Exploring pulmonary distribution of intratracheally instilled liquid foams in excised porcine lungs.

The applicability of inhalation therapy to some severe pulmonary conditions is often compromised by limited delivery rates (i.e. total dose) and low deposition efficiencies in the respiratory tract, most notably in the deep pulmonary acinar airways. To circumvent such limitations, alternative therapeutic techniques have relied for instance on intratracheal liquid instillations for the delivery of high-dose therapies. Yet, a longstanding mechanistic challenge with such latter methods lies in delivering solutions homogeneously across the whole lungs, despite an inherent tendency of non-uniform spreading driven mainly by gravitational effects. Here, we hypothesize that the pulmonary distribution of instilled liquid solutions can be meaningfully improved by foaming the solution prior to its instillation, owing to the increased volume and the reduced gravitational bias of foams. As a proof-of-concept, we show in excised adult porcine lungs that liquid foams can lead to significant improvement in homogenous pulmonary distributions compared with traditional liquid instillations. Our ex-vivo results suggest that liquid foams can potentially offer an attractive novel pulmonary delivery modality with applications for high-dose regimens of respiratory therapeutics.

Shear thinning effect on liquid foam distribution in heterogeneously constricted in vitro airway models.

Treating diseased lung regions using inhalation therapy is often limited due to airway constrictions and obstructions that significantly reduce aerosol deposition efficiency. Intratracheal administration of liquid foams is a potential strategy to improve pulmonary drug delivery to these affected airway regions. Here, we use effective viscosity measurements and in vitro small-airway models to examine how shear thinning effects in the foam can be leveraged to achieve a more uniform distribution within heterogeneously constricted or partially obstructed airways. We find that a foamed solution based on the formulation of Tacholiquin® exhibited a 5.75-fold decrease in effective viscosity across a shear rate range spanning 970 to 14'500 s-1. As a result, the foam volume penetrating through the constricted airway models was up to 154% higher compared with air, depending on the cross-sectional area of the constrictions. This proof-of-concept study represents a first step towards understanding the transport mechanics of liquid foams towards future pulmonary delivery applications.