Towards More Precise Targeting of Inhaled Aerosols to Different Areas of the Respiratory System

Pharmaceutical aerosols play a key role in the treatment of lung disorders, but also systemic diseases, due to their ability to target specific areas of the respiratory system (RS). This article focuses on identifying and clarifying the influence of various factors involved in the generation of aerosol micro- and nanoparticles on their regional distribution and deposition in the RS. Attention is given to the importance of process parameters during the aerosolization of liquids or powders and the role of aerosol flow dynamics in the RS. The interaction of deposited particles with the fluid environment of the lung is also pointed out as an important step in the mass transfer of the drug to the RS surface. The analysis presented highlights the technical aspects of preparing the precursors to ensure that the properties of the aerosol are suitable for a given therapeutic target. Through an analysis of existing technical limitations, selected strategies aimed at enhancing the effectiveness of targeted aerosol delivery to the RS have been identified and presented. These strategies also include the use of smart inhaling devices and systems with built-in AI algorithms.

Effect of transient breathing cycle on the deposition of micro and nanoparticles on respiratory walls

BACKGROUND AND OBJECTIVE

From various perspectives (e.g. inhalation exposure and drug delivery), it is important to provide insights into the behavior of inhaled particles in the human respiratory system. Although most of the experimental and numerical studies have relied on an assumption of steady inhalation, the transient breathing profile is a key factor in particle deposition in the respiratory tract. In this study, particle transportation and deposition were predicted in a realistic human airway model during a breathing cycle and the effects of steady-state and transient flows on the deposition fraction were observed using computational fluid dynamics.

METHODS

Two transient breathing cycles with different respiratory durations were considered to evaluate the effects of respiration duration on particle transport and deposition characteristics. Two types of steady breathing conditions with corresponding steady-state respiratory volumes were reproduced. The Lagrangian discrete phase model approach was used to investigate particle transportation and deposition under transient breathing conditions. Additionally, the Eulerian approach was used to analyze the transport of nanoparticles in the gas phase. A total of >50,000 monodispersed particles with aerodynamic diameters ranging between 2 nm and 10 μm were selected for comprehensive deposition predictions for particle sizes ranging from the nano- to microscale.

RESULTS

The predicted results were compared with the experimental data. The particle deposition fraction in the nasal cavity and tracheal regions showed differences between the steady and transient simulations. In addition, particle analysis under steady inhalation conditions cannot accurately predict particle transportation and deposition in the lower airway. Furthermore, the breathing cycle had a significant effect on the deposition fraction of the particles and the behavior of the inhaled particles.

CONCLUSIONS

Transient simulation mimicking the breathing cycle was observed to be an important factor in accurately predicting the transportation and deposition of particles in the respiratory tract.

Numerical and Experimental Analysis of Drug Inhalation in Realistic Human Upper Airway Model

The demand for a more efficient and targeted method for intranasal drug delivery has led to sophisticated device design, delivery methods, and aerosol properties. Due to the complex nasal geometry and measurement limitations, numerical modeling is an appropriate approach to simulate the airflow, aerosol dispersion, and deposition for the initial assessment of novel methodologies for better drug delivery. In this study, a CT-based, 3D-printed model of a realistic nasal airway was reconstructed, and airflow pressure, velocity, turbulent kinetic energy (TKE), and aerosol deposition patterns were simultaneously investigated. Different inhalation flowrates (5, 10, 15, 30, and 45 L/min) and aerosol sizes (1, 1.5, 2.5, 3, 6, 15, and 30 µm) were simulated using laminar and SST viscous models, with the results compared and verified by experimental data. The results revealed that from the vestibule to the nasopharynx, the pressure drop was negligible for flow rates of 5, 10, and 15 L/min, while for flow rates of 30 and 40 L/min, a considerable pressure drop was observed by approximately 14 and 10%, respectively. However, from the nasopharynx and trachea, this reduction was approximately 70%. The aerosol deposition fraction alongside the nasal cavities and upper airway showed a significant difference in pattern, dependent on particle size. More than 90% of the initiated particles were deposited in the anterior region, while just under 20% of the injected ultrafine particles were deposited in this area. The turbulent and laminar models showed slightly different values for the deposition fraction and efficiency of drug delivery for ultrafine particles (about 5%); however, the deposition pattern for ultrafine particles was very different.

Solid Anorganic Particles and Chronic Rhinosinusitis: A Histopathology Study

Although extensive research has shown the pathological effect of fine and ultrafine airborne particles, clear evidence of association of environmental exposure to them and inflammatory changes in human nasal mucosa is missing. Meanwhile, pathogenesis of chronic rhinosinusitis, despite being a disease with high prevalence in the population, is still unclear. The increasing evidence of the pro-inflammatory properties of these particles raises the question of their possible role in chronic rhinosinusitis. The presented study focused on detection of microsized anorganic particles and clusters of nanosized anorganic particles in the nasal mucosa of patients with chronic rhinosinusitis by Raman microspectroscopy and comparison of their composition to histologic findings. The results were compared to the findings in mucosa obtained from cadavers with no history of chronic rhinosinusitis. Solid particles were found in 90% of tissue samples in the group with chronic rhinosinusitis, showing histologic signs of inflammation in 95%, while in the control group, the particles were found in 20% of samples, with normal histologic findings in all of them. The main detected compounds were graphite, TiO₂, amorphous carbon, calcite, ankerite and iron compounds. The results are in accordance with the premise that exogenous airborne particles interact with the nasal mucosa and possibly deposit in it in cases where the epithelial barrier is compromised in chronic rhinosinusitis.

Fate of the inhaled smoke particles from fire scenes in the nasal airway of a realistic firefighter: A simulation study

Understanding the inhalation, transport and deposition of smoke particles during fire missions are important to evaluating the health risks for firefighters. In this study, measurements from Underwriters Laboratories' large-scale fire experiments on smoke particle size distribution and concentration in three residential fire scenes were incorporated into models to investigate the fate of inhaled toxic ultrafine particulates in a realistic firefighter nasal cavity model. Deposition equations were developed, and the actual particle dosimetry (in mass, number and surface area) was evaluated. A strong monotonic growth of nasal airway dosages of simulated smoke particles was identified for airflow rates and fire duration across all simulated residential fire scene conditions. Even though the "number" dosage of arsenic in the limited ventilation living room fire was similar to the "number" dosage of chromium in the living room, particle mass and surface area dosages simulated in the limited living room were 90-200 fold higher than that in the ventilated living room. These were also confirmed when comparing the dosimetry in the living room and the kitchen. This phenomenon implied that particles with larger size were the dominant factors in mass and surface area dosages. Firefighters should not remove the self-contained breathing apparatus (SCBA) during fire suppression and overhaul operations, especially in smoldering fires with limited ventilation.

Numerical investigation of transient transport and deposition of microparticles under unsteady inspiratory flow in human upper airways

In the present study, unsteady airflow patterns and particle deposition in healthy human upper airways were simulated. A realistic 3-D computational model of the upper airways including the vestibule to the end of the trachea was developed using a series of CT scan images of a healthy human. Unsteady simulations of the inhaled and exhaled airflow fields in the upper airway passages were performed by solving the Navier-Stokes and continuity equations for low breathing rates corresponding to low and moderate activities. The Lagrangian trajectory analysis approach was utilized to investigate the transient particle transport and deposition under cyclic breathing condition. Particles were released uniformly at the nostrils' entrance during the inhalation phase, and the total and regional depositions for various micro-particle sizes were evaluated. The transient particle deposition fractions for various regions of the human upper airways were compared with those obtained from the equivalent steady flow condition. The presented results revealed that the equivalent constant airflow simulation can approximately predict the total particle deposition during cyclic breathing in human upper airways. While the trends of steady and unsteady model predictions for local deposition were similar, there were noticeable differences in the predicted amount of deposition. In addition, it was shown that a steady simulation cannot properly predict some critical parameters, such as the penetration fraction. Finally, the presented results showed that using a detached nasal cavity (commonly used in earlier studies) for evaluation of total deposition fraction of particles in the nasal cavity was reasonably accurate for the steady flow simulations. However, in transient simulation for predicting the deposition fraction in a specific region, such as the nasal cavity, using the full airway system geometry becomes necessary.

Transport and Deposition of Welding Fume Agglomerates in a Realistic Human Nasal Airway

Welding fume is a complex mixture containing ultra-fine particles in the nanometer range. Rather than being in the form of a singular sphere, due to the high particle concentration, welding fume particles agglomerate into long straight chains, branches, or other forms of compact shapes. Understanding the transport and deposition of these nano-agglomerates in human respiratory systems is of great interest as welding fumes are a known health hazard. The neurotoxin manganese (Mn) is a common element in welding fumes. Particulate Mn, either as soluble salts or oxides, that has deposited on the olfactory mucosa in human nasal airway is transported along the olfactory nerve to the olfactory bulb within the brain. If this Mn is further transported to the basal ganglia of the brain, it could accumulate at the part of the brain that is the focal point of its neurotoxicity. Accounting for various dynamic shape factors due to particle agglomeration, the current computational study is focused on the exposure route, the deposition pattern, and the deposition efficiency of the inhaled welding fume particles in a realistic human nasal cavity. Particular attention is given to the deposition pattern and deposition efficiency of inhaled welding fume agglomerates in the nasal olfactory region. For particles in the nanoscale, molecular diffusion is the dominant transport mechanism. Therefore, Brownian diffusion, hydrodynamic drag, Saffman lift force, and gravitational force are included in the model study. The deposition efficiencies for single spherical particles, two kinds of agglomerates of primary particles, two-dimensional planar and straight chains, are investigated for a range of primary particle sizes and a range of number of primary particles per agglomerate. A small fraction of the inhaled welding fume agglomerates is deposited on the olfactory mucosa, approximately in the range 0.1-1%, and depends on particle size and morphology. The strong size dependence of the deposition in olfactory mucosa on particle size implies that the occupation deposition of welding fume manganese can be expected to vary with welding method.