Institute for Lung Biology and Disease, German Research Center for Environmental Health, Neuherberg, Germany.
Rhinology. 2011 Aug;49(3):286-91. doi: 10.4193/Rhino10.268.
Topical delivery of drugs to the sinuses is challenging and requires also particular administration manoeuvres from the patient. This study was conducted to investigate 1) the delivery efficiency of a pulsating aerosol (Vibrent prototype device) to the sinuses and the nose, 2) the aerosol fraction that will deposit in the lungs and 3) potential differences regarding sinus and nasal deposition ratio when comparing aerosol administration during two different administration routes.
An open label deposition study in healthy volunteers was conducted using 99mTc-DTPA radiolabeled pulsating aerosols in comparison to nasal pump sprays. Deposition and retention of pulsating aerosols was assessed by gamma camera imaging during spontaneous nasal breathing and during closed soft palate administration.
Aerosol administration during nasal breathing vs. application with closed soft plate results in significant lung, nasal and sinus deposition. No significant differences were observed for nasal clearance. In comparison, drug delivery using nasal pump sprays resulted in non-significant sinus, 100 % nasal and non-significant lung deposition. The clearance kinetics after nasal pump spray delivery was significantly accelerated.
The standard application mode of pulsation aerosols with closed soft palate results in negligible lung deposition and therefore limits drug delivery to the nasal cavity only, minimizing unwanted side effects. Administration during spontaneous nasal breathing shows only 10% lung deposition, which is tolerable during drug administration. Relevant paranasal sinus deposition is noted during both application modes and clearance kinetics remains essentially unchanged. In contrast, nasal pump sprays do not show sinus drug delivery and nasal drug residence time is shortened.
Pulsating aerosols offer advantageous topical nasal and sinus drug delivery options.
将药物递送到鼻窦具有挑战性,需要患者进行特殊的给药操作。本研究旨在调查 1)脉冲气溶胶(Vibrent 原型设备)向鼻窦和鼻腔的输送效率,2)沉积在肺部的气溶胶分数,以及 3)比较两种不同给药途径时鼻窦和鼻腔沉积比的潜在差异。
在健康志愿者中进行了一项开放标签沉积研究,使用 99mTc-DTPA 标记的脉冲气溶胶与鼻喷泵进行比较。在自发鼻腔呼吸和闭合软腭给药期间,通过伽马相机成像评估脉冲气溶胶的沉积和保留。
与应用闭合软腭相比,鼻腔呼吸时的气溶胶给药会导致显著的肺部、鼻腔和鼻窦沉积。鼻腔清除率无显著差异。相比之下,鼻喷泵给药导致鼻窦、100%鼻腔和肺部无显著沉积。鼻喷泵给药后的清除动力学明显加快。
使用闭合软腭的脉冲气溶胶的标准应用模式导致肺部沉积可忽略不计,因此仅将药物输送到鼻腔,最大限度地减少了不必要的副作用。在自发鼻腔呼吸期间给药仅显示 10%的肺部沉积,这在药物给药期间是可耐受的。在两种给药模式下都注意到相关的副鼻窦沉积,清除动力学基本保持不变。相比之下,鼻喷泵不显示鼻窦药物输送,并且鼻腔药物停留时间缩短。
脉冲气溶胶提供了有利的局部鼻腔和鼻窦药物输送选择。