Administering aerosols to the lungs via the nose, while convenient, is known to be challenging due to high aerosol depositional losses in the delivery system and extrathoracic airways. In the first phase of this project, we demonstrated that the new excipient enhanced growth (EEG) technique could significantly improve lung delivery efficiency of aerosols administered during non-invasive ventilation and high flow nasal cannula (HFNC) therapy. The EEG approach implements a small particle aerosol containing a hygroscopic excipient to reduce depositional loss in the delivery system, increase aerosol particle size in the airways, and target the site of deposition within the lungs. Using EEG, lung delivery efficiency values were increased from ~1-10% to ~80% together with improved targeting of the small tracheobronchial airways (30-40-fold dose increase) and reduced intersubject variability. These results were based on testing in realistic in vitro airway models and new whole-airway computational fluid dynamics (CFD) simulations. The goal of this translational project is to determine the in vivo lung delivery efficiency of EEG aerosols administered during HFNC therapy using a newly developed and optimized HFNC aerosol delivery unit. A new standalone HFNC therapy aerosol device (delivery unit) will be developed that can simultaneously generate and administer an EEG aerosol. Depositional loss of the medication in the new delivery unit and streamlined nasal cannula interface combined will be <10% of the nebulized dose. Radiolabeled conventional and EEG formulations for mesh nebulization will be developed for human subject testing. The expected lung delivery efficiency of 1-10% with a commercial system will be increased to 80% or greater with the new EEG clinical system. In the human subject study, SPECT-CT images of the lung deposition will be segmented using 2D and 3D approaches and compared with CFD predictions. To accomplish these project goals, the following Aims are proposed:
Specific Aim 1. Develop a HFNC aerosol delivery unit for nose-to-lung aerosol administration and optimize performance using concurrent in vitro tests and whole-airway CFD simulations.
Specific Aim 2. Characterize the in vitro performance of the radiolabeled aerosol generated using the EEG method and delivery unit and the standard of care method to establish human subject dosimetry.
Specific Aim 3. Conduct human subject testing of the HFNC aerosol delivery unit and compare delivery efficiency with current standard of care. Validate whole-airway predictions of the CFD model, and further optimize device performance. Impact. This project will provide a new technique (EEG) and clinical platform (HFNC delivery unit) for high efficiency aerosol delivery, low intersubject variability, and targeted delivery within the lungs for improving the efficacy of existing and new inhaled medications administered using the convenient nose-to-lung route.

Public Health Relevance

Pharmaceutical aerosols administered during non-invasive ventilation or high flow nasal cannula (HFNC) therapy have very low lung delivery efficiencies, leading to wasted medication, reduced drug effectiveness, and potentially increased side effects. In the first phase of this project, the new excipient enhanced growth (EEG) aerosol delivery technique was developed and demonstrated to provide high efficiency lung deposition, reduced intersubject dose variability, and targeted deposition in the small airways during nose-to-lung aerosol administration based on experiments in realistic in vitro airway models and new whole-airway computational fluid dynamics (CFD) simulations. The goal of this new phase is to conduct human subject experiments and determine the in vivo lung delivery efficiency of EEG aerosols using a newly developed and optimized HFNC aerosol delivery unit.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL107333-08
Application #
9856503
Study Section
Gene and Drug Delivery Systems Study Section (GDD)
Program Officer
Punturieri, Antonello
Project Start
2011-06-01
Project End
2021-01-31
Budget Start
2020-02-01
Budget End
2021-01-31
Support Year
8
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Virginia Commonwealth University
Department
Engineering (All Types)
Type
Biomed Engr/Col Engr/Engr Sta
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Bass, Karl; Longest, P Worth (2018) Recommendations for Simulating Microparticle Deposition at Conditions Similar to the Upper Airways with Two-Equation Turbulence Models. J Aerosol Sci 119:31-50
Walenga, Ross L; Longest, P Worth; Kaviratna, Anubhav et al. (2017) Aerosol Drug Delivery During Noninvasive Positive Pressure Ventilation: Effects of Intersubject Variability and Excipient Enhanced Growth. J Aerosol Med Pulm Drug Deliv 30:190-205
Walenga, Ross L; Longest, P Worth (2016) Current Inhalers Deliver Very Small Doses to the Lower Tracheobronchial Airways: Assessment of Healthy and Constricted Lungs. J Pharm Sci 105:147-59
Longest, P Worth; Tian, Geng; Khajeh-Hosseini-Dalasm, Navvab et al. (2016) Validating Whole-Airway CFD Predictions of DPI Aerosol Deposition at Multiple Flow Rates. J Aerosol Med Pulm Drug Deliv 29:461-481
Farkas, Dale R; Hindle, Michael; Longest, P Worth (2015) Characterization of a New High-Dose Dry Powder Inhaler (DPI) Based on a Fluidized Bed Design. Ann Biomed Eng 43:2804-15
Khajeh-Hosseini-Dalasm, Navvab; Longest, P Worth (2015) Deposition of Particles in the Alveolar Airways: Inhalation and Breath-Hold with Pharmaceutical Aerosols. J Aerosol Sci 79:15-30
Longest, P Worth; Golshahi, Laleh; Behara, Srinivas R B et al. (2015) Efficient Nose-to-Lung (N2L) Aerosol Delivery with a Dry Powder Inhaler. J Aerosol Med Pulm Drug Deliv 28:189-201
Tian, Geng; Hindle, Michael; Lee, Sau et al. (2015) Validating CFD Predictions of Pharmaceutical Aerosol Deposition with In Vivo Data. Pharm Res 32:3170-87
Behara, Srinivas R B; Longest, P Worth; Farkas, Dale R et al. (2014) Development of high efficiency ventilation bag actuated dry powder inhalers. Int J Pharm 465:52-62
Behara, Srinivas R B; Longest, P Worth; Farkas, Dale R et al. (2014) Development and comparison of new high-efficiency dry powder inhalers for carrier-free formulations. J Pharm Sci 103:465-77

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