a Department of Mechanical Engineering , University of Alberta , Edmonton , AB , Canada.
Expert Opin Drug Deliv. 2018 Dec;15(12):1175-1188. doi: 10.1080/17425247.2018.1544616. Epub 2018 Nov 14.
Aerosol drug delivery to the lungs via inhalation is widely used in the treatment of respiratory diseases. The deposition pattern of inhaled particles within the airways of the respiratory tract is key in determining the initial delivered dose. Thereafter, dose-dependent processes including drug release or dissolution, clearance, and absorption influence local and systemic exposure to inhaled drugs over time.
Empirical correlations, numerical simulation, and in vitro airway geometries that permit improved prediction of extrathoracic and lung deposition fractions in a variety of age groups and breathing conditions are described. Efforts to link deposition models with pharmacokinetic models predicting lung and systemic exposure to inhaled drugs over time are then reviewed. Finally, new methods to predict intersubject variability in extrathoracic deposition, capturing variability in both size and shape of the upper airways, are highlighted.
Recent work has been done to expand in vitro deposition experiments to a wide range of age groups and breathing conditions, to link regional lung deposition models with pharmacokinetic models, and to improve prediction of intersubject variability. These efforts are improving predictive understanding of respiratory drug delivery, and will aid the development of new inhaled drugs and delivery devices.
通过吸入将药物气溶胶递送至肺部在呼吸系统疾病的治疗中得到广泛应用。吸入颗粒在呼吸道中的气道内的沉积模式是决定初始递药剂量的关键。此后,剂量依赖性过程(包括药物释放或溶解、清除和吸收)会随时间影响吸入药物的局部和全身暴露。
本文描述了可改进预测各种年龄段和呼吸条件下胸外和肺部沉积分数的经验相关性、数值模拟和体外气道几何形状。然后,综述了将沉积模型与预测随时间推移吸入药物肺部和全身暴露的药代动力学模型进行关联的工作。最后,突出了新的方法来预测胸外沉积的个体间变异性,这些方法可捕捉上呼吸道的大小和形状的变异性。
最近的工作已经开展,将体外沉积实验扩展到广泛的年龄组和呼吸条件,将区域性肺部沉积模型与药代动力学模型联系起来,并改进对个体间变异性的预测。这些努力正在提高对呼吸药物输送的预测性理解,并将有助于新吸入药物和输送装置的开发。