How severe acute respiratory syndrome coronavirus-2 aerosol propagates through the age-specific upper airways

Engineering nanoliposomal tiotropium bromide embedded in a lactose-arginine carrier forming Trojan-particle dry powders for efficient pulmonary drug delivery: A combined approach of in vitro-3D printing and in silico-CFD modeling

Nanocarrier-based dry powders for lung disease treatment are crucial, with in vitro and in silico research being pivotal to their success. This study introduces a method for creating Tiotropium-bromide liposomal inhalation dry powder, termed "Trojan-particles," utilizing thin-film hydration and spray-drying with lactose-arginine carriers. Encapsulating tiotropium-bromide in nanoliposomes enhances lung treatment via liposomes' unique features. This formulation was examined through in vitro-3D-printing and in silico-CFD analysis. Nanoliposomes and powder were evaluated for physicochemical attributes, aerosolization, encapsulation-efficiency (EE%), and release. Both liposomes (90 nm) and powder particles (3 µm) were spherical. Liposomes had an EE% over 95 % and a zeta-potential of -28.3 mV. The optimal formulation was tested in vitro at 30, 60, and 90 L/min using a 3D-printed airway replica. CFD analysis evaluated particle deposition in steady and realistic inhalation with monodisperse and polydisperse particles. Based on realistic airway geometry, model utilized k-ω-SST turbulence model for the continuous phase and Lagrangian-DEM for the discrete phase, analyzed through ANSYS Fluent. The 20 %-arginine nanoliposomal-tiotropium formulation outperformed others due to arginine's dispersibility and therapeutic benefits, including nitric oxide conversion. The formulation competes with commercial dry powders due to its chemical, biochemical advantages, and Trojan-based physical traits, reducing exhalation risk. Simulation data aligned with experimental findings, showing that higher inhalation flows increase particle deposition in airways due to greater inertia and turbulence. At 60 L/min, the polydisperse model matched experimental data better than the monodisperse model. Alongside improving dry powder performance via a nanoliposomal formulation, this research highlights the development of a novel CFD method for their assessment.

Optimal Treatment of Tumor in Upper Human Respiratory Tract Using Microaerosols

Lung cancer is a frequently diagnosed respiratory disease caused by particulate matter in the environment, especially among older individuals. For its effective treatment, a promising approach involves administering drug particles through the inhalation route. Multiple studies have investigated the flow behavior of inhaled particles in the respiratory airways of healthy patients. However, the existing literature lacks studies on the precise understanding of the transportation and deposition (TD) of inhaled particles through age-specific, unhealthy respiratory tracts containing a tumor, which can potentially optimize lung cancer treatment. This study aims to investigate the TD of inhaled drug particles within a tumorous, age-specific human respiratory tract. The computational model reports that drug particles within the size range of 5-10 μm are inclined to deposit more on the tumor located in the upper airways of a 70-year-old lung. Conversely, for individuals aged 50 and 60 years, an optimal particle size range for achieving the highest degree of particle deposition onto upper airway tumor falls within the 11-20 μm range. Flow disturbances are found to be at a maximum in the airway downstream of the tumor. Additionally, the impact of varying inhalation flow rates on particle TD is examined. The obtained patterns of airflow distribution and deposition efficiency on the tumor wall for different ages and tumor locations in the upper tracheobronchial airways would be beneficial for developing an efficient and targeted drug delivery system.

Effects of the deformation and size of the upper airway on the deposition of aerosols

Aerosol drug delivery in the human airway is significantly affected by the morphology and size of the airway. This work developed a CFD-DEM model to simulate and analyze air flow and powder dynamics in combined inhaler-airway systems with different degrees of airway deformation (non-deformed, 50%, and 75% deformed) and sizes (adult, 0.80, and 0.62 scaled). The airways were generated based on a regular airway constructed from the MRI images through finite element method (for deformed airways) or scaling-down (for smaller airways). The airways were connected to Turbuhaler® through a connector. The results showed that under the same flow rate, the variation in the airway geometry and size had a minimum impact on the flow field and powder deposition in the device and the connector. However, deformation caused more particle deposition in the deformed region. Notably, the airway with 50% deformation had the most particles passing through the airway with the largest particle sizes due to its lower air velocity in the deformed area. Reducing airway size resulted in more powder deposition on the airway, particularly at the pharynx and mouth regions. This was because, with the same flow rate, the flow velocity in the smaller airway was higher, causing more particle-wall collisions in the mouth and pharynx regions. More importantly, the deposition efficiency in the 0.62-scaled airway was significantly higher than the other two airways, highlighting the importance of the different administration of aerosol drugs for young children.

Evaluation of 6-PPD quinone toxicity on lung of male BALB/c mice by quantitative proteomics

N-(1,3-dimethylbutyl)-N'-phenyl-p-phenylenediamine quinone (6-PPDQ), a transformation product of tyre-derived 6-PPD, has been frequently detected in different environments. After 6-PPDQ exposure, we here aimed to examine dynamic lung bioaccumulation, lung injury, and the underlying molecular basis in male BALB/c mice. After single injection at concentration of 4 mg/kg, 6-PPDQ remained in lung up to day 28, and higher level of 6-PPDQ bioaccumulation in lung was observed after repeated injection. Severe inflammation was observed in lung after both single and repeated 6-PPDQ injection as indicated by changes of inflammatory cytokines (TNF-α, IL-6 and IL-10). Sirius red staining and hydroxyproline content analysis indicated that repeated rather than single 6-PPDQ injection induced fibrosis in lung. Repeated 6-PPDQ injection also severely impaired lung function in mice by influencing chord compliance (Cchord) and enhanced pause (Penh). Proteomes analysis was further carried out to identify molecular targets of 6-PPDQ after repeated injection, which was confirmed by transcriptional expression analysis and immunohistochemistry staining. Alterations in Ripk1, Fadd, Il-6st, and Il-16 expressions were identified to be associated with inflammation induction of lung after repeated 6-PPDQ injection. Alteration in Smad2 expression was identified to be associated with fibrosis formation in lung of 6-PPDQ exposed mice. Therefore, long-term and repeated 6-PPDQ exposure potentially resulted in inflammation and fibrosis in lung by affecting certain molecular signals in mammals. Our results suggested several aspects of lung injury caused by 6-PPDQ and provide the underlying molecular basis. These observations implied the possible risks of long-term 6-PPDQ exposure to human health.

Development of multi-generation lower respiratory tract model and insights into the transport and deposition characteristics of inhalable particles

Airborne particles can spread quickly and enter human respiratory system via inhalation, causing chronic diseases, even cancer. Although recent studies have informed of toxicity of various pollutants, understanding the transport and deposition characteristics of particles in lower respiratory tract is still challenging. The current study proposes a novel model to simulate flow field change from the entrance of lower respiratory tract to pulmonary acinus, while studying particle transport and deposition characteristics. This model for lower respiratory tract with several bronchial extensions containing virtual pulmonary acinus is calculated using computational fluid dynamics and dynamics mesh. The results showed that in the first 10 generations of the lower respiratory tract, vortices and gravity interfered with particles' trajectory, affecting particle deposition distribution. For the first to the tenth-generation respiratory tract, coarse particles were deposited throughout almost the whole respiratory tract model. In contrast, ultrafine particles did not deposit in the higher-generation respiratory tract. The particle enrichment ability of various lobes was uneven with three particle deposition fraction variation patterns. Virtual pulmonary acinus influenced particle deposition and distribution because of vortex ring's trapped ability during expansion and contraction. This new attempt to build a virtual pulmonary acinus model to simulate particle deposition effects in human respiratory system may provide a reference for studying the toxicities of inhalable particles in the exposed human body.

Upscaling of Electrospinning Technology and the Application of Functionalized PVDF-HFP@TiO2 Electrospun Nanofibers for the Rapid Photocatalytic Deactivation of Bacteria on Advanced Face Masks

In recent years, Electrospinning (ES) has been revealed to be a straightforward and innovative approach to manufacture functionalized nanofiber-based membranes with high filtering performance against fine Particulate Matter (PM) and proper bioactive properties. These qualities are useful for tackling current issues from bacterial contamination on Personal Protective Equipment (PPE) surfaces to the reusability of both disposable single-use face masks and respirator filters. Despite the fact that the conventional ES process can be upscaled to promote a high-rate nanofiber production, the number of research works on the design of hybrid materials embedded in electrospun membranes for face mask application is still low and has mainly been carried out at the laboratory scale. In this work, a multi-needle ES was employed in a continuous processing for the manufacturing of both pristine Poly (Vinylidene Fluoride-co-Hexafluoropropylene) (PVDF-HFP) nanofibers and functionalized membrane ones embedded with TiO2 Nanoparticles (NPs) (PVDF-HFP@TiO2). The nanofibers were collected on Polyethylene Terephthalate (PET) nonwoven spunbond fabric and characterized by using Scanning Electron Microscopy and Energy Dispersive X-ray (SEM-EDX), Raman spectroscopy, and Atomic Force Microscopy (AFM) analysis. The photocatalytic study performed on the electrospun membranes proved that the PVDF-HFP@TiO2 nanofibers provide a significant antibacterial activity for both Staphylococcus aureus (~94%) and Pseudomonas aeruginosa (~85%), after only 5 min of exposure to a UV-A light source. In addition, the PVDF-HFP@TiO2 nanofibers exhibit high filtration efficiency against submicron particles (~99%) and a low pressure drop (~3 mbar), in accordance with the standard required for Filtering Face Piece masks (FFPs). Therefore, these results aim to provide a real perspective on producing electrospun polymer-based nanotextiles with self-sterilizing properties for the implementation of advanced face masks on a large scale.

Electrospun nanofibers for medical face mask with protection capabilities against viruses: State of the art and perspective for industrial scale-up

Face masks have proven to be a useful protection from airborne viruses and bacteria, especially in the recent years pandemic outbreak when they effectively lowered the risk of infection from Coronavirus disease (COVID-19) or Omicron variants, being recognized as one of the main protective measures adopted by the World Health Organization (WHO). The need for improving the filtering efficiency performance to prevent penetration of fine particulate matter (PM), which can be potential bacteria or virus carriers, has led the research into developing new methods and techniques for face mask fabrication. In this perspective, Electrospinning has shown to be the most efficient technique to get either synthetic or natural polymers-based fibers with size down to the nanoscale providing remarkable performance in terms of both particle filtration and breathability. The aim of this Review is to give further insight into the implementation of electrospun nanofibers for the realization of the next generation of face masks, with functionalized membranes via addiction of active material to the polymer solutions that can give optimal features about antibacterial, antiviral, self-sterilization, and electrical energy storage capabilities. Furthermore, the recent advances regarding the use of renewable materials and green solvent strategies to improve the sustainability of electrospun membranes and to fabricate eco-friendly filters are here discussed, especially in view of the large-scale nanofiber production where traditional membrane manufacturing may result in a high environmental and health risk.

Exposure to SARS-CoV-2 and Infantile Diseases

Background and Aim  Immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in newborns and children after prophylactic immunization is currently a relevant research topic. The present study analyzes the issue by examining the possibility that the anti-SARS-CoV-2 immune responses are not uniquely directed against the virus but can-via molecular mimicry and the consequent cross-reactivity-also hit human proteins involved in infantile diseases. Methods  Human proteins that-if altered-associate with infantile disorders were searched for minimal immune pentapeptide determinants shared with SARS-CoV-2 spike glycoprotein (gp). Then, the shared pentapeptides were analyzed for immunologic potential and immunologic imprinting phenomena. Results  Comparative sequence analysis shows that: (1) numerous pentapeptides (namely, 54) are common to SARS-CoV-2 spike gp and human proteins that, when altered, are linked to infantile diseases; (2) all the shared peptides have an immunologic potential since they are present in experimentally validated SARS-CoV-2 spike gp-derived epitopes; and (3) many of the shared peptides are also hosted in infectious pathogens to which children can have already been exposed, thus making immunologic imprint phenomena feasible. Conclusion  Molecular mimicry and the consequent cross-reactivity can represent the mechanism that connects exposure to SARS-CoV-2 and various pediatric diseases, with a fundamental role of the immunologic memory and the history of the child's infections in determining and specifying the immune response and the pathologic autoimmune sequela.

Nanoparticle transport and deposition in a heterogeneous human lung airway tree: An efficient one path model for CFD simulations

Understanding nano-particle inhalation in human lung airways helps targeted drug delivery for treating lung diseases. A wide range of numerical models have been developed to analyse nano-particle transport and deposition (TD) in different parts of airways. However, a precise understanding of nano-particle TD in large-scale airways is still unavailable in the literature. This study developed an efficient one-path numerical model for simulating nano-particle TD in large-scale lung airway models. This first-ever one-path numerical approach simulates airflow and nano-particle TD in generations 0-11 of the human lung, accounting for 93% of the whole airway length. The one-path model enables the simulation of particle TD in many generations of airways with an affordable time. The particle TD of 5 nm, 10 nm and 20 nm particles is simulated at inhalation flow rates for two different physical activities: resting and moderate activity. It is found that particle deposition efficiency of 5 nm particles is 28.94% higher than 20 nm particles because of the higher dispersion capacity. It is further proved that the diffusion mechanism dominates the particle TD in generations 0-11. The deposition efficiency decreases with the increase of generation number irrespective of the flow rate and particle size. The effects of the particle size and flow rate on the escaping rate of each generation are opposite to the corresponding effects on the deposition rate. The quantified deposition and escaping rates at generations 0-11 provide valuable guidelines for drug delivery in human lungs.

Investigation of tracer gas transport in a new numerical model of lung acini

Obstructive pulmonary diseases are associated with considerable morbidity. For an early diagnosis of these diseases, inert gas washouts can potentially be used. However, the complex interaction between lung anatomy and gas transport mechanisms complicates data analysis. In order to investigate this interaction, a numerical model, based on the finite difference method, consisting of two lung units connected in parallel, was developed to simulate the tracer gas transport within the human acinus. Firstly, the geometries of the units were varied and the diffusion coefficients (D) were kept constant. Secondly, D was changed and the geometry was kept constant. Furthermore, simple monoexponential growth functions were applied to evaluate the simulated data. In 109 of the 112 analyzed curves, monoexponential function matched simulated data with an accuracy of over 90%, potentially representing a suitable numerical tool to predict transport processes in further model extensions. For total flows greater than 5 × 10−4 ml/s, the exponential growth constants increased linearly with linear increasing flow to an accuracy of over 95%. The slopes of these linear trend lines of 1.23 µl−1 (D = 0.6 cm2/s), 1.69 µl−1 (D = 0.3 cm2/s), and 2.25 µl−1 (D = 0.1 cm2/s) indicated that gases with low D are more sensitive to changes in flows than gases with high D.

Graphical abstract

How Nanoparticle Aerosols Transport through Multi-Stenosis Sections of Upper Airways: A CFD-DPM Modelling

Airway stenosis is a global respiratory health problem that is caused by airway injury, endotracheal intubation, malignant tumor, lung aging, or autoimmune diseases. A precise understanding of the airflow dynamics and pharmaceutical aerosol transport through the multi-stenosis airways is vital for targeted drug delivery, and is missing from the literature. The object of this study primarily relates to behaviors and nanoparticle transport through the multi-stenosis sections of the trachea and upper airways. The combination of a CT-based mouth–throat model and Weibel’s model was adopted in the ANSYS FLUENT solver for the numerical simulation of the Euler–Lagrange (E-L) method. Comprehensive grid refinement and validation were performed. The results from this study indicated that, for all flow rates, a higher velocity was usually found in the stenosis section. The maximum velocity was found in the stenosis section having a 75% reduction, followed by the stenosis section having a 50% reduction. Increasing flow rate resulted in higher wall shear stress, especially in stenosis sections. The highest pressure was found in the mouth–throat section for all flow rates. The lowest pressure was usually found in stenosis sections, especially in the third generation. Particle escape rate was dependent on flow rate and inversely dependent on particle size. The overall deposition efficiency was observed to be significantly higher in the mouth–throat and stenosis sections compared to other areas. However, this was proven to be only the case for a particle size of 1 nm. Moreover, smaller nanoparticles were usually trapped in the mouth–throat section, whereas larger nanoparticle sizes escaped through the lower airways from the left side of the lung; this accounted for approximately 50% of the total injected particles, and 36% escaped from the right side. The findings of this study can improve the comprehensive understanding of airflow patterns and nanoparticle deposition. This would be beneficial in work with polydisperse particle deposition for treatment of comprehensive stenosis with specific drugs under various disease conditions.

Investigation of the Upper Respiratory Tract of a Male Smoker with Laryngeal Cancer by Inhaling Air Associated with Various Physical Activity Levels

Smokers are at a higher risk of laryngeal cancer, which is a type of head and neck cancer in which cancer cells proliferate and can metastasize to other tissues after a tumor has formed. Cigarette smoke greatly reduces the inhaled air quality and can also lead to laryngeal cancer. In this study, the upper airway of a 70-year-old smoker with laryngeal cancer was reconstructed by taking a CT scan using Mimics software. To solve the governing equations, computational fluid dynamics (CFD) with a pressure base approach was used with the help of Ansys 2021 R1 software. As a result, the maximum turbulence intensity occurred in the larynx. At 13 L/min, 55 L/min, and 100 L/min, the maximum turbulence intensity was 1.1, 3.5, and 6.1, respectively. The turbulence intensity in the respiratory system is crucial because it demonstrates the ability to transfer energy. The maximum wall shear stress (WSS) also occurred in the larynx. At 13 L/min, 55 L/min, and 100 L/min, the maximum WSS was 0.62 Pa, 5.4 Pa, and 12.4 Pa, respectively. The WSS index cannot be calculated in vivo and should be calculated in vitro. Excessive WSS in the epiglottis is inappropriate and can lead to an airway obstruction. Furthermore, real mathematical modeling outcomes provide an approach for future prevention, treatment, and management planning by forecasting the zones prone to an acceleration of disease progression. In this regard, accurate computational modeling leads to pre-visualization in surgical planning to define the best reformative techniques to determine the most probable patient condition consequences.

Is the SARS CoV-2 Omicron Variant Deadlier and More Transmissible Than Delta Variant?

Genetic variants of severe acute respiratory syndrome coronavirus (SARS-CoV-2) have been globally surging and devastating many countries around the world. There are at least eleven reported variants dedicated with inevitably catastrophic consequences. In 2021, the most dominant Delta and Omicron variants were estimated to lead to more severity and deaths than other variants. Furthermore, these variants have some contagious characteristics involving high transmissibility, more severe illness, and an increased mortality rate. All outbreaks caused by the Delta variant have been rapidly skyrocketing in infection cases in communities despite tough restrictions in 2021. Apart from it, the United States, the United Kingdom and other high-rate vaccination rollout countries are still wrestling with this trend because the Delta variant can result in a significant number of breakthrough infections. However, the pandemic has changed since the latest SARS-CoV-2 variant in late 2021 in South Africa, Omicron. The preliminary data suggest that the Omicron variant possesses 100-fold greater than the Delta variant in transmissibility. Therefore, this paper aims to review these characteristics based on the available meta-data and information from the first emergence to recent days. Australia and the five most affected countries, including the United States, India, Brazil, France, as well as the United Kingdom, are selected in order to review the transmissibility, severity and fatality due to Delta and Omicron variants. Finally, the vaccination programs for each country are also reviewed as the main factor in prevention.

Biomedical and biophysical limits to mathematical modeling of pulmonary system mechanics: a scoping review on aerosol and drug delivery

Undoubtedly, the construction of the biomechanical geometry systems with the help of computer tomography (CT) and magnetic resonance imaging (MRI) has made a significant advancement in studying in vitro numerical models as accurately as possible. However, some simplifying assumptions in the computational studies of the respiratory system have caused errors and deviations from the in vivo actual state. The most important of these hypotheses is how to generate volume from the point cloud exported from CT or MRI images, not paying attention to the wall thickness and its effect in computational fluid dynamic method, statistical logic of aerosol trap in software; and most importantly, the viscoelastic effect of respiratory tract wall in living tissue pointed in the fluid-structure interaction method. So that applying the viscoelastic dynamic mesh effect in the form of the moving deforming mesh can be very effective in achieving more appropriate response quality. Also, changing the volume fraction of the pulmonary extracellular matrix constituents leads to changes in elastic modulus (storage modulus) and the viscous modulus (loss modulus) of lung tissue. Therefore, in the biomedical computational methods where the model wall is considered flexible, the viscoelastic properties of the texture must be considered correctly.

The Impact of the Dynamics of Agglomeration Externalities on Air Pollution: Evidence from Urban Panel Data in China

Air pollution in China has become a matter of increasing public concern. In this paper, we attempted to build a theoretical model to explore the impact of the dynamics of agglomeration externalities on haze pollution in urban China, where agglomeration is differentiated by regional specialization and geographical concentration. Based on China’s panel data for 289 cities during the period of 1998–2018, the empirical result shows that the relationship between industrial agglomeration and urban haze pollution is not simply linear or of an inversed U-type but turns out to be dynamically N-shaped. To be specific, the increase in local haze pollution can be explained by agglomeration externalities in the beginning stage, whereas the reducing effect only occurs during the mature stage. The heterogeneity test indicated that the effect of the type of agglomeration on haze pollution seems to be mixed in different groups of cities, but is still consistent with the hypothesis of the dynamic change of agglomeration externalities. The results are found to be quite robust and consistent after replacing variables and using other regression methods. This paper provides answers to the question of how to coordinate the relationship between developing industry parks and air pollution in terms of the life cycle of agglomeration as well as the types of city.

Free and Forced Convective Flow in Pleural Fluid with Effect of Injection between Different Permeable Regions

Pleural effusion is an interruption of a pleural cavity in the lung wall. The lung and chest wall reversal process leads to pleural fluid aggregation in the pleural space. The parietal lymphatic expansion occurs because of increased pleural fluid. This model has been developed to obtain new results of respiratory tract infections, and also investigated the reaction of injection on an unstable free and forced convection flow of visceral pleural fluid transports in two different vertical porous regions. Finally, the model gives an impact of COVID-19 in the human respiratory tract, as it helps to anticipate early summary of establishing current pandemic infection. Results are computed analytically and plotted graphically for various physical parameters. The main highlights of this paper are mixed convection has been investigated mathematically in porous media, the effect of temperature and velocity field of pleural fluid was analyzed based on human lung mechanism, heat exchange associates with mucus layer and pleural fluid layer corresponding to thermal radiation and heat absorption, contribution of injection parameter over the region’s mucus and pleural phase, it has shown high sensitivity flow in diagnosis of COVID-19 due to pleural effusion.

Aerosol Particle Transport and Deposition in Upper and Lower Airways of Infant, Child and Adult Human Lungs

Understanding transportation and deposition (TD) of aerosol particles in the human respiratory system can help clinical treatment of lung diseases using medicines. The lung airway diameters and the breathing capacity of human lungs normally increase with age until the age of 30. Many studies have analyzed the particle TD in the human lung airways. However, the knowledge of the nanoparticle TD in airways of infants and children with varying inhalation flow rates is still limited in the literature. This study investigates nanoparticle (5 nm ≤ dp ≤ 500 nm) TD in the lungs of infants, children, and adults. The inhalation air flow rates corresponding to three ages are considered as Qin=3.22 L/min (infant), 8.09 L/min (Child), and Qin=14 L/min (adult). It is found that less particles are deposited in upper lung airways (G0–G3) than in lower airways (G12–G15) in the lungs of all the three age groups. The results suggest that the particle deposition efficiency in lung airways increases with the decrease of particle size due to the Brownian diffusion mechanism. About 3% of 500 nm particles are deposited in airways G12–G15 for the three age groups. As the particle size is decreased to 5 nm, the deposition rate in G12–G15 is increased to over 95%. The present findings can help medical therapy by individually simulating the distribution of drug-aerosol for the patient-specific lung.