Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine最新文献

{"title":"Recent advances in aerosol therapy for children with asthma.","authors":"Sunalene G Devadason","doi":"10.1089/jam.2006.19.61","DOIUrl":"https://doi.org/10.1089/jam.2006.19.61","url":null,"abstract":"<p><p>Inhalational drug delivery is the primary mode of asthma therapy in children and is the main focus of this article. Pressurized metered dose inhalers (pMDIs) are now the method of choice in infants and children under 5 years old, when used in combination with an appropriate valved holding chamber or spacer. Spacers are particularly important for steroid inhalation to maximize lung deposition and minimize unwanted oropharyngeal deposition. Optimal inhalation technique with a pMDI-spacer in infants is to inhale the drug by breathing tidally through the spacer. Drug delivery to the lungs using pMDIs can vary greatly, depending on the formulation used and the age of the child. Dry powder inhalers (DPIs) are driven by the peak inspiratory flow of the patient and are usually not appropriate for children under 5 or 6 years of age. Nebulizers continue to play a role in the treatment of acute asthma where high doses of bronchodilator are required, though multiple doses via pMDI spacer may suffice. Important drug delivery issues specific to children include compliance, use of mask versus mouthpiece, lower tidal volumes and inspiratory flows, determination of appropriate dosages, and minimization of adverse local and systemic effects.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 1","pages":"61-6"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.61","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25916757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical characteristics and health effects of aerosols from collapsed buildings.","authors":"Stephen H Gavett","doi":"10.1089/jam.2006.19.84","DOIUrl":"https://doi.org/10.1089/jam.2006.19.84","url":null,"abstract":"<p><p>Airborne pollutants can rise to extreme levels when large buildings fall down. The terrorist attack on New York's World Trade Center (WTC) towers caused the release of an enormous quantity of pulverized building materials and combustion products into the local environment. Particulate matter (PM) from crushed WTC building materials is primarily non-respirable (>96% larger than 10 microm mass median aerodynamic diameter [MMAD]) and composed of fibrous and nonfibrous components such as gypsum, calcite, silica, glass fibers, cellulose, and asbestos. Respirable fine WTC PM (PM(2.5)) may include finely crushed building materials as well as combustion products such as dioxins and polycyclic aromatic hydrocarbons (PAHs). Rescue workers at the WTC site had exposure-related increases in the incidences of nasal congestion, bronchial hyperreactivity to aerosolized methacholine, gastroesophageal reflux disease, and persistent cough. Toxicological studies in mice indicate that WTC PM(2.5) causes airflow obstruction above a critical dose. The review of physical characteristics and health effects of major pollutants derived from the collapse of the WTC towers has assisted in risk assessment efforts related to the collapse of large buildings.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 1","pages":"84-91"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.84","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25916760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liquid atomizing: nebulizing and other methods of producing aerosols.","authors":"Carlos F Lange,&nbsp;Warren H Finlay","doi":"10.1089/jam.2006.19.28","DOIUrl":"https://doi.org/10.1089/jam.2006.19.28","url":null,"abstract":"<p><p>Liquid atomization (or nebulization) is the most traditional method of drug delivery to the lung. Although other methods seem to often be preferred for the delivery of new drugs, nebulizers are experiencing a revival, with new devices based on different atomization techniques, and the more traditional jet nebulizers evolving to become \"smart nebulizers.\" These smart devices synchronize delivery with the patient's breath, estimate or measure delivered dose, provide feedback and data storage, and in some cases control breathing maneuvers. Besides adding new features, new nebulizers are also addressing traditional shortcomings, namely, reducing size, bulkiness, and power consumption. But in the longer term, nebulizers are expected to offer even more important features. Following the trend toward individually optimized therapy, nebulizers will be able to estimate deposited dosage and concentrations in the lung. In addition, as progress in nanotechnology allows the development of smart drug carrying particles, advanced liquid nebulization is expected to be the delivery mode of choice for these smart particle aerosols.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 1","pages":"28-35"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25917467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of different scintigraphic approaches to assess pulmonary ventilation.","authors":"J Magnant,&nbsp;L Vecellio,&nbsp;M de Monte,&nbsp;D Grimbert,&nbsp;C Valat,&nbsp;E Boissinot,&nbsp;D Guilloteau,&nbsp;E Lemarié,&nbsp;P Diot","doi":"10.1089/jam.2006.19.148","DOIUrl":"https://doi.org/10.1089/jam.2006.19.148","url":null,"abstract":"<p><p>A study was carried out to investigate the predictive value of 81-metastable-krypton (81mKr) distribution, high-size 99-metastable-technetium (99mTc) aerosol deposition and low-size 99mTc aerosol (Technegas) deposition on the pulmonary ventilation evaluated by 133-xenon (133Xe) lung scintigraphy, and to assess the correlation between the 81mKr distribution, the 99mTc aerosols deposition, and the respiratory parameters of patients with chronic obstructive pulmonary disease (COPD). Twenty COPD patients were included. The 81mKr, 133Xe, and 99mTc aerosol lung scintigraphies were successively carried out. The 81mKr distribution and 99mTc deposition were compared to the 133Xe distribution at equilibrium and to the 133Xe clearance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 81mKr and Technegas lung scintigraphies to detect alterations in ventilation revealed by 133Xe were defined. The 81mKr distribution and 99mTc deposition according to respiratory parameters were described using a principal component analysis. Compared to 133Xe distribution, a significantly higher distribution of 81mKr in the upper parts of the lungs in the more severe patients (p = 0.05), a significantly higher deposition of Technegas in the lower parts of the lungs (p = 0.0008), and a significantly higher deposition in the central parts of the high-size 99mTc aerosol were observed (p = 0.0001). The PPV and the NPV were, respectively, 0.54 and 0.58 for 81mKr and 0.54 and 0.55 for Technegas. There was a significant negative correlation between 81mKr distribution and 133Xe clearance (p = 0.0001) between Technegas deposition and 133Xe clearance (p = 0.0007), and between 99mTc diethylene-triamino-penta-acetate (DTPA) deposition and 133Xe clearance (p = 0.001). Both the 81mKr peripheral distribution and Technegas peripheral deposition correlated negatively with increased obstruction, as measured by forced expiratory volume in 1 sec (FEV1). Peripheral deposition of the high-size 99mTc aerosol deposition correlated with the inspiration/expiration time ratio. In conclusion, 81mKr and 99mTc aerosols' lung scintigraphies do not reflect exactly the pulmonary ventilation as measured by 133Xe scintigraphy.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 2","pages":"148-59"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26108756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degree of throat deposition can explain the variability in lung deposition of inhaled drugs.","authors":"Lars Borgström,&nbsp;Bo Olsson,&nbsp;Lars Thorsson","doi":"10.1089/jam.2006.19.473","DOIUrl":"https://doi.org/10.1089/jam.2006.19.473","url":null,"abstract":"<p><p>Inhalation is a mainstay for treatment of asthma, and lung deposition can be seen as a surrogate marker for the ensuing clinical effects. Not only absolute lung deposition, but also its variability is of interest, as it indicates the range of expected lung deposition in an individual patient when prescribing the drug and the expected day-to-day variability when using it. A literature survey found 71 studies with relevant information on lung deposition and its variability. Further characteristics of the studies, such as if the subjects were healthy or asthmatics, adults or children, and what device that was used, were noted. In all, 187 data points were included. Variability in lung deposition was depicted as a function of mean lung deposition; for the entire data set and for subsets thereof. Independent of device type or subject category high lung deposition was associated with low relative variability and vice versa. Using a published throat deposition model, the observed correlation of lung deposition variability to mean lung deposition could be explained as being determined largely by the extent of and variability in throat deposition. We hypothesize that throat deposition is the major determinant for lung deposition of an inhaled aerosol, and its absolute variability will largely be determined by the absolute variability in throat deposition. The relative variability in lung deposition will therefore tend to be high for low lung deposition and low for high lung deposition. Consequently, low relative variability in lung deposition can only be attained if high lung deposition is achieved.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 4","pages":"473-83"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26465826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetry counts: molecular hypersensitivity may not drive pulmonary hyperresponsiveness.","authors":"O R Moss,&nbsp;M J Oldham","doi":"10.1089/jam.2006.19.555","DOIUrl":"https://doi.org/10.1089/jam.2006.19.555","url":null,"abstract":"<p><p>Airway hyperresponsiveness is one measure of allergic asthma. One such test, the methacholine challenge, uses an inhaled aerosol to induce changes in resistance to breathing. The test is also used to test hyperresponsiveness in rodent models of asthma. For two varieties of mice, the B6C3F1 and the Balb/c, exposure to aerosolized methacholine demonstrates that the Balb/c is 12x more responsive based on the concentration of methacholine in the solution used to produce the inhaled aerosol (the normally accepted dose-metric). Here we show that the 12x difference in exposure disappears when measurements of airway dimensions of generations 1-6 are used first to calculate deposited mass of methacholine; and second to account for the physiology of airway constriction and pressure drop. These observations in mice provide one explanation of how some hyperresponsive subjects can have no underlying molecular sensitivity; and how constriction in the upper airways can have greater impact on breathing than constriction of airway generations 6-16.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 4","pages":"555-64"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26465833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser diffractometry as a technique for the rapid assessment of aerosol particle size from inhalers.","authors":"Jolyon P Mitchell,&nbsp;Mark W Nagel,&nbsp;Steve Nichols,&nbsp;Ola Nerbrink","doi":"10.1089/jam.2006.19.409","DOIUrl":"https://doi.org/10.1089/jam.2006.19.409","url":null,"abstract":"<p><p>The rapid assessment of aerosols produced by medicinal inhalers is highly desirable from several standpoints, including the assurance of product quality, the development of new delivery systems, and the need to meet an increasing requirement by regulatory bodies for reliable in vitro performance data. Particle size analysis has traditionally been undertaken by cascade impactor on account of the direct assessment of active pharmaceutical ingredient(s) (APIs) that is possible by this method. However, laser diffractometry is less labor-intensive, more rapid, and can be a less invasive procedure. The technique provides meaningful results; as long as precautions are taken to validate that the measurements are an accurate reflection of the distribution of API mass as a function of particle or droplet size. We begin the review by examining the underlying theory of the laser diffraction method. After a brief description of current laser diffractometers used in inhaler measurements, we continue by examining the range of applications by inhaler class. We then examine the basis upon which inhaler measurements made by laser-diffractometry can be compared with equivalent particle size distribution data from compendial techniques. We conclude the assessment of the technique by developing guidelines for its valid application as a component of the range of in vitro methods that are available for inhaler performance assessment.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 4","pages":"409-33"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26524974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic delivery of drugs to humans via inhalation.","authors":"Igor Gonda","doi":"10.1089/jam.2006.19.47","DOIUrl":"https://doi.org/10.1089/jam.2006.19.47","url":null,"abstract":"<p><p>Unwanted systemic absorption of drugs delivered for the local treatment of respiratory disease is well documented. Methods to minimize this now exist, especially for reduction of oropharyngeal deposition. While small molecules appear to be absorbed also from the airways, it is the alveolated regions that provide a large absorptive surface. Lung has been used as a portal for systemic delivery of substances such as anesthetics, nicotine and a number of illicit drugs. Much research has lead to the solutions of the fundamental technical hurdles of practicable delivery of systemic therapeutic drugs in milligram quantities to the lung efficiently and reproducibly. Commercial manufacturing processes exist for production of delivery systems suitable for this purpose. Generally, the deposition of small molecules in the \"deep lung\" leads to high absorption rates, making the inhalation delivery attractive for drugs with intended rapid onset of action. Many therapeutics, especially peptides and proteins, that cannot be delivered systemically non-invasively, are absorbed with various degrees of systemic bioavailability via inhalation. The critical factor for efficient and reproducible systemic delivery is lung deposition which depends on the properties of drug particles (size, shape, density, hygroscopicity, velocity, charge) and the state of the respiratory system (including the individual's anatomy, age, sex, disease, lung volume). While concerns exist about the potential adverse reactions of the immune system to therapeutic proteins and peptides delivered to and through the lung, there is not much data on the immune response or its link to any safety issues with inhaled biologics. Desirable systemic immune effects have been demonstrated by cytokine delivery to the lung.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 1","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.47","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25916755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving prediction of aerosol deposition in an idealized mouth using large-Eddy simulation.","authors":"Edgar A Matida,&nbsp;Warren H Finlay,&nbsp;Michael Breuer,&nbsp;Carlos F Lange","doi":"10.1089/jam.2006.19.290","DOIUrl":"https://doi.org/10.1089/jam.2006.19.290","url":null,"abstract":"<p><p>Monodisperse aerosol deposition in an idealized mouth geometry with a relatively small inlet diameter (D (in) = 3.0 mm) was studied numerically using a standard Large Eddy Simulation (LES). A steady inhalation flow rate of Q = 32.2 L/min was used. Thousands of particles (2.5, 3.7, and 5.0 microm in diameter and rho (f) = 912.0 kg/m(3) density) were released separately in the computational domain and aerosol deposition was determined. The total aerosol deposition results in this idealized mouth were in relatively good agreement when compared with measured data obtained in separate experiments, showing considerable improvement over the standard RANS/EIM (Reynolds Averaged Navier-Stokes/Eddy Interaction Model) approach.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 3","pages":"290-300"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26359391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional computational fluid dynamics simulations of particle deposition in the tracheobronchial tree.","authors":"Kristin K Isaacs,&nbsp;R B Schlesinger,&nbsp;Ted B Martonen","doi":"10.1089/jam.2006.19.344","DOIUrl":"https://doi.org/10.1089/jam.2006.19.344","url":null,"abstract":"<p><p>Simulation of the dynamics and disposition of inhaled particles within human lungs is an invaluable tool in both the development of inhaled pharmacologic drugs and the risk assessment of environmental particulate matter (PM). The goal of the present focused study was to assess the utility of three-dimensional computational fluid dynamics (CFD) models in studying the local deposition patterns of PM in respiratory airways. CFD models were validated using data from published experimental studies in human lung casts. The ability of CFD to appropriately simulate trends in deposition patterns due to changing ventilatory conditions was specifically addressed. CFD simulations of airflow and particle motion were performed in a model of the trachea and main bronchi using Fluent Inc.'s FIDAP CFD software. Particle diameters of 8 microm were considered for input flow rates of 15 and 60 L/min. CFD was able to reproduce the observed spatial heterogeneities of deposition within the modeled bifurcations, and correctly predicted the \"hot-spots\" of particle deposition on carinal ridges. The CFD methods also predicted observed differences in deposition for high-versus-low flow rates. CFD models may provide an efficient means of studying the complex effects of airway geometry, particle characteristics, and ventilatory parameters on particle deposition and therefore aid in the design of human subject experiments.</p>","PeriodicalId":14878,"journal":{"name":"Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine","volume":"19 3","pages":"344-52"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/jam.2006.19.344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26359395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}