Transient Absorption of Inhaled Vapors into a Multilayer Mucus–Tissue–Blood System

Secondary indoor air pollution and passive smoking associated with cannabis smoking using electric cigarette device-demonstrative in silico study

With electronic (e)-liquids containing cannabis components easily available, many anecdotal examples of cannabis vaping using electronic cigarette devices have been reported. For electronic cigarette cannabis vaping, there are potential risks of secondary indoor air pollution from vapers. However, quantitative and accurate prediction of the inhalation and dermal exposure of a passive smoker in the same room is difficult to achieve due to the ethical constraints on subject experiments. The numerical method, i.e., in silico method, is a powerful tool to complement these experiments with real humans. In this study, we adopted a computer-simulated person that has been validated from multiple perspectives for prediction accuracy. We then conducted an in silico study to elucidate secondary indoor air pollution and passive smoking associated with cannabis vaping using an electronic cigarette device in an indoor environment. The aerosols exhaled by a cannabis vaper were confirmed to be a secondary emission source in an indoor environment; non-smokers were exposed to these aerosols via respiratory and dermal pathways. Tetrahydrocannabinol was used as a model chemical compound for the exposure study. Its uptake by the non-smoker through inhalation and dermal exposure under a worst-case scenario was estimated to be 5.9% and 2.6% of the exhaled quantity from an e-cigarette cannabis user, respectively.

How can we best mitigate unintended passive smoking in an indoor environment? As marijuana tends to be legalized in more countries, there is an increasing number of cases of vaping cannabis using e-cigarette devices. E-cigarette vaping is presumed to cause relatively low levels of indoor air pollution due to the absence of a direct combustion process. In this study, we developed a numerical simulation model to quantitatively predict the impact of first- and second-hand cannabis vaping in an indoor environment. The study was conducted in response to vulnerable residents who are concerned regarding the deterioration of indoor air quality and informs policymakers of the potential risk of second-hand cannabis vaping exposure.

A numerical investigation of the potential effects of e-cigarette smoking on local tissue dosimetry and the deterioration of indoor air quality

Electronic (e)-cigarette smoking is considered to be less harmful than traditional tobacco smoking because of the lack of a combustion process. However, e-cigarettes have the potential to release harmful chemicals depending on the constituents of the vapor. To date, there has been significant evidence on the adverse health effects of e-cigarette usage. However, what is less known are the impacts of the chemicals contained in exhaled air from an e-cigarette smoker on indoor air quality, the second-hand passive smoking of residents, and the toxicity of the exhaled air. In this study, we develop a comprehensive numerical model and computer-simulated person to investigate the potential effects of e-cigarette smoking on local tissue dosimetry and the deterioration of indoor air quality. We also conducted demonstrative numerical analyses for first-hand and second-hand e-cigarette smoking in an indoor environment. To investigate local tissue dosimetry, we used newly developed physiologically based pharmacokinetic/toxicokinetic models that reproduce inhalation exposure by way of the respiratory tract and dermal exposure through the human skin surface. These models were integrated into the computer-simulated person. Our numerical simulation results quantitatively demonstrated the potential impacts of e-cigarette smoking in enclosed spaces on indoor air quality.

Bioaccessibility and bioavailability of environmental semi-volatile organic compounds via inhalation: A review of methods and models

Semi-volatile organic compounds (SVOCs) present in indoor environments are known to cause adverse health effects through multiple routes of exposure. To assess the aggregate exposure, the bioaccessibility and bioavailability of SVOCs need to be determined. In this review, we discussed measurements of the bioaccessibility and bioavailability of SVOCs after inhalation. Published literature related to this issue is available for 2,3,7,8-tetrachlorodibenzo-p-dioxin and a few polycyclic aromatic hydrocarbons, such as benzo[a]pyrene and phenanthrene. Then, we reviewed common modeling approaches for the characterization of the gas- and particle-phase partitioning of SVOCs during inhalation. The models are based on mass transfer mechanisms as well as the structure of the respiratory system, using common computational techniques, such as computational fluid dynamics. However, the existing models are restricted to special conditions and cannot predict SVOC bioaccessibility and bioavailability in the whole respiratory system. The present review notes two main challenges for the estimation of SVOC bioaccessibility and bioavailability via inhalation in humans. First, in vitro and in vivo methods need to be developed and validated for a wide range of SVOCs. The in vitro methods should be validated with in vivo tests to evaluate human exposures to SVOCs in airborne particles. Second, modeling approaches for SVOCs need to consider the whole respiratory system. Alterations of the respiratory cycle period and human biological variability may be considered in future studies.

Linking Suspension Nasal Spray Drug Deposition Patterns to Pharmacokinetic Profiles: A Proof-of-Concept Study Using Computational Fluid Dynamics

The objective of this study was to link regional nasal spray deposition patterns of suspension formulations, predicted with computational fluid dynamics, to in vivo human pharmacokinetic plasma concentration profiles. This is accomplished through the use of computational fluid dynamics simulations coupled with compartmental pharmacokinetic modeling. Results showed a rapid initial rise in plasma concentration that is due to the absorption of drug particles deposited in the nasal middle passages, followed by a slower increase in plasma concentration that is governed by the transport of drug particles from the nasal vestibule to the middle passages. Although drug deposition locations in the nasal cavity had a significant effect on the shape of the concentration profile, the absolute bioavailability remained constant provided that all the drug remained in the nose over the course of the simulation. Loss of drug through the nostrils even after long periods resulted in a significant decrease in bioavailability and increased variability. The results of this study quantify how differences in nasal drug deposition affect transient plasma concentrations and overall bioavailability. These findings are potentially useful for establishing bioequivalence for nasal spray devices and reducing the burden of in vitro testing, pharmacodynamics, and clinical studies.

Absorption and Clearance of Pharmaceutical Aerosols in the Human Nose: Development of a CFD Model

PURPOSE

The objective of this study was to develop a computational fluid dynamics (CFD) model to predict the deposition, dissolution, clearance, and absorption of pharmaceutical particles in the human nasal cavity.

METHODS

A three-dimensional nasal cavity geometry was converted to a surface-based model, providing an anatomically-accurate domain for the simulations. Particle deposition data from a commercial nasal spray product was mapped onto the surface model, and a mucus velocity field was calculated and validated with in vivo nasal clearance rates. A submodel for the dissolution of deposited particles was developed and validated based on comparisons to existing in vitro data for multiple pharmaceutical products. A parametric study was then performed to assess sensitivity of epithelial drug uptake to model conditions and assumptions.

RESULTS

The particle displacement distance (depth) in the mucus layer had a modest effect on overall drug absorption, while the mucociliary clearance rate was found to be primarily responsible for drug uptake over the timescale of nasal clearance for the corticosteroid mometasone furoate (MF). The model revealed that drug deposition in the nasal vestibule (NV) could slowly be transported into the main passage (MP) and then absorbed through connection of the liquid layer in the NV and MP regions. As a result, high intersubject variability in cumulative uptake was predicted, depending on the length of time the NV dose was left undisturbed without blowing or wiping the nose.

CONCLUSIONS

This study has developed, for the first time, a complete CFD model of nasal aerosol delivery from the point of spray formation through absorption at the respiratory epithelial surface. For the development and assessment of nasal aerosol products, this CFD-based in silico model provides a new option to complement existing in vitro nasal cast studies of deposition and in vivo imaging experiments of clearance.

Absorption and Clearance of Pharmaceutical Aerosols in the Human Nose: Effects of Nasal Spray Suspension Particle Size and Properties

PURPOSE

The objective of this study was to use a recently developed nasal dissolution, absorption, and clearance (DAC) model to evaluate the extent to which suspended drug particle size influences nasal epithelial drug absorption for a spray product.

METHODS

Computational fluid dynamics (CFD) simulations of mucociliary clearance and drug dissolution were used to calculate total and microscale epithelial absorption of drug delivered with a nasal spray pump. Ranges of suspended particle sizes, drug solubilities, and partition coefficients were evaluated.

RESULTS

Considering mometasone furoate as an example, suspended drug particle sizes in the range of 1-5 μm did not affect the total nasal epithelial uptake. However, the microscale absorption of suspended drug particles with low solubilities was affected by particle size and this controlled the extent to which the drug penetrated into the distal nasal regions.

CONCLUSIONS

The nasal-DAC model was demonstrated to be a useful tool in determining the nasal exposure of spray formulations with different drug particle sizes and solubilities. Furthermore, the model illustrated a new strategy for topical nasal drug delivery in which drug particle size is selected to increase the region of epithelial surface exposure using mucociliary clearance while minimizing the drug dose exiting the nasopharynx.

Measuring the Effect of Filters on Segmentation of Developmental Dysplasia of the Hip

Background

Developmental dysplasia of the hip (DDH) can be detected with ultrasonography (USG) images. However, the accuracy of this method is dependent on the skill of the radiologist. Radiologists measure the hip joint angles without computer-based diagnostic systems. This causes mistakes in the diagnosis of DDH.

Objectives

In this study, we aimed to automate segmentation of DDH ultrasound images in order to make it convenient for radiologic diagnosis by this recommended system.

Materials and Methods

This experiment consisted of several steps, in which pure DDH and various noise-added images were formed. Then, seven different filters (mean, median, Gaussian, Wiener, Perona and Malik, Lee, and Frost) were applied to the images, and the output images were evaluated. The study initially evaluated the filter implementations on the pure DDH images. Then, three different noise functions, speckle, salt and pepper, and Gaussian, were applied to the images and the noisy images were filtered. In the last part, the peak signal to noise ratio (PSNR) and mean square error (MSE) values of the filtered images were evaluated. PSNR and MSE distortion measurements were applied to determine the image qualities of the original image and the output image. As a result, the differences in the results of different noise removal filters were observed.

Results

The best results of PSNR values obtained in filtering were: Wiener (43.49), Perona and Malik (27.68), median (40.60) and Lee (35.35) for the noise functions of raw images, Gaussian noise added, salt and pepper noise added and speckle noise added images, respectively. After the segmentation process, it was seen that applying filtering to DDH USG images had low influence. We correctly segmented the ilium zone with the active contour model.

Conclusion

Various filters are needed to improve the image quality. In this study, seven different filters were implemented and investigated on both noisy and noise-free images.

Comparative Risks of Aldehyde Constituents in Cigarette Smoke Using Transient Computational Fluid Dynamics/Physiologically Based Pharmacokinetic Models of the Rat and Human Respiratory Tracts

Computational fluid dynamics (CFD) modeling is well suited for addressing species-specific anatomy and physiology in calculating respiratory tissue exposures to inhaled materials. In this study, we overcame prior CFD model limitations to demonstrate the importance of realistic, transient breathing patterns for predicting site-specific tissue dose. Specifically, extended airway CFD models of the rat and human were coupled with airway region-specific physiologically based pharmacokinetic (PBPK) tissue models to describe the kinetics of 3 reactive constituents of cigarette smoke: acrolein, acetaldehyde and formaldehyde. Simulations of aldehyde no-observed-adverse-effect levels for nasal toxicity in the rat were conducted until breath-by-breath tissue concentration profiles reached steady state. Human oral breathing simulations were conducted using representative aldehyde yields from cigarette smoke, measured puff ventilation profiles and numbers of cigarettes smoked per day. As with prior steady-state CFD/PBPK simulations, the anterior respiratory nasal epithelial tissues received the greatest initial uptake rates for each aldehyde in the rat. However, integrated time- and tissue depth-dependent area under the curve (AUC) concentrations were typically greater in the anterior dorsal olfactory epithelium using the more realistic transient breathing profiles. For human simulations, oral and laryngeal tissues received the highest local tissue dose with greater penetration to pulmonary tissues than predicted in the rat. Based upon lifetime average daily dose comparisons of tissue hot-spot AUCs (top 2.5% of surface area-normalized AUCs in each region) and numbers of cigarettes smoked/day, the order of concern for human exposures was acrolein > formaldehyde > acetaldehyde even though acetaldehyde yields were 10-fold greater than formaldehyde and acrolein.

Airway exchange of highly soluble gases

Highly blood soluble gases exchange with the bronchial circulation in the airways. On inhalation, air absorbs highly soluble gases from the airway mucosa and equilibrates with the blood before reaching the alveoli. Highly soluble gas partial pressure is identical throughout all alveoli. At the end of exhalation the partial pressure of a highly soluble gas decreases from the alveolar level in the terminal bronchioles to the end-exhaled partial pressure at the mouth. A mathematical model simulated the airway exchange of four gases (methyl isobutyl ketone, acetone, ethanol, and propylene glycol monomethyl ether) that have high water and blood solubility. The impact of solubility on the relative distribution of airway exchange was studied. We conclude that an increase in water solubility shifts the distribution of gas exchange toward the mouth. Of the four gases studied, ethanol had the greatest decrease in partial pressure from the alveolus to the mouth at end exhalation. Single exhalation breath tests are inappropriate for estimating alveolar levels of highly soluble gases, particularly for ethanol.

Application of a new dosimetry program TAOCS to assess transient vapour absorption in the upper airways

Most previous models of vapour absorption in the respiratory tract have assumed steady state flow fields and steady state diffusion into the airway walls. However, recent studies have shown that transient absorption flux into the walls of the upper airways can significantly influence predicted uptake or deposition values. The disadvantage of accounting for transient absorption into the airway walls is a more complex boundary condition and numerical model. The objective of this study was to evaluate the effects of both transient flow fields and transient mass absorption on the uptake of highly and moderately soluble compounds in an upper airway model. The geometry consisted of the mouth-throat region coupled with a multilayer wall model containing air, mucus, tissue, and blood phases. Based on previous studies, a boundary condition that represents transient absorption into the airway walls was applied. A new dosimetry program, named transient absorption of chemical species (TAOCS) 1.0, was developed and implemented to determine the coefficients needed for the transient boundary condition expression and to apply the boundary condition to the computational fluid dynamics (CFD) model. Both steady state and transient conditions were considered for the airflow field and wall absorption. The case of perfect wall absorption with a zero surface concentration was also considered. Results indicated that steady state airflow provided a reasonable approximation to transient airflow conditions in terms of total and local deposition (values within 10-30%). However, the simulation of transient wall absorption was critical unless the compound was highly soluble (with a mucus-air partition coefficient ≥320), in which case a perfect absorption boundary condition was accurate to within a relative difference of 50%. Still, the perfect absorption boundary condition did not accurately capture local deposition enhancement factor values. Based on these findings, implementation of the transient absorption boundary condition appears critical to predict local deposition characteristics for even highly soluble compounds. Use of the TAOCS program simplified the implementation of the complex transient absorption condition making the CFD simulation process more efficient and user-friendly.

Development of a CFD boundary condition to model transient vapor absorption in the respiratory airways

The absorption of moderately and highly soluble vapors into the walls of the conducting airways was previously shown to be a transient process over the timescale of an inhalation cycle. However, a boundary condition to predict the transient wall absorption of vapors in CFD simulations does not exist. The objective of this study was to develop and test a boundary condition that can be used to predict the transient absorption of vapors in CFD simulations of transport in the respiratory airways. To develop the boundary condition, an analytical expression for the concentration of an absorbed vapor in an air-mucus-tissue-blood (AMTB) model of the respiratory wall was developed for transient and variable air-phase concentrations. Based on the analytical expression, a flux boundary condition was developed at the air-mucus interface as a function of the far-field air-phase concentration. The new transient boundary condition was then implemented to predict absorption in a realistic model of the extrathoracic nasal airways through the larynx (nasal-laryngeal geometry). The results of the AMTB wall model verified that absorption was highly time dependent over the timescale of an inhalation cycle (approximately 1-2 s). At 1 s, transient conditions resulted in approximately 2-3 times more uptake in tissue and 20-25 times less uptake in blood than steady state conditions for both acetaldehyde and benzene. Application of this boundary condition to computational fluid dynamics simulations of the nasal-laryngeal geometry showed, as expected, that transient absorption significantly affected total deposition fractions in the mucus, tissue, and blood. Moreover, transient absorption was also shown to significantly affect the local deposition patterns of acetaldehyde and benzene. In conclusion, it is recommended that future analyses of vapors in the conducting airways consider time-dependent wall absorption based on the transient flux boundary condition developed in this study. Alternatively, a steady state absorption condition may be applied in conjunction with correction factors determined from the AMTB wall model.