School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK.
Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA.
Int J Pharm. 2022 Jan 25;612:121321. doi: 10.1016/j.ijpharm.2021.121321. Epub 2021 Dec 4.
For many of the one billion sufferers of respiratory diseases worldwide, managing their disease with inhalers improves their ability to breathe. Poor disease management and rising pollution can trigger exacerbations that require urgent relief. Higher drug deposition in the throat instead of the lungs limits the impact on patient symptoms. To optimise delivery to the lung, patient-specific computational studies of aerosol inhalation can be used. However in many studies, inhalation modelling does not represent situations when the breathing is impaired, such as in recovery from an exacerbation, where the patient's inhalation is much faster and shorter. Here we compare differences in deposition of inhaler particles (10, 4 μm) in the airways of three patients. We aimed to evaluate deposition differences between healthy and impaired breathing with image-based healthy and diseased patient models. We found that the ratio of drug in the lower to upper lobes was 35% larger with a healthy inhalation. For smaller particles the upper airway deposition was similar in all patients, but local deposition hotspots differed in size, location and intensity. Our results identify that image-based airways must be used in respiratory modelling. Various inhalation profiles should be tested for optimal prediction of inhaler deposition.
对于全球 10 亿呼吸系统疾病患者中的许多人来说，使用吸入器来控制疾病可以提高他们的呼吸能力。疾病管理不善和污染加剧会引发需要紧急缓解的恶化。药物在喉咙中的沉积高于肺部会限制其对患者症状的影响。为了优化药物在肺部的输送，可以使用针对特定患者的气溶胶吸入计算研究。然而，在许多研究中，吸入模型并没有代表呼吸受损的情况，例如在恶化后恢复期间，患者的吸气速度更快、时间更短。在这里，我们比较了三位患者气道中吸入器颗粒（10、4μm）的沉积差异。我们旨在通过基于图像的健康和患病患者模型来评估健康呼吸和受损呼吸之间的沉积差异。我们发现，健康吸入时，药物在下肺叶和上肺叶的比例增加了 35%。对于较小的颗粒，所有患者的上呼吸道沉积都相似，但局部沉积热点的大小、位置和强度不同。我们的研究结果表明，在呼吸建模中必须使用基于图像的气道。应测试各种吸入器特性，以最佳预测吸入器沉积。
