Modeling of Inhalation Profiles Through Dry Powder Inhaler in Healthy Adults and Asthma Patients As a Prerequisite for Further In Vitro and In Silico Studies

Agata Dorosz; Tomasz Urbankowski; Krzysztof Zieliński; Marcin Michnikowski; Rafał Krenke; Arkadiusz Moskal

doi:10.1089/jamp.2021.0021

Modeling of Inhalation Profiles Through Dry Powder Inhaler in Healthy Adults and Asthma Patients As a Prerequisite for Further In Vitro and In Silico Studies

J Aerosol Med Pulm Drug Deliv. 2022 Apr;35(2):91-103. doi: 10.1089/jamp.2021.0021. Epub 2021 Sep 13.

Authors

Agata Dorosz¹, Tomasz Urbankowski², Krzysztof Zieliński³, Marcin Michnikowski³, Rafał Krenke², Arkadiusz Moskal¹

Affiliations

¹ Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland.
² Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
³ Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.

PMID: 34516926
DOI: 10.1089/jamp.2021.0021

Abstract

Background: The severity of airway obstruction may affect patient's ability to perform an effective drug inhalation from a dry powder inhaler (DPI). Also, an incorrect inhalation technique may negatively affect the efficacy of asthma treatment. The aims of the study were (1) to analyze and compare inhalation profiles recorded with the use of different inhalation techniques, and thus, (2) to establish model inhalation profiles representative for healthy subjects and subjects with mild and moderate-to-severe asthma. Methods: This study was performed in healthy volunteers, patients with mild and moderate-to-severe asthma. A modified flow-volume test to define two different expiratory levels (to residual volume and half-way to residual volume) was performed. Inspiratory flow parameters were extracted: peak inspiratory flow rate (PIF_inh), time at which peak inspiratory flow rate occurs (tPIF_inh), total inhalation time (T), and inhaled volume (V). Test of frequency for tPIF_inh100% and tPIF_inh50% by asthma severity was performed, to provide information about initial flow accelerations. The impact of two different expiratory levels preceding inhalation (with severity of asthma as a categorical factor) on inspiratory flow parameters was examined. Results: PIF_inh was dependent upon asthma severity (p = 0.046). Type of exhalation before inhalation had no effect on PIF_inh values. V value was significantly affected both by asthma severity (p = 0.024) and type of exhalation before inhalation (p < 0.0001). Mean T value was influenced by type of exhalation before inhalation (p = 0.0003), but not by asthma severity. Mean tPIF_inh value was affected by the type of exhalation before inhalation only in healthy subjects (p = 0.01). Conclusions: Both asthma severity and type of exhalation before inhalation have little impact on the dynamics of inhalation through a DPI. An alternative form of equation describing inhalation profiles demonstrating a relationship between lung mechanics and dynamics of inspiratory profile has been proposed.

Keywords: asthma; dry powder inhaler; in vitro/in vivo correlations; inhalation profile; inhalation technique; inspiratory flow parameters.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Administration, Inhalation
Adult
Asthma* / drug therapy
Dry Powder Inhalers*
Humans
Lung
Powders / therapeutic use

Substances

Powders