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使用脉冲气溶胶团注和吸入量跟踪方法向上呼吸道进行靶向药物递送。

Targeted Drug Delivery to Upper Airways Using a Pulsed Aerosol Bolus and Inhaled Volume Tracking Method.

作者信息

Ostrovski Yan, Dorfman Simon, Mezhericher Maksim, Kassinos Stavros, Sznitman Josué

机构信息

Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel.

Department of Mechanical Engineering, Shamoon College of Engineering, Beer-Sheva, Israel.

出版信息

Flow Turbul Combust. 2019 Jan;102(1):73-87. doi: 10.1007/s10494-018-9927-1. Epub 2018 May 2.

Abstract

The pulmonary route presents an attractive delivery pathway for topical treatment of lung diseases. While significant progress has been achieved in understanding the physical underpinnings of aerosol deposition in the lungs, our ability to target or confine the deposition of inhalation aerosols to specific lung regions remains meagre. Here, we present a novel inhalation proof-of-concept for regional targeting in the upper airways, quantitatively supported by computational fluid dynamics (CFD) simulations of inhaled micron-sized particles (i.e. 1-10 μm) using an intubated, anatomically-realistic, multi-generation airway tree model. Our targeting strategy relies on selecting the particle release time, whereby a short-pulsed bolus of aerosols is injected into the airways and the inhaled volume of clean air behind the bolus is tracked to reach a desired inhalation depth (i.e. airway generations). A breath hold maneuver then follows to facilitate deposition, via sedimentation, before exhalation resumes and remaining airborne particles are expelled. Our numerical findings showcase how particles in the range 5-10 μm combined with such inhalation methodology are best suited to deposit in the upper airways, with deposition fractions between 0.68 and unity. In contrast, smaller (< 2 μm) particles are less than optimal due to their slow sedimentation rates. We illustrate further how modulating the volume inhaled behind the pulsed bolus, prior to breath hold, may be leveraged to vary the targeted airway sites. We discuss the feasibility of the proposed inhalation framework and how it may help pave the way for specialized topical lung treatments.

摘要

肺部给药途径为肺部疾病的局部治疗提供了一种有吸引力的给药方式。虽然在理解肺部气溶胶沉积的物理基础方面已经取得了重大进展,但我们将吸入性气溶胶的沉积靶向或限制在特定肺区域的能力仍然很有限。在此,我们提出了一种用于上呼吸道区域靶向的新型吸入概念验证方法,该方法通过使用插管的、解剖学上真实的多代气道树模型对吸入的微米级颗粒(即1 - 10μm)进行计算流体动力学(CFD)模拟得到了定量支持。我们的靶向策略依赖于选择颗粒释放时间,即将短脉冲的气溶胶团注入气道,并跟踪团块后面吸入的清洁空气量以达到所需的吸入深度(即气道代数)。然后进行屏气动作,以促进通过沉降进行沉积,之后再恢复呼气并排出剩余的空气中的颗粒。我们的数值研究结果表明,5 - 10μm范围内的颗粒与这种吸入方法相结合最适合沉积在上呼吸道,沉积分数在0.68到1之间。相比之下,较小(< 2μm)的颗粒由于沉降速度慢而不太理想。我们进一步说明了在屏气之前调节脉冲团块后面吸入的空气量如何可以用来改变靶向的气道部位。我们讨论了所提出的吸入框架的可行性以及它如何可能有助于为专门的局部肺部治疗铺平道路。

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