, USA
| | - Aleksandra Tata
- Department of Cell Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Lucia Borriello
- Department of Cancer and Cellular Biology, Lewis Katz School of Medicine, Fox Chase Cancer, Philadelphia, PA 19140, USA
| | - John E McDonough
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Arvind Konkimalla
- Department of Cell Biology, Duke University School of Medicine, Durham, NC 27710, USA; Medical Scientist Training Program, Duke University School of Medicine, Durham, NC 27710, USA
| | - Sang-Hun Kim
- Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Jessica Nouws
- Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - David G Gonzalez
- Department of Genetics and Comparative Medicine, Yale University, New Haven, CT 06519, USA
| | - Brian Traub
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA
| | - Xianjun Ye
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA
| | - Tao Yang
- Section of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - David R Entenberg
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA
| | - Smita Krishnaswamy
- Department of Genetics and Comparative Medicine, Yale University, New Haven, CT 06519, USA; Department of Computer Science, Yale University, New Haven, CT 06511, USA
| | - Caroline E Hendry
- Department of Genetics and Comparative Medicine, Yale University, New Haven, CT 06519, USA
| | - Naftali Kaminski
- Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Purushothama Rao Tata
- Department of Cell Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Maor Sauler
- Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06520, USA
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6
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Quiros KAM, Nelson TM, Ulu A, Dominguez EC, Biddle TA, Lo DD, Nordgren TM, Eskandari M. A Comparative Study of Ex-Vivo Murine Pulmonary Mechanics Under Positive- and Negative-Pressure Ventilation. Ann Biomed Eng 2024; 52:342-354. [PMID: 37906375 PMCID: PMC10808462 DOI: 10.1007/s10439-023-03380-1] [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: 12/07/2022] [Accepted: 10/03/2023] [Indexed: 11/02/2023]
Abstract
Increased ventilator use during the COVID-19 pandemic resurrected persistent questions regarding mechanical ventilation including the difference between physiological and artificial breathing induced by ventilators (i.e., positive- versus negative-pressure ventilation, PPV vs NPV). To address this controversy, we compare murine specimens subjected to PPV and NPV in ex vivo quasi-static loading and quantify pulmonary mechanics via measures of quasi-static and dynamic compliances, transpulmonary pressure, and energetics when varying inflation frequency and volume. Each investigated mechanical parameter yields instance(s) of significant variability between ventilation modes. Most notably, inflation compliance, percent relaxation, and peak pressure are found to be consistently dependent on the ventilation mode. Maximum inflation volume and frequency note varied dependencies contingent on the ventilation mode. Contradictory to limited previous clinical investigations of oxygenation and end-inspiratory measures, the mechanics-focused comprehensive findings presented here indicate lung properties are dependent on loading mode, and importantly, these dependencies differ between smaller versus larger mammalian species despite identical custom-designed PPV/NPV ventilator usage. Results indicate that past contradictory findings regarding ventilation mode comparisons in the field may be linked to the chosen animal model. Understanding the differing fundamental mechanics between PPV and NPV may provide insights for improving ventilation strategies and design to prevent associated lung injuries.
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Affiliation(s)
- K A M Quiros
- Department of Mechanical Engineering, University of California Riverside, 900 University Ave., Riverside, CA, 92506, USA
| | - T M Nelson
- Department of Mechanical Engineering, University of California Riverside, 900 University Ave., Riverside, CA, 92506, USA
| | - A Ulu
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
| | - E C Dominguez
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California, Riverside, CA, USA
| | - T A Biddle
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California, Riverside, CA, USA
- School of Medicine, BREATHE Center, University of California, Riverside, CA, USA
| | - D D Lo
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- School of Medicine, BREATHE Center, University of California, Riverside, CA, USA
- Center for Health Disparities Research, University of California, Riverside, CA, USA
| | - T M Nordgren
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California, Riverside, CA, USA
- School of Medicine, BREATHE Center, University of California, Riverside, CA, USA
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - M Eskandari
- Department of Mechanical Engineering, University of California Riverside, 900 University Ave., Riverside, CA, 92506, USA.
- School of Medicine, BREATHE Center, University of California, Riverside, CA, USA.
- Department of Bioengineering, University of California, Riverside, CA, USA.
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7
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Nelson TM, Quiros KAM, Dominguez EC, Ulu A, Nordgren TM, Eskandari M. Diseased and healthy murine local lung strains evaluated using digital image correlation. Sci Rep 2023; 13:4564. [PMID: 36941463 PMCID: PMC10026788 DOI: 10.1038/s41598-023-31345-w] [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: 12/07/2022] [Accepted: 03/09/2023] [Indexed: 03/22/2023] Open
Abstract
Tissue remodeling in pulmonary disease irreversibly alters lung functionality and impacts quality of life. Mechanical ventilation is amongst the few pulmonary interventions to aid respiration, but can be harmful or fatal, inducing excessive regional (i.e., local) lung strains. Previous studies have advanced understanding of diseased global-level lung response under ventilation, but do not adequately capture the critical local-level response. Here, we pair a custom-designed pressure-volume ventilator with new applications of digital image correlation, to directly assess regional strains in the fibrosis-induced ex-vivo mouse lung, analyzed via regions of interest. We discuss differences between diseased and healthy lung mechanics, such as distensibility, heterogeneity, anisotropy, alveolar recruitment, and rate dependencies. Notably, we compare local and global compliance between diseased and healthy states by assessing the evolution of pressure-strain and pressure-volume curves resulting from various ventilation volumes and rates. We find fibrotic lungs are less-distensible, with altered recruitment behaviors and regional strains, and exhibit disparate behaviors between local and global compliance. Moreover, these diseased characteristics show volume-dependence and rate trends. Ultimately, we demonstrate how fibrotic lungs may be particularly susceptible to damage when contrasted to the strain patterns of healthy counterparts, helping to advance understanding of how ventilator induced lung injury develops.
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Affiliation(s)
- T M Nelson
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - K A M Quiros
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - E C Dominguez
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California Riverside, Riverside, CA, USA
| | - A Ulu
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
| | - T M Nordgren
- Division of Biomedical Sciences, Riverside School of Medicine, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California Riverside, Riverside, CA, USA
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - M Eskandari
- Department of Mechanical Engineering, University of California, Riverside, CA, USA.
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA.
- Department of Bioengineering, University of California, Riverside, CA, USA.
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8
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Wei Y, Wang F, Guo Z. Bio-inspired and metal-derived superwetting surfaces: Function, stability and applications. Adv Colloid Interface Sci 2023; 314:102879. [PMID: 36934513 DOI: 10.1016/j.cis.2023.102879] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/19/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
Due to their exceptional anti-icing, anti-corrosion, and anti-drag qualities, biomimetic metal-derived superwetting surfaces, which are widely employed in the aerospace, automotive, electronic, and biomedical industries, have raised significant concern. However, further applications in other domains have been hampered by the poor mechanical and chemical durability of superwetting metallic surfaces, which can result in metal fatigue and corrosion. The potential for anti-corrosion, anti-contamination, anti-icing, oil/water separation, and oil transportation on surfaces with superwettability has increased in recent years due to the advancement of research in biomimetic superwetting interface theory and practice. Recent developments in functionalized biomimetic metal-derived superwetting surfaces were summarized in this paper. Firstly, a detailed presentation of biomimetic metal-derived superwetting surfaces with unique capabilities was made. The problems with the long-term mechanical and chemical stability of biomimetic metal-derived superwetting surfaces were then examined, along with potential solutions. Finally, in an effort to generate fresh concepts for the study of biomimetic metal-derived superwetting surfaces, the applications of superwetting metallic surfaces in various domains were discussed in depth. The future direction of biomimetic metal-derived superwetting surfaces was also addressed.
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Affiliation(s)
- Yuren Wei
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering, Hubei Key Laboratory of Polymer Materials, Hubei University, Wuhan 430062, China
| | - Fengyi Wang
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering, Hubei Key Laboratory of Polymer Materials, Hubei University, Wuhan 430062, China.
| | - Zhiguang Guo
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering, Hubei Key Laboratory of Polymer Materials, Hubei University, Wuhan 430062, China; State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China.
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9
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Herrmann J, Kollisch-Singule M, Satalin J, Nieman GF, Kaczka DW. Assessment of Heterogeneity in Lung Structure and Function During Mechanical Ventilation: A Review of Methodologies. JOURNAL OF ENGINEERING AND SCIENCE IN MEDICAL DIAGNOSTICS AND THERAPY 2022; 5:040801. [PMID: 35832339 PMCID: PMC9132008 DOI: 10.1115/1.4054386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/13/2022] [Indexed: 06/15/2023]
Abstract
The mammalian lung is characterized by heterogeneity in both its structure and function, by incorporating an asymmetric branching airway tree optimized for maintenance of efficient ventilation, perfusion, and gas exchange. Despite potential benefits of naturally occurring heterogeneity in the lungs, there may also be detrimental effects arising from pathologic processes, which may result in deficiencies in gas transport and exchange. Regardless of etiology, pathologic heterogeneity results in the maldistribution of regional ventilation and perfusion, impairments in gas exchange, and increased work of breathing. In extreme situations, heterogeneity may result in respiratory failure, necessitating support with a mechanical ventilator. This review will present a summary of measurement techniques for assessing and quantifying heterogeneity in respiratory system structure and function during mechanical ventilation. These methods have been grouped according to four broad categories: (1) inverse modeling of heterogeneous mechanical function; (2) capnography and washout techniques to measure heterogeneity of gas transport; (3) measurements of heterogeneous deformation on the surface of the lung; and finally (4) imaging techniques used to observe spatially-distributed ventilation or regional deformation. Each technique varies with regard to spatial and temporal resolution, degrees of invasiveness, risks posed to patients, as well as suitability for clinical implementation. Nonetheless, each technique provides a unique perspective on the manifestations and consequences of mechanical heterogeneity in the diseased lung.
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Affiliation(s)
- Jacob Herrmann
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242
| | | | - Joshua Satalin
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210
| | - Gary F. Nieman
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210
| | - David W. Kaczka
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242; Department of Anesthesia, University of Iowa, Iowa City, IA 52242; Department of Radiology, University of Iowa, Iowa City, IA 52242
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10
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Nelson TM, Quiros KAM, Mariano CA, Sattari S, Ulu A, Dominguez EC, Nordgren TM, Eskandari M. Associating local strains to global pressure-volume mouse lung mechanics using digital image correlation. Physiol Rep 2022; 10:e15466. [PMID: 36207795 PMCID: PMC9547081 DOI: 10.14814/phy2.15466] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 12/24/2022] Open
Abstract
Pulmonary diseases alter lung mechanical properties, can cause loss of function, and necessitate use of mechanical ventilation, which can be detrimental. Investigations of lung tissue (local) scale mechanical properties are sparse compared to that of the whole organ (global) level, despite connections between regional strain injury and ventilation. We examine ex vivo mouse lung mechanics by investigating strain values, local compliance, tissue surface heterogeneity, and strain evolutionary behavior for various inflation rates and volumes. A custom electromechanical, pressure-volume ventilator is coupled with digital image correlation to measure regional lung strains and associate local to global mechanics by analyzing novel pressure-strain evolutionary measures. Mean strains at 5 breaths per minute (BPM) for applied volumes of 0.3, 0.5, and 0.7 ml are 5.0, 7.8, and 11.3%, respectively, and 4.7, 8.8, and 12.2% for 20 BPM. Similarly, maximum strains among all rate and volume combinations range 10.7%-22.4%. Strain values (mean, range, mode, and maximum) at peak inflation often exhibit significant volume dependencies. Additionally, select evolutionary behavior (e.g., local lung compliance quantification) and tissue heterogeneity show significant volume dependence. Rate dependencies are generally found to be insignificant; however, strain values and surface lobe heterogeneity tend to increase with increasing rates. By quantifying strain evolutionary behavior in relation to pressure-volume measures, we associate time-continuous local to global mouse lung mechanics for the first time and further examine the role of volume and rate dependency. The interplay of multiscale deformations evaluated in this work can offer insights for clinical applications, such as ventilator-induced lung injury.
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Affiliation(s)
- Talyah M. Nelson
- Department of Mechanical EngineeringUniversity of CaliforniaRiversideCaliforniaUSA
| | | | - Crystal A. Mariano
- Department of Mechanical EngineeringUniversity of CaliforniaRiversideCaliforniaUSA
| | - Samaneh Sattari
- Department of Mechanical EngineeringUniversity of CaliforniaRiversideCaliforniaUSA
| | - Arzu Ulu
- BREATHE CenterSchool of Medicine University of CaliforniaRiversideCaliforniaUSA,Division of Biomedical SciencesSchool of Medicine, University of CaliforniaRiversideCaliforniaUSA
| | - Edward C. Dominguez
- BREATHE CenterSchool of Medicine University of CaliforniaRiversideCaliforniaUSA,Division of Biomedical SciencesSchool of Medicine, University of CaliforniaRiversideCaliforniaUSA
| | - Tara M. Nordgren
- BREATHE CenterSchool of Medicine University of CaliforniaRiversideCaliforniaUSA,Division of Biomedical SciencesSchool of Medicine, University of CaliforniaRiversideCaliforniaUSA
| | - Mona Eskandari
- Department of Mechanical EngineeringUniversity of CaliforniaRiversideCaliforniaUSA,BREATHE CenterSchool of Medicine University of CaliforniaRiversideCaliforniaUSA,Department of BioengineeringUniversity of CaliforniaRiversideCaliforniaUSA
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11
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Liu JY, Pradhan SH, Hussain S, Sayes CM. Platform for Exposing Aerosolized Substances to Lung Surfactant and Alveolar Cells at the Air-Liquid Interface. ACS CHEMICAL HEALTH & SAFETY 2022. [DOI: 10.1021/acs.chas.2c00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- James Y. Liu
- Department of Environmental Science, Baylor University, Waco, Texas 76706, United States
| | - Sahar H. Pradhan
- Department of Environmental Science, Baylor University, Waco, Texas 76706, United States
| | - Saber Hussain
- 711th Human Performance Wing, Air Force Research Laboratory, Dayton, Ohio 45435, United States
| | - Christie M. Sayes
- Department of Environmental Science, Baylor University, Waco, Texas 76706, United States
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12
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Feng Y, Wang Q, Zhi L, Sun S, Zhao C. Anticoagulant biomimetic consecutive gas exchange network for advanced artificial lung membrane. J Memb Sci 2022. [DOI: 10.1016/j.memsci.2022.120502] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Self-Oscillating Liquid Gating Membranes with Periodic Gas Transport. MEMBRANES 2022; 12:membranes12070642. [PMID: 35877845 PMCID: PMC9316610 DOI: 10.3390/membranes12070642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Liquid gating membranes with molecular-level smooth liquid lining layers break through the limitations of traditional porous membrane materials in gas transport control. Owing to the stable, self-healing, and reconfigurable properties, liquid gating membranes have shown wide application prospects in microfluidics, intelligent valves, chemical reactions, and beyond. Here, we develop a periodic gas transport control system based on the self-oscillating liquid gating membrane. Under continuous gas injection, the gas–liquid interface is reversibly deformed, enabling self-oscillating behavior for discontinuous and periodic gas transport without the need for any complex external changes to the original system. Meanwhile, our experimental analysis reveals that the periodic time and periodic gas release in the system can be regulated. Based on the cycle stability of the system, we further demonstrate the controllability of the system for periodic droplet manipulation in microfluidics. Looking forward, it will offer new opportunities for various applications, such as pneumatic robots, gas-involved chemical reactions, droplet microfluidics, and beyond.
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14
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Quiros KAM, Nelson TM, Sattari S, Mariano CA, Ulu A, Dominguez EC, Nordgren TM, Eskandari M. Mouse lung mechanical properties under varying inflation volumes and cycling frequencies. Sci Rep 2022; 12:7094. [PMID: 35501363 PMCID: PMC9059689 DOI: 10.1038/s41598-022-10417-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/30/2022] [Indexed: 01/23/2023] Open
Abstract
Respiratory pathologies alter the structure of the lung and impact its mechanics. Mice are widely used in the study of lung pathologies, but there is a lack of fundamental mechanical measurements assessing the interdependent effect of varying inflation volumes and cycling frequency. In this study, the mechanical properties of five male C57BL/6J mice (29-33 weeks of age) lungs were evaluated ex vivo using our custom-designed electromechanical, continuous measure ventilation apparatus. We comprehensively quantify and analyze the effect of loading volumes (0.3, 0.5, 0.7, 0.9 ml) and breathing rates (5, 10, 20 breaths per minute) on pulmonary inflation and deflation mechanical properties. We report means of static compliance between 5.4-16.1 µl/cmH2O, deflation compliance of 5.3-22.2 µl/cmH2O, percent relaxation of 21.7-39.1%, hysteresis of 1.11-7.6 ml•cmH2O, and energy loss of 39-58% for the range of four volumes and three rates tested, along with additional measures. We conclude that inflation volume was found to significantly affect hysteresis, static compliance, starting compliance, top compliance, deflation compliance, and percent relaxation, and cycling rate was found to affect only hysteresis, energy loss, percent relaxation, static compliance and deflation compliance.
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Affiliation(s)
- K A M Quiros
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - T M Nelson
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - S Sattari
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - C A Mariano
- Department of Mechanical Engineering, University of California, Riverside, CA, USA
| | - A Ulu
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, USA
| | - E C Dominguez
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, USA
| | - T M Nordgren
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, USA
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - M Eskandari
- Department of Mechanical Engineering, University of California, Riverside, CA, USA.
- BREATHE Center, School of Medicine, University of California, Riverside, CA, USA.
- Department of Bioengineering, University of California, Riverside, CA, USA.
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15
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Cercos-Pita JL, Fardin L, Leclerc H, Maury B, Perchiazzi G, Bravin A, Bayat S. Lung tissue biomechanics imaged with synchrotron phase contrast microtomography in live rats. Sci Rep 2022; 12:5056. [PMID: 35322152 PMCID: PMC8942151 DOI: 10.1038/s41598-022-09052-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/09/2022] [Indexed: 12/19/2022] Open
Abstract
The magnitude and distribution of strain imposed on the peripheral airspaces by mechanical ventilation at the microscopic level and the consequent deformations are unknown despite their importance for understanding the mechanisms occurring at the onset of ventilator-induced lung injury. Here a 4-Dimensional (3D + time) image acquisition and processing technique is developed to assess pulmonary acinar biomechanics at microscopic resolution. Synchrotron radiation phase contrast CT with an isotropic voxel size of 6 µm3 is applied in live anesthetized rats under controlled mechanical ventilation. Video animations of regional acinar and vascular strain are acquired in vivo. Maps of strain distribution due to positive-pressure breaths and cardiovascular activity in lung acini and blood vessels are derived based on CT images. Regional strain within the lung peripheral airspaces takes average values of 0.09 ± 0.02. Fitting the expression S = kVn, to the changes in peripheral airspace area (S) and volume (V) during a positive pressure breath yields an exponent n = 0.82 ± 0.03, suggesting predominant alveolar expansion rather than ductal expansion or alveolar recruitment. We conclude that this methodology can be used to assess acinar conformational changes during positive pressure breaths in intact peripheral lung airspaces.
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Affiliation(s)
- Jose-Luis Cercos-Pita
- Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Luca Fardin
- European Synchrotron Radiation Facility, Grenoble, France
| | - Hugo Leclerc
- Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay, Orsay, France
| | - Bertrand Maury
- Département de Mathématiques Appliquées, Ecole Normale Supérieure, Université PSL, Paris, France
| | - Gaetano Perchiazzi
- Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Alberto Bravin
- Physics Department, Milano Bicocca University, Milan, Italy
| | - Sam Bayat
- Synchrotron Radiation for Biomedicine STROBE Inserm UA07, Univ. Grenoble Alpes, Grenoble, France.
- Univ. Grenoble Alpes - Inserm UA07, Synchrotron Radiation for Biomedicine (STROBE) Laboratory, 2280 Rue de la Piscine, 38400, Grenoble, France.
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16
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Sheng Z, Ding Y, Li G, Fu C, Hou Y, Lyu J, Zhang K, Zhang X. Solid-Liquid Host-Guest Composites: The Marriage of Porous Solids and Functional Liquids. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2104851. [PMID: 34623698 DOI: 10.1002/adma.202104851] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Composite materials can provide remarkable improvements over the individual constituents. Especially, with a liquid component introduced into a solid porous host, solid-liquid host-guest composites have recently come to the forefront with exceptional functions that promise them for a wealth of applications. Combining the unprecedented dynamic, transparent, omniphobic, self-healing, diffusive and adaptive nature of functional liquid with inherent solid host's property, solid-liquid host-guest composites can realize the ease of fabrication, long-term stability, and a broad spectrum of enhanced properties, which cannot be fully met by conventional solid-solid composites or liquid-liquid composites. This review presents the state-of-the-art progress in solid-liquid host-guest composites. Initially, the concept, classification, design strategy, as well as fabrication methods as a path forward to develop the composites are unraveled, and further it is elaborated on how the functionality of porous solid and functional liquid can be harnessed to create composites with a broad range of unique properties, especially, the optical, thermal, electric, mechanical, sorption, and separation properties. With these fascinating properties, a myriad of emerging applications such as optical devices, thermal management, electromagnetic-interference shielding, soft electronics, gas capture and release, and multiphase separations are touched upon, inspiring more frontier researches in materials science, interfacial chemistry, membrane science, engineering, and multidisciplinary. Finally, this review provides the perspective on the future directions of solid-liquid host-guest composites and assesses the challenges and opportunities ahead.
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Affiliation(s)
- Zhizhi Sheng
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Yi Ding
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Guangyong Li
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Chen Fu
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Yinglai Hou
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Jing Lyu
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Kun Zhang
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
| | - Xuetong Zhang
- Suzhou Institute of Nano-Tech and Nano Bionics, Chinese Academy of Sciences, Suzhou, 215123, China
- Division of Surgery & Interventional Science, University College London, London, NW3 2PF, UK
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17
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Kallet RH, Lipnick MS, Burns GD. The Nature of Recruitment and De-Recruitment and Its Implications for Management of ARDS. Respir Care 2021; 66:510-530. [PMID: 33051254 PMCID: PMC9994058 DOI: 10.4187/respcare.08280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recruitment maneuvers in ARDS are used to improve oxygenation and lung mechanics by applying high airway pressures to reopen collapsed or obstructed peripheral airways and alveoli. In the early 1990s, recruitment maneuvers became a central feature of a variant form of lung-protective ventilation known as open-lung ventilation. This strategy is based on the belief that repetitive opening and closing of distal airspaces induces shear injury and therefore contributes both to ventilator-induced lung injury and ARDS-associated mortality. However, the largest multi-center randomized controlled trial of open-lung ventilation in moderate to severe ARDS reported that recruitment maneuver plateau pressures of 50-60 cm H2O were associated with significantly higher mortality compared to traditional lung-protective ventilation. Despite being based on well conducted preclinical and clinical recruitment maneuver studies, the higher mortality associated with the open-lung ventilation strategy requires re-examining the assumptions and conclusions drawn from those previous studies. This narrative review examines the evidence used to design recruitment maneuver strategies. We also review the radiologic, rheologic, and histopathologic evidence regarding the nature of lung injury and the phenomena of recruitment and de-recruitment as it informs our perceptions of recruitment potential in ARDS. Major lung-protective ventilation clinical trial data and other clinical data are also examined to assess the practical necessity of recruitment maneuvers in ARDS and whether a subset of cases might benefit from pursuing recruitment maneuver therapy. Finally, a less a radical approach to recruitment maneuvers is offered that might achieve the goals of recruitment maneuvers with less risk of harm.
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Affiliation(s)
- Richard H Kallet
- Respiratory Care Division, Department of Anesthesia and Perioperative Care, University of California San Francisco at San Francisco General Hospital, San Francisco, California.
| | - Michael S Lipnick
- Critical Care Division, Department of Anesthesia and Perioperative Care, University of California San Francisco at San Francisco General Hospital, San Francisco, California
| | - Gregory D Burns
- Respiratory Care Division, Department of Anesthesia and Perioperative Care, University of California San Francisco at San Francisco General Hospital, San Francisco, California
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18
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Blickensdorf M, Timme S, Figge MT. Hybrid Agent-Based Modeling of Aspergillus fumigatus Infection to Quantitatively Investigate the Role of Pores of Kohn in Human Alveoli. Front Microbiol 2020; 11:1951. [PMID: 32903715 PMCID: PMC7438790 DOI: 10.3389/fmicb.2020.01951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/24/2020] [Indexed: 12/31/2022] Open
Abstract
The healthy state of an organism is constantly threatened by external cues. Due to the daily inhalation of hundreds of particles and pathogens, the immune system needs to constantly accomplish the task of pathogen clearance in order to maintain this healthy state. However, infection dynamics are highly influenced by the peculiar anatomy of the human lung. Lung alveoli that are packed in alveolar sacs are interconnected by so called Pores of Kohn. Mainly due to the lack of in vivo methods, the role of Pores of Kohn in the mammalian lung is still under debate and partly contradicting hypotheses remain to be investigated. Although it was shown by electron microscopy that Pores of Kohn may serve as passageways for immune cells, their impact on the infection dynamics in the lung is still unknown under in vivo conditions. In the present study, we apply a hybrid agent-based infection model to quantitatively compare three different scenarios and discuss the importance of Pores of Kohn during infections of Aspergillus fumigatus. A. fumigatus is an airborne opportunistic fungus with rising incidences causing severe infections in immunocompromised patients that are associated with high mortality rates. Our hybrid agent-based model incorporates immune cell dynamics of alveolar macrophages – the resident phagocytes in the lung – as well as molecular dynamics of diffusing chemokines that attract alveolar macrophages to the site of infection. Consequently, this model allows a quantitative comparison of three different scenarios and to study the importance of Pores of Kohn. This enables us to demonstrate how passaging of alveolar macrophages and chemokine diffusion affect A. fumigatus infection dynamics. We show that Pores of Kohn alter important infection clearance mechanisms, such as the spatial distribution of macrophages and the effect of chemokine signaling. However, despite these differences, a lack of passageways for alveolar macrophages does impede infection clearance only to a minor extend. Furthermore, we quantify the importance of recruited macrophages in comparison to resident macrophages.
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Affiliation(s)
- Marco Blickensdorf
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Jena, Germany.,Faculty of Biological Sciences, Institute of Microbiology, Friedrich Schiller University Jena, Jena, Germany
| | - Sandra Timme
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Jena, Germany
| | - Marc Thilo Figge
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Jena, Germany.,Faculty of Biological Sciences, Institute of Microbiology, Friedrich Schiller University Jena, Jena, Germany
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19
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Niedbalski PJ, Cochran AS, Akinyi TG, Thomen RP, Fugate EM, Lindquist DM, Pratt RG, Cleveland ZI. Preclinical hyperpolarized 129 Xe MRI: ventilation and T 2 * mapping in mouse lungs at 7 T using multi-echo flyback UTE. NMR IN BIOMEDICINE 2020; 33:e4302. [PMID: 32285574 PMCID: PMC7702724 DOI: 10.1002/nbm.4302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/28/2020] [Accepted: 03/07/2020] [Indexed: 05/13/2023]
Abstract
Fast apparent transverse relaxation (short T2 *) is a common obstacle when attempting to perform quantitative 1 H MRI of the lungs. While T2 * times are longer for pulmonary hyperpolarized (HP) gas functional imaging (in particular for gaseous 129 Xe), T2 * can still lead to quantitative inaccuracies for sequences requiring longer echo times (such as diffusion weighted images) or longer readout duration (such as spiral sequences). This is especially true in preclinical studies, where high magnetic fields lead to shorter relaxation times than are typically seen in human studies. However, the T2 * of HP 129 Xe in the most common animal model of human disease (mice) has not been reported. Herein, we present a multi-echo radial flyback imaging sequence and use it to measure HP 129 Xe T2 * at 7 T under a variety of respiratory conditions. This sequence mitigates the impact of T1 relaxation outside the animal by using multiple gradient-refocused echoes to acquire images at a number of effective echo times for each RF excitation. After validating the sequence using a phantom containing water doped with superparamagnetic iron oxide nanoparticles, we measured the 129 Xe T2 * in vivo for 10 healthy C57Bl/6 J mice and found T2 * ~ 5 ms in the lung airspaces. Interestingly, T2 * was relatively constant over all experimental conditions, and varied significantly with sex, but not age, mass, or the O2 content of the inhaled gas mixture. These results are discussed in the context of T2 * relaxation within porous media.
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Affiliation(s)
- Peter J. Niedbalski
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Alexander S. Cochran
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Teckla G. Akinyi
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Robert P. Thomen
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Elizabeth M. Fugate
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Diana M. Lindquist
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Ronald G. Pratt
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Zackary I. Cleveland
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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20
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Matuszak J, Tabuchi A, Kuebler WM. Ventilation and Perfusion at the Alveolar Level: Insights From Lung Intravital Microscopy. Front Physiol 2020; 11:291. [PMID: 32308629 PMCID: PMC7145899 DOI: 10.3389/fphys.2020.00291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/16/2020] [Indexed: 01/13/2023] Open
Abstract
Intravital microscopy (IVM) offers unique possibilities for the observation of biological processes and disease related mechanisms in vivo. Especially for anatomically complex and dynamic organs such as the lung and its main functional unit, the alveolus, IVM provides exclusive advantages in terms of spatial and temporal resolution. By the use of lung windows, which have advanced and improved over time, direct access to the lung surface is provided. In this review we will discuss two main topics, namely alveolar dynamics and perfusion from the perspective of IVM-based studies. Of special interest are unanswered questions regarding alveolar dynamics such as: What are physiologic alveolar dynamics? How do these dynamics change under pathologic conditions and how do those changes contribute to ventilator-induced lung injury? How can alveolar dynamics be targeted in a beneficial way? With respect to alveolar perfusion IVM has propelled our understanding of the pulmonary microcirculation and its perfusion, as well as pulmonary vasoreactivity, permeability and immunological aspects. Whereas the general mechanism behind these processes are understood, we still lack a proper understanding of the complex, multidimensional interplay between alveolar ventilation and microvascular perfusion, capillary recruitment, or vascular immune responses under physiologic and pathologic conditions. These are only part of the unanswered questions and problems, which we still have to overcome. IVM as the tool of choice might allow us to answer part of these questions within the next years or decades. As every method, IVM has advantages as well as limitations, which have to be taken into account for data analysis and interpretation, which will be addressed in this review.
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Affiliation(s)
- Jasmin Matuszak
- Institute of Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Arata Tabuchi
- The Keenan Research Centre for Biomedical Science at St. Michael’s, Toronto, ON, Canada
| | - Wolfgang M. Kuebler
- Institute of Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Departments of Surgery and Physiology, University of Toronto, Toronto, ON, Canada
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21
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Kollisch-Singule M, Satalin J, Blair SJ, Andrews PL, Gatto LA, Nieman GF, Habashi NM. Mechanical Ventilation Lessons Learned From Alveolar Micromechanics. Front Physiol 2020; 11:233. [PMID: 32265735 PMCID: PMC7105828 DOI: 10.3389/fphys.2020.00233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 02/28/2020] [Indexed: 01/05/2023] Open
Abstract
Morbidity and mortality associated with lung injury remains disappointingly unchanged over the last two decades, in part due to the current reliance on lung macro-parameters set on the ventilator instead of considering the micro-environment and the response of the alveoli and alveolar ducts to ventilator adjustments. The response of alveoli and alveolar ducts to mechanical ventilation modes cannot be predicted with current bedside methods of assessment including lung compliance, oxygenation, and pressure-volume curves. Alveolar tidal volumes (Vt) are less determined by the Vt set on the mechanical ventilator and more dependent on the number of recruited alveoli available to accommodate that Vt and their heterogeneous mechanical properties, such that high lung Vt can lead to a low alveolar Vt and low Vt can lead to high alveolar Vt. The degree of alveolar heterogeneity that exists cannot be predicted based on lung calculations that average the individual alveolar Vt and compliance. Finally, the importance of time in promoting alveolar stability, specifically the inspiratory and expiratory times set on the ventilator, are currently under-appreciated. In order to improve outcomes related to lung injury, the respiratory physiology of the individual patient, specifically at the level of the alveolus, must be targeted. With experimental data, this review highlights some of the known mechanical ventilation adjustments that are helpful or harmful at the level of the alveolus.
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Affiliation(s)
| | - Joshua Satalin
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Sarah J. Blair
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Penny L. Andrews
- Department of Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, United States
| | - Louis A. Gatto
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, United States
- Department of Biological Sciences, SUNY Cortland, Cortland, NY, United States
| | - Gary F. Nieman
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Nader M. Habashi
- Department of Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, United States
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22
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Zhang J, Liu P, Yi B, Wang Z, Huang X, Jiang L, Yao X. Bio-Inspired Elastic Liquid-Infused Material for On-Demand Underwater Manipulation of Air Bubbles. ACS NANO 2019; 13:10596-10602. [PMID: 31465692 DOI: 10.1021/acsnano.9b04771] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Precise and robust manipulation of air bubbles will favor intense demands from governing processes of chemical reactions to enhancing transportation efficiency in multiphase engineering systems. Inspired by the working mechanism of mucous lining in lung alveoli, the elastic liquid-infused material (eLIM) is constructed by infiltrating an interconnected porous elastomer with a low-surface-energy lining liquid. With the help of the lining liquid, the pore pressure of the interconnected channels in eLIM can be reversibly regulated under mechanical stretching, balancing the capillary pressure in the channels with diverse radii and allowing gas flow in these channels. Therefore, air bubbles could be transported in and across the eLIM, showing on-demand control on the bubble contact angle, merging and splitting in an active and precise manner. The robust manipulation strategies on air bubbles can find applications in bioreactors and many other bubble-involved processes.
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Affiliation(s)
- Jianqiang Zhang
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
| | - Peng Liu
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
| | - Bo Yi
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
| | - Zhaoyue Wang
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
| | - Xin Huang
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
| | - Lei Jiang
- Key Laboratory of Bio-Inspired Smart Interfacial Science and Technology of Ministry of Education, School of Chemistry , Beihang University , Beijing 100191 , China
| | - Xi Yao
- Department of Biomedical Sciences , City University of Hong Kong , Tat Chee Avenue , Kowloon , Hong Kong, China
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23
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Xi J, Talaat M. Nanoparticle Deposition in Rhythmically Moving Acinar Models with Interalveolar Septal Apertures. NANOMATERIALS 2019; 9:nano9081126. [PMID: 31382669 PMCID: PMC6723253 DOI: 10.3390/nano9081126] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 11/16/2022]
Abstract
Pulmonary delivery of nanomedicines has been extensively studied in recent years because of their enhanced biocompatibility, sustained-release properties, and surface modification capability. The lung as a target also offers many advantages over other routers, such as large surface area, noninvasive, quick therapeutic onset, and avoiding first-pass metabolism. However, nanoparticles smaller than 0.26 µm typically escape phagocytosis and remain in the alveoli for a long time, leading to particle accumulation and invoking tissue responses. It is imperative to understand the behavior and fates of inhaled nanoparticles in the alveoli to reliably assess therapeutic outcomes of nanomedicines or health risk of environmental toxins. The objective of this study is to numerically investigate nanoparticle deposition in a duct-alveolar model with varying sizes of inter-alveolar septal apertures (pores). A discrete phase Lagrangian model was implemented to track nanoparticle trajectories under the influence of rhythmic wall expansion and contraction. Both temporal and spatial dosimetry in the alveoli were computed. Wall motions are essential for nanoparticles to penetrate the acinar region and deposit in the alveoli. The level of aerosol irreversibility (i.e., mixing of inhaled nanoparticles with residual air in the alveolar airspace) is determined by the particle diffusivity, which in turn, dictates the fraction of particles being exhaled out. When deposition in the upper airways was not considered, high alveolar deposition rates (74–95%) were predicted for all nanoparticles considered (1–1000 nm), which were released into the alveoli at the beginning of the inhalation. The pore size notably affects the deposition pattern of inhaled nanoparticles but exerts a low impact upon the total deposition fractions. This finding indicates that consistent pulmonary doses of nanomedicine are possible in emphysema patients if breathing maneuver with the same tidal volume can be performed.
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Affiliation(s)
- Jinxiang Xi
- Department of Biomedical Engineering, University of Massachusetts, Lowell, MA 01854, USA.
- Department of Biomedical Engineering, California Baptist University, Riverside, CA 92504, USA.
| | - Mohamed Talaat
- Department of Aerospace, Industrial, and Mechanical Engineering, California Baptist University, Riverside, CA 92504, USA
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24
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Grune J, Tabuchi A, Kuebler WM. Alveolar dynamics during mechanical ventilation in the healthy and injured lung. Intensive Care Med Exp 2019; 7:34. [PMID: 31346797 PMCID: PMC6658629 DOI: 10.1186/s40635-019-0226-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 02/12/2023] Open
Abstract
Mechanical ventilation is a life-saving therapy in patients with acute respiratory distress syndrome (ARDS). However, mechanical ventilation itself causes severe co-morbidities in that it can trigger ventilator-associated lung injury (VALI) in humans or ventilator-induced lung injury (VILI) in experimental animal models. Therefore, optimization of ventilation strategies is paramount for the effective therapy of critical care patients. A major problem in the stratification of critical care patients for personalized ventilation settings, but even more so for our overall understanding of VILI, lies in our limited insight into the effects of mechanical ventilation at the actual site of injury, i.e., the alveolar unit. Unfortunately, global lung mechanics provide for a poor surrogate of alveolar dynamics and methods for the in-depth analysis of alveolar dynamics on the level of individual alveoli are sparse and afflicted by important limitations. With alveolar dynamics in the intact lung remaining largely a "black box," our insight into the mechanisms of VALI and VILI and the effectiveness of optimized ventilation strategies is confined to indirect parameters and endpoints of lung injury and mortality.In the present review, we discuss emerging concepts of alveolar dynamics including alveolar expansion/contraction, stability/instability, and opening/collapse. Many of these concepts remain still controversial, in part due to limitations of the different methodologies applied. We therefore preface our review with an overview of existing technologies and approaches for the analysis of alveolar dynamics, highlighting their individual strengths and limitations which may provide for a better appreciation of the sometimes diverging findings and interpretations. Joint efforts combining key technologies in identical models to overcome the limitations inherent to individual methodologies are needed not only to provide conclusive insights into lung physiology and alveolar dynamics, but ultimately to guide critical care patient therapy.
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Affiliation(s)
- Jana Grune
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, 10117 Berlin, Germany
| | - Arata Tabuchi
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Wolfgang M. Kuebler
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, 10117 Berlin, Germany
- The Keenan Research Centre for Biomedical Science at St. Michael’s, Toronto, Canada
- Departments of Surgery and Physiology, University of Toronto, Toronto, Canada
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25
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LIU TIANYA, WANG YUXING, LIU XIAOYU, YUAN LAN, LI DEYU, QIAO HUITING, FAN YUBO. EFFECTS OF ALVEOLAR MORPHOLOGY ON ALVEOLAR MECHANICS: AN EXPERIMENTAL STUDY OF MOUSE LUNG BASED ON TWO- AND THREE-DIMENSIONAL IMAGING METHODS. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419500271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Understanding alveolar mechanics is important for preventing the possible lung injuries during mechanical ventilation. Alveolar clusters with smaller size are found having lower compliance in two-dimensional studies. But the influence of alveolar shape on compliance is unclear. In order to investigate how alveolar morphology affects their behavior, we tracked subpleural alveoli of isolated mouse lungs during quasi-static ventilation using two- and three-dimensional imaging techniques. Results showed that alveolar clusters with smaller size and more spherical shape had lower compliance. There was a better correlation of sphericity rather than circularity with alveolar compliance. The compliance of clusters with great shape change was larger than that with relatively slight shape change. These findings suggest the contribution of lung heterogeneous expansion to lung injuries associated with mechanical ventilation.
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Affiliation(s)
- TIANYA LIU
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - YUXING WANG
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - XIAOYU LIU
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - LAN YUAN
- Beijing Key Laboratory of Rehabilitation Engineering for Elderly, National Research Center for Rehabilitation Technical Aids, Beijing 100176, P. R. China
| | - DEYU LI
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - HUITING QIAO
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - YUBO FAN
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
- Medical and Health Analysis Center, Peking University, Beijing 100191, P. R. China
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26
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Kollisch-Singule M, Andrews P, Satalin J, Gatto LA, Nieman GF, Habashi NM. The time-controlled adaptive ventilation protocol: mechanistic approach to reducing ventilator-induced lung injury. Eur Respir Rev 2019; 28:28/152/180126. [PMID: 30996041 DOI: 10.1183/16000617.0126-2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/16/2019] [Indexed: 11/05/2022] Open
Abstract
Airway pressure release ventilation (APRV) is a ventilator mode that has previously been considered a rescue mode, but has gained acceptance as a primary mode of ventilation. In clinical series and experimental animal models of extrapulmonary acute respiratory distress syndrome (ARDS), the early application of APRV was able to prevent the development of ARDS. Recent experimental evidence has suggested mechanisms by which APRV, using the time-controlled adaptive ventilation (TCAV) protocol, may reduce lung injury, including: 1) an improvement in alveolar recruitment and homogeneity; 2) reduction in alveolar and alveolar duct micro-strain and stress-risers; 3) reduction in alveolar tidal volumes; and 4) recruitment of the chest wall by combating increased intra-abdominal pressure. This review examines these studies and discusses our current understanding of the pleiotropic mechanisms by which TCAV protects the lung. APRV set according to the TCAV protocol has been misunderstood and this review serves to highlight the various protective physiological and mechanical effects it has on the lung, so that its clinical application may be broadened.
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Affiliation(s)
| | - Penny Andrews
- Dept of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joshua Satalin
- Dept of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Louis A Gatto
- Dept of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.,Dept of Biological Sciences, SUNY Cortland, Cortland, NY, USA
| | - Gary F Nieman
- Dept of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Nader M Habashi
- Dept of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
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27
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Blickensdorf M, Timme S, Figge MT. Comparative Assessment of Aspergillosis by Virtual Infection Modeling in Murine and Human Lung. Front Immunol 2019; 10:142. [PMID: 30804941 PMCID: PMC6370618 DOI: 10.3389/fimmu.2019.00142] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/17/2019] [Indexed: 01/01/2023] Open
Abstract
Aspergillus fumigatus is a ubiquitous opportunistic fungal pathogen that can cause severe infections in immunocompromised patients. Conidia that reach the lower respiratory tract are confronted with alveolar macrophages, which are the resident phagocytic cells, constituting the first line of defense. If not efficiently removed in time, A. fumigatus conidia can germinate causing severe infections associated with high mortality rates. Mice are the most extensively used model organism in research on A. fumigatus infections. However, in addition to structural differences in the lung physiology of mice and the human host, applied infection doses in animal experiments are typically orders of magnitude larger compared to the daily inhalation doses of humans. The influence of these factors, which must be taken into account in a quantitative comparison and knowledge transfer from mice to humans, is difficult to measure since in vivo live cell imaging of the infection dynamics under physiological conditions is currently not possible. In the present study, we compare A. fumigatus infection in mice and humans by virtual infection modeling using a hybrid agent-based model that accounts for the respective lung physiology and the impact of a wide range of infection doses on the spatial infection dynamics. Our computer simulations enable comparative quantification of A. fumigatus infection clearance in the two hosts to elucidate (i) the complex interplay between alveolar morphometry and the fungal burden and (ii) the dynamics of infection clearance, which for realistic fungal burdens is found to be more efficiently realized in mice compared to humans.
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Affiliation(s)
- Marco Blickensdorf
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
- Faculty of Biological Sciences, Friedrich Schiller University of Jena, Jena, Germany
| | - Sandra Timme
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
- Faculty of Biological Sciences, Friedrich Schiller University of Jena, Jena, Germany
| | - Marc Thilo Figge
- Research Group Applied Systems Biology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
- Faculty of Biological Sciences, Friedrich Schiller University of Jena, Jena, Germany
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28
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Ziener CH, Kampf T, Kurz FT, Schlemmer HP, Buschle LR. Pseudo-diffusion effects in lung MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2019; 299:1-11. [PMID: 30529849 DOI: 10.1016/j.jmr.2018.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
Magnetic resonance imaging of lung tissue is strongly influenced by susceptibility effects between spin-bearing water molecules and air-filled alveoli. The measured lineshape, however, also depends on the interplay between susceptibility effects and blood-flow around alveoli that can be approximated as pseudo-diffusion. Both effects are quantitatively described by the Bloch-Torrey-equation, which was so far only solved for dephasing on the alveolar surface. In this work, we extend this model to the whole range of physiological relevant air volume fractions. The results agree very well with in vivo measurements in human lung tissue.
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Affiliation(s)
- C H Ziener
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany; Würzburg University Hospital, Department of Neuroradiology, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - F T Kurz
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - H P Schlemmer
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - L R Buschle
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
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29
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Howell C, Grinthal A, Sunny S, Aizenberg M, Aizenberg J. Designing Liquid-Infused Surfaces for Medical Applications: A Review. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30:e1802724. [PMID: 30151909 DOI: 10.1002/adma.201802724] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/06/2018] [Indexed: 05/21/2023]
Abstract
The development of new technologies is key to the continued improvement of medicine, relying on comprehensive materials design strategies that can integrate advanced therapeutic and diagnostic functions with a variety of surface properties such as selective adhesion, dynamic responsiveness, and optical/mechanical tunability. Liquid-infused surfaces have recently come to the forefront as a unique approach to surface coatings that can resist adhesion of a wide range of contaminants on medical devices. Furthermore, these surfaces are proving highly versatile in enabling the integration of established medical surface treatments alongside the antifouling capabilities, such as drug release or biomolecule organization. Here, the range of research being conducted on liquid-infused surfaces for medical applications is presented, from an understanding of the basics behind the interactions of physiological fluids, microbes, and mammalian cells with liquid layers to current applications of these materials in point-of-care diagnostics, medical tubing, instruments, implants, and tissue engineering. Throughout this exploration, the design parameters of liquid-infused surfaces and how they can be adapted and tuned to particular applications are discussed, while identifying how the range of controllable factors offered by liquid-infused surfaces can be used to enable completely new and dynamic approaches to materials and devices for human health.
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Affiliation(s)
- Caitlin Howell
- Department of Chemical and Biomedical Engineering and School of Biomedical Science and Engineering, University of Maine, 5737 Jenness Hall, Orono, ME, 04469, USA
| | - Alison Grinthal
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 021383, USA
| | - Steffi Sunny
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 021383, USA
| | - Michael Aizenberg
- Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Boston, MA, 02115, USA
| | - Joanna Aizenberg
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 021383, USA
- Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Boston, MA, 02115, USA
- Kavli Institute for Bionano Science and Technology, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, USA
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30
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Airflow and Particle Deposition in Acinar Models with Interalveolar Septal Walls and Different Alveolar Numbers. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:3649391. [PMID: 30356402 PMCID: PMC6176334 DOI: 10.1155/2018/3649391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 11/17/2022]
Abstract
Unique features exist in acinar units such as multiple alveoli, interalveolar septal walls, and pores of Kohn. However, the effects of such features on airflow and particle deposition remain not well quantified due to their structural complexity. This study aims to numerically investigate particle dynamics in acinar models with interalveolar septal walls and pores of Kohn. A simplified 4-alveoli model with well-defined geometries and a physiologically realistic 45-alveoli model was developed. A well-validated Lagrangian tracking model was used to simulate particle trajectories in the acinar models with rhythmically expanding and contracting wall motions. Both spatial and temporal dosimetries in the acinar models were analyzed. Results show that collateral ventilation exists among alveoli due to pressure imbalance. The size of interalveolar septal aperture significantly alters the spatial deposition pattern, while it has an insignificant effect on the total deposition rate. Surprisingly, the deposition rate in the 45-alveoli model is lower than that in the 4-alveoli model, indicating a stronger particle dispersion in more complex models. The gravity orientation angle has a decreasing effect on acinar deposition rates with an increasing number of alveoli retained in the model; such an effect is nearly negligible in the 45-alveoli model. Breath-holding increased particle deposition in the acinar region, which was most significant in the alveoli proximal to the duct. Increasing inhalation depth only slightly increases the fraction of deposited particles over particles entering the alveolar model but has a large influence on dispensing particles to the peripheral alveoli. Results of this study indicate that an empirical correlation for acinar deposition can be developed based on alveolar models with reduced complexity; however, what level of geometry complexity would be sufficient is yet to be determined.
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31
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Ngo C, Dahlmanns S, Vollmer T, Misgeld B, Leonhardt S. An object-oriented computational model to study cardiopulmonary hemodynamic interactions in humans. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 159:167-183. [PMID: 29650311 DOI: 10.1016/j.cmpb.2018.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/02/2018] [Accepted: 03/09/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system. The model considers non-linear behaviors of veins, pulmonary capillaries, collapsible airways, alveoli, and the chest wall. Model parameters were derisved based on literature values. Model validation was performed by comparing simulation results with clinical and animal data reported in literature. RESULTS The model is able to provide quantitative values of alveolar, pleural, interstitial, aortic and ventricular pressures, as well as heart and lung volumes during spontaneous breathing and mechanical ventilation. Results of baseline simulation demonstrate the consistency of the assigned parameters. Simulation results during mechanical ventilation with PEEP trials can be directly compared with animal and clinical data given in literature. CONCLUSIONS Object-oriented programming languages can be used to model interconnected systems including model non-linearities. The model provides a useful tool to investigate cardiopulmonary activity during spontaneous breathing and mechanical ventilation.
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Affiliation(s)
- Chuong Ngo
- Chair of Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany.
| | - Stephan Dahlmanns
- Chair of Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - Thomas Vollmer
- Philips Technologie GmbH Innovative Technologies, Pauwelsstr. 17, 52074 Aachen, Germany
| | - Berno Misgeld
- Chair of Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - Steffen Leonhardt
- Chair of Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
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32
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Morozov VN, Mikheev AY, Shlyapnikov YM, Nikolaev AA, Lyadova IV. Non-invasive lung disease diagnostics from exhaled microdroplets of lung fluid: perspectives and technical challenges. J Breath Res 2017; 12:017103. [PMID: 28850044 PMCID: PMC7099678 DOI: 10.1088/1752-7163/aa88e4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/22/2017] [Accepted: 08/29/2017] [Indexed: 01/27/2023]
Abstract
The combination of ultra-sensitive assay techniques and recent improvements in the instrumentation used to collect microdroplets of lung fluid (MLF) from exhaled breath has enabled the development of non-invasive lung disease diagnostics that are based on MLF analysis. In one example of this approach, electrospun nylon filters were used to collect MLFs from patients with pulmonary tuberculosis. The filters were washed to obtain liquid probes, which were then tested for human immunoglobulin A (h-IgA) and fractions of h-IgA specific to ESAT-6 and Psts-1, two antigens secreted by Mycobacterium tuberculosis. Probes collected for 10 min contained 100-1500 fg of h-IgA and, in patients with pulmonary tuberculosis, a portion of these h-IgA molecules showed specificity to the secreted antigens. Separate MLFs and their dry residues were successfully collected using an electrostatic collector and impactor developed especially for this purpose. Visualization of MLF dry residues by atomic force microscopy made it possible to estimate the lipid content in each MLF and revealed mucin molecules in some MLFs. This exciting new approach will likely make it possible to detect biomarkers in individual MLFs. MLFs emerging from an infection site ('hot' microdroplets) are expected to be enriched with infection biomarkers. This paper discusses possible experimental approaches to detecting biomarkers in single MLFs, as well as certain technological problems that need to be resolved in order to develop new non-invasive diagnostics based on analysing biomarkers in separate MLFs.
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Affiliation(s)
- Victor N Morozov
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, Pushchino, Moscow Region, Russia
- National Center for Biodefense and Infectious Diseases, George Mason University, VA, United States of America
| | - Andrey Y Mikheev
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, Pushchino, Moscow Region, Russia
| | - Yuri M Shlyapnikov
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, Pushchino, Moscow Region, Russia
| | - Alexander A Nikolaev
- Department of Immunology, Central Tuberculosis Research Institute, Russian Academy of Medical Sciences, Moscow, Russia
| | - Irina V Lyadova
- Department of Immunology, Central Tuberculosis Research Institute, Russian Academy of Medical Sciences, Moscow, Russia
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Nieman GF, Satalin J, Andrews P, Aiash H, Habashi NM, Gatto LA. Personalizing mechanical ventilation according to physiologic parameters to stabilize alveoli and minimize ventilator induced lung injury (VILI). Intensive Care Med Exp 2017; 5:8. [PMID: 28150228 PMCID: PMC5289131 DOI: 10.1186/s40635-017-0121-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/26/2017] [Indexed: 12/15/2022] Open
Abstract
It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation. Thus, Vt is often but not always set as a "one-size-fits-all" approach and although PEEP is often set arbitrarily at 5 cmH2O, it may be personalized according to changes in a physiologic parameter, most often to oxygenation. However, there is evidence that oxygenation as a method to optimize PEEP is not congruent with the PEEP levels necessary to maintain an open and stable lung. Thus, optimal PEEP might not be personalized to the lung pathology of an individual patient using oxygenation as the physiologic feedback system. Multiple methods of personalizing PEEP have been tested and include dead space, lung compliance, lung stress and strain, ventilation patterns using computed tomography (CT) or electrical impedance tomography (EIT), inflection points on the pressure/volume curve (P/V), and the slope of the expiratory flow curve using airway pressure release ventilation (APRV). Although many studies have shown that personalizing PEEP is possible, there is no consensus as to the optimal technique. This review will assess various methods used to personalize PEEP, directed by physiologic parameters, necessary to adaptively adjust ventilator settings with progressive changes in lung pathophysiology.
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Affiliation(s)
- Gary F. Nieman
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY USA
| | - Joshua Satalin
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY USA
- Cardiopulmonary Critical Care Lab, Department of Surgery, Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210 USA
| | | | - Hani Aiash
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY USA
| | - Nader M. Habashi
- Department of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD USA
| | - Louis A. Gatto
- Biological Sciences Department, Biological Sciences Department, SUNY Cortland, Cortland, NY USA
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Kollisch-Singule MC, Jain SV, Andrews PL, Satalin J, Gatto LA, Villar J, De Backer D, Gattinoni L, Nieman GF, Habashi NM. Looking beyond macroventilatory parameters and rethinking ventilator-induced lung injury. J Appl Physiol (1985) 2017; 124:1214-1218. [PMID: 29146685 DOI: 10.1152/japplphysiol.00412.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Sumeet V Jain
- Department of Surgery, SUNY Upstate Medical University , Syracuse, New York
| | - Penny L Andrews
- Department of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine , Baltimore, Maryland
| | - Joshua Satalin
- Department of Surgery, SUNY Upstate Medical University , Syracuse, New York
| | - Louis A Gatto
- Department of Surgery, SUNY Upstate Medical University , Syracuse, New York.,Department of Biological Sciences, SUNY Cortland, Cortland, New York
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III , Madrid , Spain.,Research Unit, Hospital Universitario Dr. Negrin , Las Palmas de Gran Canaria , Spain
| | - Daniel De Backer
- Department of Intensive Care, CHIREC Hospitals, Université Libre de Bruxelles , Brussels , Belgium
| | - Luciano Gattinoni
- Department of Anesthesia and Intensive Care, Georg-August-Universität, Göttingen , Germany
| | - Gary F Nieman
- Department of Surgery, SUNY Upstate Medical University , Syracuse, New York
| | - Nader M Habashi
- Department of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine , Baltimore, Maryland
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35
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Nieman GF, Satalin J, Kollisch-Singule M, Andrews P, Aiash H, Habashi NM, Gatto LA. Physiology in Medicine: Understanding dynamic alveolar physiology to minimize ventilator-induced lung injury. J Appl Physiol (1985) 2017; 122:1516-1522. [PMID: 28385915 PMCID: PMC7203565 DOI: 10.1152/japplphysiol.00123.2017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/16/2017] [Accepted: 04/03/2017] [Indexed: 02/01/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) remains a serious clinical problem with the main treatment being supportive in the form of mechanical ventilation. However, mechanical ventilation can be a double-edged sword: if set improperly, it can exacerbate the tissue damage caused by ARDS; this is known as ventilator-induced lung injury (VILI). To minimize VILI, we must understand the pathophysiologic mechanisms of tissue damage at the alveolar level. In this Physiology in Medicine paper, the dynamic physiology of alveolar inflation and deflation during mechanical ventilation will be reviewed. In addition, the pathophysiologic mechanisms of VILI will be reviewed, and this knowledge will be used to suggest an optimal mechanical breath profile (MBP: all airway pressures, volumes, flows, rates, and the duration that they are applied at both inspiration and expiration) necessary to minimize VILI. Our review suggests that the current protective ventilation strategy, known as the "open lung strategy," would be the optimal lung-protective approach. However, the viscoelastic behavior of dynamic alveolar inflation and deflation has not yet been incorporated into protective mechanical ventilation strategies. Using our knowledge of dynamic alveolar mechanics (i.e., the dynamic change in alveolar and alveolar duct size and shape during tidal ventilation) to modify the MBP so as to minimize VILI will reduce the morbidity and mortality associated with ARDS.
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Affiliation(s)
- Gary F Nieman
- State University of New York Upstate Medical University, Syracuse, New York
| | - Josh Satalin
- State University of New York Upstate Medical University, Syracuse, New York;
| | | | - Penny Andrews
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland
| | - Hani Aiash
- State University of New York Upstate Medical University, Syracuse, New York
- Suez Canal University, Ismailia, Egypt; and
| | | | - Louis A Gatto
- State University of New York Upstate Medical University, Syracuse, New York
- State University of New York Cortland, Cortland, New York
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36
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Fahlman A, Moore MJ, Garcia-Parraga D. Respiratory function and mechanics in pinnipeds and cetaceans. J Exp Biol 2017; 220:1761-1773. [DOI: 10.1242/jeb.126870] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT
In this Review, we focus on the functional properties of the respiratory system of pinnipeds and cetaceans, and briefly summarize the underlying anatomy; in doing so, we provide an overview of what is currently known about their respiratory physiology and mechanics. While exposure to high pressure is a common challenge among breath-hold divers, there is a large variation in respiratory anatomy, function and capacity between species – how are these traits adapted to allow the animals to withstand the physiological challenges faced during dives? The ultra-deep diving feats of some marine mammals defy our current understanding of respiratory physiology and lung mechanics. These animals cope daily with lung compression, alveolar collapse, transient hyperoxia and extreme hypoxia. By improving our understanding of respiratory physiology under these conditions, we will be better able to define the physiological constraints imposed on these animals, and how these limitations may affect the survival of marine mammals in a changing environment. Many of the respiratory traits to survive exposure to an extreme environment may inspire novel treatments for a variety of respiratory problems in humans.
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Affiliation(s)
- Andreas Fahlman
- Fundación Oceanográfic de la Comunidad Valenciana, Gran Vía Marques del Turia 19, Valencia 46005, Spain
- Department of Life Sciences, Texas A&M University-Corpus Christi, 6300 Ocean Drive, Corpus Christi, TX 78412, USA
| | - Michael J. Moore
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - Daniel Garcia-Parraga
- Fundación Oceanográfic de la Comunidad Valenciana, Gran Vía Marques del Turia 19, Valencia 46005, Spain
- Oceanográfic-Avanqua, Ciudad de las Artes y las Ciencias, Valencia 46013, Spain
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Xin Y, Cereda M, Kadlecek S, Emami K, Hamedani H, Duncan I, Rajaei J, Hughes L, Meeder N, Naji J, Profka H, Bolognese BJ, Foley JP, Podolin PL, Rizi RR. Hyperpolarized gas diffusion MRI of biphasic lung inflation in short- and long-term emphysema models. Am J Physiol Lung Cell Mol Physiol 2017; 313:L305-L312. [PMID: 28473321 DOI: 10.1152/ajplung.00048.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/28/2017] [Accepted: 04/29/2017] [Indexed: 11/22/2022] Open
Abstract
During lung inflation, airspace dimensions are affected nonlinearly by both alveolar expansion and recruitment, potentially confounding the identification of emphysematous lung by hyperpolarized helium-3 diffusion magnetic resonance imaging (HP MRI). This study aimed to characterize lung inflation over a broad range of inflation volume and pressure values in two different models of emphysema, as well as in normal lungs. Elastase-treated rats (n = 7) and healthy controls (n = 7) were imaged with HP MRI. Gradual inflation was achieved by incremental changes to both inflation volume and airway pressure. The apparent diffusion coefficient (ADC) was measured at each level of inflation and fitted to the corresponding airway pressures as the second-order response equation, with minimizing residue (χ2 < 0.001). A biphasic ADC response was detected, with an initial ADC increase followed by a decrease at airway pressures >18 cmH2O. Discrimination between treated and control rats was optimal when airway pressure was intermediate (between 10 and 11 cmH2O). Similar findings were confirmed in mice following long-term exposure to cigarette smoke, where optimal discrimination between treated and healthy mice occurred at a similar airway pressure as in the rats. We subsequently explored the evolution of ADC measured at the intermediate inflation level in mice after prolonged smoke exposure and found a significant increase (P < 0.01) in ADC over time. Our results demonstrate that measuring ADC at intermediate inflation enhances the distinction between healthy and diseased lungs, thereby establishing a model that may improve the diagnostic accuracy of future HP gas diffusion studies.
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Affiliation(s)
- Yi Xin
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maurizio Cereda
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ian Duncan
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Liam Hughes
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Natalie Meeder
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph Naji
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Harrilla Profka
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Joseph P Foley
- Glaxosmithkline, Incorpoarted, King of Prussia, Pennsylvania
| | | | - Rahim R Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania;
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38
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Buschle LR, Kurz FT, Kampf T, Wagner WL, Duerr J, Stiller W, Konietzke P, Wünnemann F, Mall MA, Wielpütz MO, Schlemmer HP, Ziener CH. Dephasing and diffusion on the alveolar surface. Phys Rev E 2017; 95:022415. [PMID: 28297921 DOI: 10.1103/physreve.95.022415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Indexed: 06/06/2023]
Abstract
We propose a surface model of spin dephasing in lung tissue that includes both susceptibility and diffusion effects to provide a closed-form solution of the Bloch-Torrey equation on the alveolar surface. The nonlocal susceptibility effects of the model are validated against numerical simulations of spin dephasing in a realistic lung tissue geometry acquired from synchotron-based μCT data sets of mouse lung tissue, and against simulations in the well-known Wigner-Seitz model geometry. The free induction decay is obtained in dependence on microscopic tissue parameters and agrees very well with in vivo lung measurements at 1.5 Tesla to allow a quantification of the local mean alveolar radius. Our results are therefore potentially relevant for the clinical diagnosis and therapy of pulmonary diseases.
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Affiliation(s)
- L R Buschle
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - F T Kurz
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany
| | - W L Wagner
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - J Duerr
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- University of Heidelberg, Department of Translational Pulmonology, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - W Stiller
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - P Konietzke
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - F Wünnemann
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - M A Mall
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- University of Heidelberg, Department of Translational Pulmonology, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - M O Wielpütz
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - H P Schlemmer
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - C H Ziener
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Kizhakke Puliyakote AS, Vasilescu DM, Newell JD, Wang G, Weibel ER, Hoffman EA. Morphometric differences between central vs. surface acini in A/J mice using high-resolution micro-computed tomography. J Appl Physiol (1985) 2016; 121:115-22. [PMID: 27174924 DOI: 10.1152/japplphysiol.00317.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 05/06/2016] [Indexed: 11/22/2022] Open
Abstract
Through interior tomography, high-resolution microcomputed tomography (μCT) systems provide the ability to nondestructively assess the pulmonary acinus at micron and submicron resolutions. With the application of systematic uniform random sampling (SURS) principles applied to in situ fixed, intact, ex vivo lungs, we have sought to characterize morphometric differences in central vs. surface acini to better understand how well surface acini reflect global acinar geometry. Lungs from six mice (A/J strain, 15-20 wk of age) were perfusion fixed in situ and imaged using a multiresolution μCT system (Micro XCT 400, Zeiss). With the use of lower-resolution whole lung images, SURS methods were used for identification of central and surface foci for high-resolution imaging. Acinar morphometric metrics included diameters, lengths, and branching angles for each alveolar duct and total path lengths from entrance of the acinus to the terminal alveolar sacs. In addition, acinar volume, alveolar surface area, and surface area/volume ratios were assessed. A generation-based analysis demonstrated that central acini have significantly smaller branch diameters at each generation with no significant increase in branch lengths. In addition to larger-diameter alveolar ducts, surface acini had significantly increased numbers of branches and terminal alveolar sacs. The total path lengths from the acinar entrance to the terminal nodes were found to be higher in the case of surface acini. Volumes and surface areas of surface acini are greater than central acini, but there were no differences in surface/volume ratios. In conclusion, there are significant structural differences between surface and central acini in the A/J mouse.
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Affiliation(s)
- Abhilash S Kizhakke Puliyakote
- Department of Radiology, University of Iowa, Iowa City, Iowa; Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
| | | | - John D Newell
- Department of Radiology, University of Iowa, Iowa City, Iowa; Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
| | - Ge Wang
- Department of Electrical and Computer Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia; Department of Biomedical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | | | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa; Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa; Department of Medicine, University of Iowa, Iowa City, Iowa;
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Hou X, Hu Y, Grinthal A, Khan M, Aizenberg J. Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour. Nature 2015; 519:70-3. [DOI: 10.1038/nature14253] [Citation(s) in RCA: 330] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 01/15/2015] [Indexed: 12/26/2022]
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41
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Cereda M, Xin Y, Kadlecek S, Hamedani H, Rajaei J, Clapp J, Rizi RR. Hyperpolarized gas diffusion MRI for the study of atelectasis and acute respiratory distress syndrome. NMR IN BIOMEDICINE 2014; 27:1468-78. [PMID: 24920074 PMCID: PMC4232982 DOI: 10.1002/nbm.3136] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/03/2014] [Accepted: 04/21/2014] [Indexed: 06/03/2023]
Abstract
Considerable uncertainty remains about the best ventilator strategies for the mitigation of atelectasis and associated airspace stretch in patients with acute respiratory distress syndrome (ARDS). In addition to several immediate physiological effects, atelectasis increases the risk of ventilator-associated lung injury, which has been shown to significantly worsen ARDS outcomes. A number of lung imaging techniques have made substantial headway in clarifying the mechanisms of atelectasis. This paper reviews the contributions of computed tomography, positron emission tomography, and conventional MRI to understanding this phenomenon. In doing so, it also reveals several important shortcomings inherent to each of these approaches. Once these shortcomings have been made apparent, we describe how hyperpolarized (HP) gas MRI--a technique that is uniquely able to assess responses to mechanical ventilation and lung injury in peripheral airspaces--is poised to fill several of these knowledge gaps. The HP-MRI-derived apparent diffusion coefficient (ADC) quantifies the restriction of (3) He diffusion by peripheral airspaces, thereby obtaining pulmonary structural information at an extremely small scale. Lastly, this paper reports the results of a series of experiments that measured ADC in mechanically ventilated rats in order to investigate (i) the effect of atelectasis on ventilated airspaces, (ii) the relationship between positive end-expiratory pressure (PEEP), hysteresis, and the dimensions of peripheral airspaces, and (iii) the ability of PEEP and surfactant to reduce airspace dimensions after lung injury. An increase in ADC was found to be a marker of atelectasis-induced overdistension. With recruitment, higher airway pressures were shown to reduce stretch rather than worsen it. Moving forward, HP MRI has significant potential to shed further light on the atelectatic processes that occur during mechanical ventilation.
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Affiliation(s)
- Maurizio Cereda
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
| | - Yi Xin
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennia Rajaei
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Justin Clapp
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahim R. Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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42
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Leong AF, Buckley GA, Paganin DM, Hooper SB, Wallace MJ, Kitchen MJ. Real-time measurement of alveolar size and population using phase contrast x-ray imaging. BIOMEDICAL OPTICS EXPRESS 2014; 5:4024-38. [PMID: 25426328 PMCID: PMC4242036 DOI: 10.1364/boe.5.004024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 10/16/2014] [Accepted: 10/18/2014] [Indexed: 05/09/2023]
Abstract
Herein a propagation-based phase contrast x-ray imaging technique for measuring particle size and number is presented. This is achieved with an algorithm that utilizes the Fourier space signature of the speckle pattern associated with the images of particles. We validate this algorithm using soda-lime glass particles, demonstrating its effectiveness on random and non-randomly packed particles. This technique is then applied to characterise lung alveoli, which are difficult to measure dynamically in vivo with current imaging modalities due to inadequate temporal resolution and/or depth of penetration and field-of-view. We obtain an important result in that our algorithm is able to measure changes in alveolar size on the micron scale during ventilation and shows the presence of alveolar recruitment/de-recruitment in newborn rabbit kittens. This technique will be useful for ventilation management and lung diagnostic procedures.
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Affiliation(s)
| | | | | | - Stuart B. Hooper
- The Ritchie Centre MIMR-PHI Institute of Medical Research and the Department of Obstetrics and Gynaecology, Monash University, Vic 3168,
Australia
| | - Megan J. Wallace
- The Ritchie Centre MIMR-PHI Institute of Medical Research and the Department of Obstetrics and Gynaecology, Monash University, Vic 3168,
Australia
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43
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Salaün M, Modzelewski R, Marie JP, Moreno-Swirc S, Bourg-Heckly G, Thiberville L. In vivo assessment of the pulmonary microcirculation in elastase-induced emphysema using probe-based confocal fluorescence microscopy. INTRAVITAL 2014. [DOI: 10.4161/intv.23471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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44
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Kollisch-Singule M, Emr B, Smith B, Ruiz C, Roy S, Meng Q, Jain S, Satalin J, Snyder K, Ghosh A, Marx WH, Andrews P, Habashi N, Nieman GF, Gatto LA. Airway pressure release ventilation reduces conducting airway micro-strain in lung injury. J Am Coll Surg 2014; 219:968-76. [PMID: 25440027 DOI: 10.1016/j.jamcollsurg.2014.09.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 07/25/2014] [Accepted: 08/01/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Improper mechanical ventilation can exacerbate acute lung damage, causing a secondary ventilator-induced lung injury (VILI). We hypothesized that VILI can be reduced by modifying specific components of the ventilation waveform (mechanical breath), and we studied the impact of airway pressure release ventilation (APRV) and controlled mandatory ventilation (CMV) on the lung micro-anatomy (alveoli and conducting airways). The distribution of gas during inspiration and expiration and the strain generated during mechanical ventilation in the micro-anatomy (micro-strain) were calculated. STUDY DESIGN Rats were anesthetized, surgically prepared, and randomized into 1 uninjured control group (n = 2) and 4 groups with lung injury: APRV 75% (n = 2), time at expiration (TLow) set to terminate appropriately at 75% of peak expiratory flow rate (PEFR); APRV 10% (n = 2), TLow set to terminate inappropriately at 10% of PEFR; CMV with PEEP 5 cm H2O (PEEP 5; n = 2); or PEEP 16 cm H2O (PEEP 16; n = 2). Lung injury was induced in the experimental groups by Tween lavage and ventilated with their respective settings. Lungs were fixed at peak inspiration and end expiration for standard histology. Conducting airway and alveolar air space areas were quantified and conducting airway micro-strain was calculated. RESULTS All lung injury groups redistributed inspired gas away from alveoli into the conducting airways. The APRV 75% minimized gas redistribution and micro-strain in the conducting airways and provided the alveolar air space occupancy most similar to control at both inspiration and expiration. CONCLUSIONS In an injured lung, APRV 75% maintained micro-anatomic gas distribution similar to that of the normal lung. The lung protection demonstrated in previous studies using APRV 75% may be due to a more homogeneous distribution of gas at the micro-anatomic level as well as a reduction in conducting airway micro-strain.
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Affiliation(s)
| | - Bryanna Emr
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Bradford Smith
- Department of Medicine, University of Vermont, Burlington, VT
| | - Cynthia Ruiz
- Department of Biological Sciences, SUNY Cortland, Cortland, NY
| | - Shreyas Roy
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Qinghe Meng
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Sumeet Jain
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Joshua Satalin
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY.
| | - Kathy Snyder
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Auyon Ghosh
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - William H Marx
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Penny Andrews
- R Adams Cowley Shock Trauma Center, Trauma Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Nader Habashi
- R Adams Cowley Shock Trauma Center, Trauma Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Gary F Nieman
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY
| | - Louis A Gatto
- Department of General Surgery, SUNY Upstate Medical University, Syracuse, NY; Department of Biological Sciences, SUNY Cortland, Cortland, NY
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45
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Perchiazzi G, Rylander C, Derosa S, Pellegrini M, Pitagora L, Polieri D, Vena A, Tannoia A, Fiore T, Hedenstierna G. Regional distribution of lung compliance by image analysis of computed tomograms. Respir Physiol Neurobiol 2014; 201:60-70. [PMID: 25026158 DOI: 10.1016/j.resp.2014.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/01/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
Computed tomography (CT) can yield quantitative information about volume distribution in the lung. By combining information provided by CT and respiratory mechanics, this study aims at quantifying regional lung compliance (CL) and its distribution and homogeneity in mechanically ventilated pigs. The animals underwent inspiratory hold maneuvers at 12 lung volumes with simultaneous CT exposure at two end-expiratory pressure levels and before and after acute lung injury (ALI) by oleic acid administration. CL and the sum of positive voxel compliances from CT were linearly correlated; negative compliance areas were found. A remarkably heterogeneous distribution of voxel compliance was found in the injured lungs. As the lung inflation increased, the homogeneity increased in healthy lungs but decreased in injured lungs. Image analysis brought novel findings regarding spatial homogeneity of compliance, which increases in ALI but not in healthy lungs by applying PEEP after a recruitment maneuver.
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Affiliation(s)
- Gaetano Perchiazzi
- Emergency and Organ Transplant, Bari University, Bari, Italy; Medical Sciences - Clinical Physiology, Uppsala University, Uppsala, Sweden.
| | - Christian Rylander
- Anaesthesia and Intensive Care Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Savino Derosa
- Emergency and Organ Transplant, Bari University, Bari, Italy
| | | | | | - Debora Polieri
- Emergency and Organ Transplant, Bari University, Bari, Italy
| | - Antonio Vena
- Intensive Care Unit, SS Annunziata Hospital, Taranto, Italy
| | - Angela Tannoia
- Emergency and Organ Transplant, Bari University, Bari, Italy
| | - Tommaso Fiore
- Emergency and Organ Transplant, Bari University, Bari, Italy
| | - Göran Hedenstierna
- Medical Sciences - Clinical Physiology, Uppsala University, Uppsala, Sweden
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46
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Time to reach a new equilibrium after changes in PEEP in acute respiratory distress syndrome patients. Intensive Care Med 2014; 39:2053-5. [PMID: 23958739 DOI: 10.1007/s00134-013-3064-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/05/2013] [Indexed: 01/11/2023]
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47
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Sera T, Uesugi K, Yagi N, Yokota H. Numerical simulation of airflow and microparticle deposition in a synchrotron micro-CT-based pulmonary acinus model. Comput Methods Biomech Biomed Engin 2014; 18:1427-35. [DOI: 10.1080/10255842.2014.915030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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48
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Ling TY, Liu YL, Huang YK, Gu SY, Chen HK, Ho CC, Tsao PN, Tung YC, Chen HW, Cheng CH, Lin KH, Lin FH. Differentiation of lung stem/progenitor cells into alveolar pneumocytes and induction of angiogenesis within a 3D gelatin--microbubble scaffold. Biomaterials 2014; 35:5660-9. [PMID: 24746968 DOI: 10.1016/j.biomaterials.2014.03.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/27/2014] [Indexed: 12/16/2022]
Abstract
The inability to adequately vascularize tissues in vitro or in vivo is a major challenge in lung tissue engineering. A method that integrates stem cell research with 3D-scaffold engineering may provide a solution. We have successfully isolated mouse pulmonary stem/progenitor cells (mPSCs) by a two-step procedure and fabricated mPSC-compatible gelatin/microbubble-scaffolds using a 2-channel fluid jacket microfluidic device. We then integrated the cells and the scaffold to construct alveoli-like structures. The mPSCs expressed pro-angiogenic factors (e.g., b-FGF and VEGF) and induced angiogenesis in vitro in an endothelial cell tube formation assay. In addition, the mPSCs were able to proliferate along the inside of the scaffolds and differentiate into type-II and type-I pneumocytes The mPSC-seeded microbubble-scaffolds showed the potential for blood vessel formation in both a chick chorioallantoic membrane (CAM) assay and in experiments for subcutaneous implantation in severe combined immunodeficient (SCID) mice. Our results demonstrate that lung stem/progenitor cells together with gelatin microbubble-scaffolds promote angiogenesis as well as the differentiation of alveolar pneumocytes, resulting in an alveoli-like structure. These findings may help advance lung tissue engineering.
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Affiliation(s)
- Thai-Yen Ling
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan; Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yen-Liang Liu
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yung-Kang Huang
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sing-Yi Gu
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hung-Kuan Chen
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Choa-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Nien Tsao
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan; Division of Neonatology, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chung Tung
- Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan
| | - Huei-Wen Chen
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chiung-Hsiang Cheng
- Department and Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Keng-Hui Lin
- Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan; Institute of Physics, Academia Sinica, Taipei, Taiwan
| | - Feng-Huei Lin
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
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49
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Ng CSH, Lau RWH, Lau KKW, Underwood MJ, Yim APC. Defeating the pores of Kohn. Asian Cardiovasc Thorac Ann 2014; 22:102-4. [PMID: 24585656 DOI: 10.1177/0218492312474454] [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: 11/17/2022]
Abstract
In the treatment of emphysema with an endobronchial valve, entire lobar treatment is important in achieving adequate atelectasis. This case illustrates that without treatment of the entire lobe, it can fail to collapse even after several years, leading to treatment failure. Intralobar collateral ventilation through the pores of Kohn is demonstrated in this case, as endobronchial valve blockage of the remaining patent anterior segment resulted in the desired atelectasis and significant improvements in pulmonary function.
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Affiliation(s)
- Calvin S H Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
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50
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Mazzuca E, Salito C, Rivolta I, Aliverti A, Miserocchi G. From morphological heterogeneity at alveolar level to the overall mechanical lung behavior: an in vivo microscopic imaging study. Physiol Rep 2014; 2:e00221. [PMID: 24744890 PMCID: PMC3966245 DOI: 10.1002/phy2.221] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 12/23/2013] [Accepted: 01/02/2014] [Indexed: 12/31/2022] Open
Abstract
In six male anesthetized, tracheotomized, and mechanically ventilated rabbits, we imaged subpleural alveoli under microscopic view (60×) through a “pleural window” obtained by stripping the endothoracic fascia and leaving the parietal pleura intact. Three different imaging scale levels were identified for the analysis on increasing stepwise local distending pressure (Pld) up to 16.5 cmH2O: alveoli, alveolar cluster, and whole image field. Alveolar profiles were manually traced, clusters of alveoli of similar size were identified through a contiguity‐constrained hierarchical agglomerative clustering analysis and alveolar surface density (ASD) was estimated as the percentage of air on the whole image field. Alveolar area distributions were remarkably right‐skewed and showed an increase in median value with a large topology‐independent heterogeneity on increasing Pld. Modeling of alveolar area distributions on increasing Pld led to hypothesize that absolute alveolar compliance (change in surface area over change in Pld) increases fairly linearly with increasing initial alveolar size, the corollary of this assumption being a constant specific compliance. Clusters were reciprocally interweaved due to their highly variable complex shapes. ASD was found to increase with a small coefficient of variation (CV <25%) with increasing Pld. The CV of lung volume at each transpulmonary pressure was further decreased (about 6%). The results of the study suggest that the considerable heterogeneity of alveolar size and of the corresponding alveolar mechanical behavior are homogenously distributed, resulting in a substantially homogenous mechanical behavior of lung units and whole organ. Alveolar mechanics of rabbit lungs was studied by using a methodological approach, which strictly preserves the in vivo physiological setting, leaving the pleural cavity intact. Data from direct in vivo microscopic imaging of alveoli at different distending pressures were analyzed by novel geostatistical analyses to evaluate the topological dependence of heterogeneity in alveolar size, shape, and compliance. Results suggest that the mechanical behavior found by scaling up from single alveoli, to alveolar clusters and to the whole organ results from a nontopological‐dependent morphological and mechanical heterogeneity at microscale level.
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Affiliation(s)
- Enrico Mazzuca
- TBM Lab, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Caterina Salito
- TBM Lab, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Ilaria Rivolta
- Department of Health Sciences, Università di Milano-Bicocca, Monza, Italy
| | - Andrea Aliverti
- TBM Lab, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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