Wang Jianwei, Zhang Ya, Chen Xiaole, Feng Yu, Ren Xiaoyong, Yang Minjuan, Ding Ting
School of Energy and Mechanical Engineering, Nanjing Normal University, Nanjing, Jiangsu 210046, China.
Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
Powder Technol. 2022 Jun;405:117520. doi: 10.1016/j.powtec.2022.117520. Epub 2022 May 17.
The coronavirus disease 2019 (COVID-19) pandemic has led to severe social and economic disruption worldwide. Although currently no consent has been reached on a specific therapy that can treat COVID-19 effectively, several inhalation therapy strategies have been proposed to inhibit SARS-CoV-2 infection. These strategies include inhalations of antiviral drugs, anti-inflammatory drugs, and vaccines. To investigate how to enhance the therapeutic effect by increasing the delivery efficiency (DE) of the inhaled aerosolized drug particles, a patient-specific tracheobronchial (TB) tree from the trachea up to generation 6 (G6) with moderate COVID-19 symptoms was selected as a testbed for the in silico trials of targeted drug delivery to the lung regions with pneumonia alba, i.e., the severely affected lung segments (SALS). The 3D TB tree geometry was reconstructed from spiral computed tomography (CT) scanned images. The airflow field and particle trajectories were solved using a computational fluid dynamics (CFD) based Euler-Lagrange model at an inhalation flow rate of 15 L/min. Particle release maps, which record the deposition locations of the released particles, were obtained at the inlet according to the particle trajectories. Simulation results show that particles with different diameters have similar release maps for targeted delivery to SALS. Point-source aerosol release (PSAR) method can significantly enhance the DE into the SALS. A C++ program has been developed to optimize the location of the PSAR tube. The optimized simulations indicate that the PSAR approach can at least increase the DE of the SALS by a factor of 3.2× higher than conventional random-release drug-aerosol inhalation. The presence of the PSAR tube only leads to a 7.12% change in DE of the SALS. This enables the fast design of a patient-specific treatment for reginal lung diseases.
2019年冠状病毒病(COVID-19)大流行已在全球范围内导致严重的社会和经济混乱。尽管目前尚未就可有效治疗COVID-19的特定疗法达成共识,但已提出了几种吸入疗法策略来抑制严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染。这些策略包括吸入抗病毒药物、抗炎药物和疫苗。为了研究如何通过提高吸入雾化药物颗粒的递送效率(DE)来增强治疗效果,选择了一名患有中度COVID-19症状、从气管到第6代(G6)的患者特异性气管支气管(TB)树作为对患有白色肺炎的肺区域(即严重受影响的肺段,SALS)进行靶向药物递送的计算机模拟试验的试验台。3D TB树几何结构由螺旋计算机断层扫描(CT)扫描图像重建。使用基于计算流体动力学(CFD)的欧拉-拉格朗日模型,以15 L/min的吸入流速求解气流场和颗粒轨迹。根据颗粒轨迹,在入口处获得记录释放颗粒沉积位置的颗粒释放图。模拟结果表明,不同直径的颗粒对于靶向递送至SALS具有相似的释放图。点源气溶胶释放(PSAR)方法可显著提高进入SALS的DE。已开发出一个C++程序来优化PSAR管的位置。优化后的模拟表明,PSAR方法至少可使SALS的DE比传统随机释放药物气溶胶吸入提高3.2倍。PSAR管的存在仅导致SALS的DE变化7.12%。这使得能够快速设计针对局部肺部疾病的患者特异性治疗方案。