Name: evaluating regional pulmonary deposition using patient-specific 3d printed lung models
Uploaded: 2020-11-11T13:00:00
Description: Watch this Scientific Journal Video about Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models at JoVE.com

Los autores agradecen al profesor Yu Feng, a la Dra. Jenna Briddell, Ian Woodward y Lucas Attia por sus útiles discusiones.

1. Preparación de componentes experimentales impresos en 3D
NOTA: Todo el software utilizado en el protocolo se indica en la Tabla de materiales. Además, el software de corte utilizado es específico de la impresora 3D que aparece en la Tabla de Materiales; sin embargo, este protocolo se puede extender a una amplia gama de impresoras 3D de estereolitografía (SLA).
<ol><li>Convierta las tomografías computarizadas del paciente en objetos 3D (archivos .stl)...

<ol>
	<li>Goel, A., Baboota, S., Sahni, J. K., Ali, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exploring+targeted+pulmonary+delivery+for+treatment+of+lung+cancer.">Exploring targeted pulmonary delivery for treatment of lung cancer.</a> International Journal of Pharmaceutical Investigation. 3 (1), 8-14 (2013).</li><li>Kleinstreuer, C., Zhang, Z., Li, Z., Roberts, W. L., Rojas, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+methodology+for+targeting+drug-aerosols+in+the+human+respiratory+system.">A new methodology for targeting drug-aerosols in the human respiratory system.</a> International Journal of Heat and Mass Transfer. 51 (23), 5578-5589 (2008).</li><li>Feng, Y., Chen, X., Yang, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+In+Silico+Investigation+of+a+Lobe-Specific+Targeted+Pulmonary+Drug+Delivery+Method.">An In Silico Investigation of a Lobe-Specific Targeted Pulmonary Drug Delivery Method.</a> Design of Medical Devices Conference. , (2018).</li><li>Marple, V. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Next+generation+pharmaceutical+impactor+(a+new+impactor+for+pharmaceutical+inhaler+testing).+Part+I:+Design.">Next generation pharmaceutical impactor (a new impactor for pharmaceutical inhaler testing). Part I: Design.</a> Journal of Aerosol Medicine. 16 (3), 283-299 (2003).</li><li>Feng, Y., Zhao, J., Chen, X., Lin, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+In+Silico+Subject-Variability+Study+of+Upper+Airway+Morphological+Influence+on+the+Airflow+Regime+in+a+Tracheobronchial+Tree.">An In Silico Subject-Variability Study of Upper Airway Morphological Influence on the Airflow Regime in a Tracheobronchial Tree.</a> Bioengineering. 4 (4), 90 (2017).</li><li>Huynh, B. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Development+and+Validation+of+an+In+Vitro+Airway+Model+to+Assess+Realistic+Airway+Deposition+and+Drug+Permeation+Behavior+of+Orally+Inhaled+Products+Across+Synthetic+Membranes.">The Development and Validation of an In Vitro Airway Model to Assess Realistic Airway Deposition and Drug Permeation Behavior of Orally Inhaled Products Across Synthetic Membranes.</a> Journal of Aerosol Medicine and Pulmonary Drug Delivery. 31 (2), 103-108 (2018).</li><li>Lizal, F., Elcner, J., Hopke, P. K., Jedelsky, J., Jicha, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+realistic+human+airway+model.">Development of a realistic human airway model.</a> Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 226 (3), 197-207 (2011).</li><li>Wei, X., Hindle, M., Delvadia, R. R., Byron, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+Vitro+Tests+for+Aerosol+Deposition.+V:+Using+Realistic+Testing+to+Estimate+Variations+in+Aerosol+Properties+at+the+Trachea.">In Vitro Tests for Aerosol Deposition. V: Using Realistic Testing to Estimate Variations in Aerosol Properties at the Trachea.</a> Journal of Aerosol Medicine and Pulmonary Drug Delivery. 30 (5), 339-348 (2017).</li><li>Kolewe, E. L., Feng, Y., Fromen, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Realizing+Lobe-Specific+Aerosol+Targeting+in+a+3D-Printed+In+Vitro+Lung+Model.">Realizing Lobe-Specific Aerosol Targeting in a 3D-Printed In Vitro Lung Model.</a> Journal of Aerosol Medicine and Pulmonary Drug Delivery. , (2020).</li><li>Sul, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+Airflow+Sensitivity+to+Healthy+and+Diseased+Lung+Conditions+in+a+Computational+Fluid+Dynamics+Model+Validated+In+Vitro.">Assessing Airflow Sensitivity to Healthy and Diseased Lung Conditions in a Computational Fluid Dynamics Model Validated In Vitro.</a> Journal of Biomechanical Engineering. 140 (5), (2018).</li><li>Martonen, T. B., Katz, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deposition+Patterns+of+Polydisperse+Aerosols+Within+Human+Lungs.">Deposition Patterns of Polydisperse Aerosols Within Human Lungs.</a> Journal of Aerosol Medicine. 6 (4), 251-274 (1993).</li><li>Nahar, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro,+in+vivo+and+ex+vivo+models+for+studying+particle+deposition+and+drug+absorption+of+inhaled+pharmaceuticals.">In vitro, in vivo and ex vivo models for studying particle deposition and drug absorption of inhaled pharmaceuticals.</a> European Journal of Pharmaceutical Sciences. 49 (5), 805-818 (2013).</li><li>Nichols, S. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Multi-laboratory+in+Vitro+Study+to+Compare+Data+from+Abbreviated+and+Pharmacopeial+Impactor+Measurements+for+Orally+Inhaled+Products:+a+Report+of+the+European+Aerosol+Group+(EPAG).">A Multi-laboratory in Vitro Study to Compare Data from Abbreviated and Pharmacopeial Impactor Measurements for Orally Inhaled Products: a Report of the European Aerosol Group (EPAG).</a> AAPS PharmSciTech. 17 (6), 1383-1392 (2016).</li><li>Yoshida, H., Kuwana, A., Shibata, H., Izutsu, K. I., Goda, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+Aerodynamic+Particle+Size+Distribution+Between+a+Next+Generation+Impactor+and+a+Cascade+Impactor+at+a+Range+of+Flow+Rates.">Comparison of Aerodynamic Particle Size Distribution Between a Next Generation Impactor and a Cascade Impactor at a Range of Flow Rates.</a> AAPS PharmSciTech. 18 (3), 646-653 (2017).</li><li>Feng, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+in+silico+inter-subject+variability+study+of+extra-thoracic+morphology+effects+on+inhaled+particle+transport+and+deposition.">An in silico inter-subject variability study of extra-thoracic morphology effects on inhaled particle transport and deposition.</a> Journal of Aerosol Science. 123, 185-207 (2018).</li><li>Kleinstreuer, C., Seelecke, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inhaler+system+for+targeted+maximum+drug-aerosol+delivery.">Inhaler system for targeted maximum drug-aerosol delivery.</a> United States patent. , (2005).</li><li>. How Medical 3D Printing is Gaining Ground in Top Hospitals Available from: <a target="_blank" href="https://www.materialise.com/en/blog/3d-printing-hospitals">https://www.materialise.com/en/blog/3d-printing-hospitals</a> (2019)</li><li>Weber, P. W., Price, O. T., McClellan, G. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Demographic+Variability+of+Inhalation+Mechanics:+A+Review.">Demographic Variability of Inhalation Mechanics: A Review.</a> Defense Threat Reduction Agency. , (2016).</li><li>Jiang, Y. Y., Xu, X., Su, H. L., Liu, D. X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gender-related+difference+in+the+upper+airway+dimensions+and+hyoid+bone+position+in+Chinese+Han+children+and+adolescents+aged+6-18+years+using+cone+beam+computed+tomography.">Gender-related difference in the upper airway dimensions and hyoid bone position in Chinese Han children and adolescents aged 6-18 years using cone beam computed tomography.</a> Acta Odontologica Scandinavica. 73 (5), 391-400 (2015).</li><li>Martin, S. E., Mathur, R., Marshall, I., Douglas, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+age,+sex,+obesity+and+posture+on+upper+airway+size.">The effect of age, sex, obesity and posture on upper airway size.</a> European Respiratory Journal. 10 (9), 2087 (1997).</li><li>Xi, J., Longest, P. W., Martonen, T. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+the+laryngeal+jet+on+nano-+and+microparticle+transport+and+deposition+in+an+approximate+model+of+the+upper+tracheobronchial+airways.">Effects of the laryngeal jet on nano- and microparticle transport and deposition in an approximate model of the upper tracheobronchial airways.</a> Journal of Applied Physiology. 104 (6), 1761-1777 (2008).</li><li>Zhao, J., Feng, Y., Fromen, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glottis+motion+effects+on+the+particle+transport+and+deposition+in+a+subject-specific+mouth-to-trachea+model:+A+CFPD+study.">Glottis motion effects on the particle transport and deposition in a subject-specific mouth-to-trachea model: A CFPD study.</a> Computers in Biology and Medicine. 116, 103532 (2020).</li><li>Kim, S. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+obstructive+pulmonary+disease:+lobe-based+visual+assessment+of+volumetric+CT+by+Using+standard+images--comparison+with+quantitative+CT+and+pulmonary+function+test+in+the+COPDGene+study.">Chronic obstructive pulmonary disease: lobe-based visual assessment of volumetric CT by Using standard images--comparison with quantitative CT and pulmonary function test in the COPDGene study.</a> Radiology. 266 (2), 626-635 (2013).</li><li>. The Cancer Imaging Archive Available from: <a target="_blank" href="https://www.cancerimagingarchive.net/">https://www.cancerimagingarchive.net/</a> (2020)</li><li>Li, A., Ahmadi, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer+Simulation+of+Deposition+of+Aerosols+in+a+Turbulent+Channel+Flow+with+Rough+Walls.">Computer Simulation of Deposition of Aerosols in a Turbulent Channel Flow with Rough Walls.</a> Aerosol Science and Technology. 18 (1), 11-24 (1993).</li><li>Khalili, S. F., Ghanbarzadeh, S., Nokhodchi, A., Hamishehkar, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+different+coating+materials+on+the+prevention+of+powder+bounce+in+the+next+generation+impactor.">The effect of different coating materials on the prevention of powder bounce in the next generation impactor.</a> Research in Pharmaceutical Sciences. 13 (3), 283-287 (2018).</li><li>Galliger, Z., Vogt, C. D., Panoskaltsis-Mortari, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=3D+bioprinting+for+lungs+and+hollow+organs.">3D bioprinting for lungs and hollow organs.</a> Translational Research. 211, 19-34 (2019).</li><li>Schwarz, K., Biller, H., Windt, H., Koch, W., Hohlfeld, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+exhaled+particles+from+the+healthy+human+lung--a+systematic+analysis+in+relation+to+pulmonary+function+variables.">Characterization of exhaled particles from the healthy human lung--a systematic analysis in relation to pulmonary function variables.</a> Journal of Aerosol Medicine and Pulmonary Drug Delivery. 23 (6), 371-379 (2010).</li><li>Patton, J. S., Byron, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inhaling+medicines:+delivering+drugs+to+the+body+through+the+lungs.">Inhaling medicines: delivering drugs to the body through the lungs.</a> Nature Reviews Drug Discovery. 6 (1), 67-74 (2007).</li><li>Zhang, Z., Kleinstreuer, C., Kim, C. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cyclic+micron-size+particle+inhalation+and+deposition+in+a+triple+bifurcation+lung+airway+model.">Cyclic micron-size particle inhalation and deposition in a triple bifurcation lung airway model.</a> Journal of Aerosol Science. 33 (2), 257-281 (2002).</li><li>Ju, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Engineering+of+Nebulized+Metal-Phenolic+Capsules+for+Controlled+Pulmonary+Deposition.">Engineering of Nebulized Metal-Phenolic Capsules for Controlled Pulmonary Deposition.</a> Advanced Science. 7 (6), 1902650 (2020).</li></ol>

El dispositivo actual de última generación para pruebas farmacéuticas pulmonares de una dosis completa de inhalación es el Next Generator Impactr (NGI), que mide el diámetro aerodinámico de un aerosol4. Estos datos de tamaño se utilizan entonces para predecir la generación pulmonar a la que el aerosol se depositará en función de una correlación desarrollada para un macho adulto sanode 11años. Desafortunadamente, este método es limitado en su capacidad para eval...

Muchas enfermedades pulmonares como el cáncer de pulmón y la enfermedad pulmonar obstructiva crónica (EPOC) presentan diferencias regionales en las características de la enfermedad; sin embargo, hay una falta de técnicas terapéuticas disponibles para el tratamiento de fármacos dirigidos a sólo las regiones enfermas del pulmón1. Múltiples modelos dinámicos de fluido computacional (CFD) han demostrado que es posible modular los perfiles de deposición de fármacos mediante la identificación de agilizaciónes específicas en el pulmón2,3. El desarrollo tanto de inhaladores como de adaptadores de tubo endotraqueal (ET) con capacidades de segmentación regionales está en marcha en nuestro laboratorio para controlar la distribución de aerosoles a las regiones pulmonares enfermas. La extensión de estos principios al uso clínico está limitada por la capacidad actual de pruebas preclínicas. La ubicación precisa de un medicamento deposita dentro del pulmón se sabe que es el mejor predictor de eficacia; sin embargo, las evaluaciones farmacéuticas actuales de las terapias inhalables se predicen con mayor frecuencia utilizando correlaciones in vitro-in vivo del tamaño de las partículas para limitarse a aproximar la deposición4. Esta técnica no permite ningún análisis espacial para determinar los efectos de diferentes geometrías de las vías respiratorias en la distribución regional a través de los diversos lóbulos del pulmón. Además, esta prueba carece de geometrías pulmonares anatómicamente precisas, que los investigadores han demostrado que pueden tener un impacto significativo en los perfiles de deposición5. Se han hecho algunos esfuerzos para incorporar geometrías pulmonares específicas del paciente en los protocolos de prueba a través de la adición de las vías respiratorias superiores; sin embargo, la mayoría de estos enfoques muestra la entrega de aerosoles a varias generaciones del pulmón en lugar de cada lóbulo pulmonar6,7,8. El siguiente protocolo presenta un método de alto rendimiento para generar modelos pulmonares específicos del paciente con capacidad para cuantificar la deposición relativa de partículas en cada uno de los cinco lóbulos del pulmón9.
Los pulmones modelo anatómicamente precisos son generados por la impresión 3D de tomografía computarizada (TC) del paciente. Cuando se utiliza junto con un sistema de flujo fácilmente ensamblado, los caudales relativos a través de cada uno de los lóbulos del pulmón modelo se pueden controlar y adaptar de forma independiente para imitar los de diferentes estados de demografía y/o enfermedad de los pacientes. Con este método, los investigadores pueden probar la eficacia de los métodos terapéuticos potenciales en una geometría pulmonar relevante y correlacionar el rendimiento de cada método con la progresión de la morfología enferma. Aquí, dos diseños de dispositivos desarrollados en nuestro laboratorio son probados por su capacidad para aumentar la deposición en un lóbulo pulmonar deseado mediante el control de la ubicación de la liberación de aerosoles en la boca o la tráquea. Este protocolo también tiene el potencial de afectar significativamente el desarrollo de procedimientos personalizados para los pacientes facilitando la rápida predicción de la eficacia del tratamiento en un pulmón modelo específico de los datos de la tomografía computarizada de ese paciente.

<table>
	<tbody>
		<tr>
			<td>1/4&#34; Plastic Barbed Tube Fitting</td>
			<td>McMaster Carr</td>
			<td>5372K111</td>
			<td></td>
		</tr>
		<tr>
			<td>10 um Filter Paper</td>
			<td>Fisher</td>
			<td>1093-110</td>
			<td></td>
		</tr>
		<tr>
			<td>1um Fluorescent Polystyrene Particles</td>
			<td>Polysciences</td>
			<td>15702-10</td>
			<td></td>
		</tr>
		<tr>
			<td>1um Non-Fluorescent Polystyrene Particles</td>
			<td>Polysciences</td>
			<td>8226</td>
			<td></td>
		</tr>
		<tr>
			<td>2-Propanol</td>
			<td>Fisher</td>
			<td>A516-4</td>
			<td>Referred to in protocol as &#34;IPA&#34;</td>
		</tr>
		<tr>
			<td>3/8&#34; Plastic Barbed Tube Fitting</td>
			<td>McMaster Carr</td>
			<td>5372K117</td>
			<td></td>
		</tr>
		<tr>
			<td>Air Flow Meter (1 - 280 mL/min)</td>
			<td>McMaster Carr</td>
			<td>41695K32</td>
			<td>Referred to in protocol as &#34;flow meter&#34;</td>
		</tr>
		<tr>
			<td>Carbon M1 3D Printer</td>
			<td>Carbon 3D</td>
			<td></td>
			<td>https://www.carbon3d.com/, Associated software referred to in protocol as &#34;slicing software&#34;</td>
		</tr>
		<tr>
			<td>Collison Jet Nebulizer</td>
			<td>CH Technologies</td>
			<td>ARGCNB0008 (CN-25)</td>
			<td>6 Jet MRE style horizontal collision with glass jar, Referred to in protocol as &#34;nebulizer&#34;, http://chtechusa.com/Manuals/MRE_Collison_Manual.pdf</td>
		</tr>
		<tr>
			<td>Convection Oven</td>
			<td>Yamato</td>
			<td>DKN602</td>
			<td></td>
		</tr>
		<tr>
			<td>Copley Critical Flow Controller TPK2000 Reve 120V</td>
			<td>MSP Corp</td>
			<td>0001-01-9810</td>
			<td>Referred to in protocol as &#34;flow controller&#34;</td>
		</tr>
		<tr>
			<td>Copley High Capacity Pump Model HCP5</td>
			<td>MSP Corp</td>
			<td>0001-01-9982</td>
			<td>Referred to in protocol as &#34;vacuum pump&#34;</td>
		</tr>
		<tr>
			<td>Cytation</td>
			<td>BioTek</td>
			<td>CYT5MPV</td>
			<td>Multifunctional Spectrophotometer/Fluorescent imager equiped with 4x/20x/40x objectives and DAPI/GFP/TexasRed laser/filter cubes</td>
		</tr>
		<tr>
			<td>EPU40 Resin</td>
			<td>Carbon 3D</td>
			<td></td>
			<td>https://www.carbon3d.com/materials/epu-elastomeric-polyurethane/, Referred to in protocol as &#34;soft resin&#34;</td>
		</tr>
		<tr>
			<td>Filter for vacuum pump</td>
			<td>Whatman</td>
			<td>6722-5000</td>
			<td></td>
		</tr>
		<tr>
			<td>Flow Meter Model DFM 2000</td>
			<td>MSP Corp</td>
			<td>0001-01-8764</td>
			<td>Referred to in protocol as &#34;electronic flow meter&#34;</td>
		</tr>
		<tr>
			<td>ImageJ Software</td>
			<td>ImageJ</td>
			<td></td>
			<td>https://imagej.nih.gov/ij/download.html</td>
		</tr>
		<tr>
			<td>Inline Air Flow Control Valve (Push-to-Connect)</td>
			<td>McMaster Carr</td>
			<td>62005K333</td>
			<td>Referred to in protocol as &#34;valve&#34;</td>
		</tr>
		<tr>
			<td>Inline Filter Devices</td>
			<td>Whatman</td>
			<td>WHA67225000</td>
			<td></td>
		</tr>
		<tr>
			<td>Marine-Grade Plywood Sheet</td>
			<td>McMaster Carr</td>
			<td>62005K333</td>
			<td>Referred to in protocol as &#34;wooden board&#34;</td>
		</tr>
		<tr>
			<td>Materialise Mimics Software</td>
			<td>Materialise</td>
			<td></td>
			<td>https://www.materialise.com/en/medical/mimics-innovation-suite, Referred to in protocol as &#34;CT scan software&#34;</td>
		</tr>
		<tr>
			<td>Meshmixer Software</td>
			<td>Autodesk</td>
			<td></td>
			<td>http://www.meshmixer.com/, Referred to in protocol as &#34;mesh editing software&#34;</td>
		</tr>
		<tr>
			<td>Methanol</td>
			<td>Fisher</td>
			<td>A454-4</td>
			<td></td>
		</tr>
		<tr>
			<td>Opticure LED Cube</td>
			<td>APM Technica</td>
			<td>102843</td>
			<td>Referred to in protocol as &#34;UV oven&#34;</td>
		</tr>
		<tr>
			<td>PR25 Resin</td>
			<td>Carbon 3D</td>
			<td></td>
			<td>https://www.carbon3d.com/materials/uma-urethanemethacrylate, /Referred to in protocol as &#34;hard resin&#34;</td>
		</tr>
		<tr>
			<td>PVC Tube for Chemicals</td>
			<td>McMaster Carr</td>
			<td>5231K161</td>
			<td>1/4&#34; ID</td>
		</tr>
		<tr>
			<td>Screws</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>SolidWorks Software</td>
			<td>Dassault Syst&#232;mes&#160;SolidWorks Corporation</td>
			<td></td>
			<td>https://www.solidworks.com/, Referred to in protocol as &#34;3D modeling software&#34;</td>
		</tr>
		<tr>
			<td>Straight Flow Rectangular Manifold</td>
			<td>McMaster Carr</td>
			<td>1125T31</td>
			<td></td>
		</tr>
		<tr>
			<td>Tubing to Flow Controller</td>
			<td>McMaster Carr</td>
			<td>5233K65</td>
			<td>3/8&#34; ID</td>
		</tr>
		<tr>
			<td>Wire</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

evaluating regional pulmonary deposition using patient-specific 3d printed lung models

El desarrollo de terapias específicas para enfermedades pulmonares está limitado por la disponibilidad de métodos de prueba preclínicos con la capacidad de predecir el suministro regional de aerosoles. Aprovechando la impresión 3D para generar modelos pulmonares específicos del paciente, delineamos el diseño de una configuración experimental in vitro de alto rendimiento para cuantificar la deposición pulmonar lobular. Este sistema está fabricado con una combinación de componentes impresos 3D y disponibles comercialmente y permite controlar de forma independiente el caudal a través de cada lóbulo del pulmón. La entrega de aerosoles fluorescentes a cada lóbulo se mide mediante microscopía de fluorescencia. Este protocolo tiene el potencial de promover el crecimiento de la medicina personalizada para enfermedades respiratorias a través de su capacidad para modelar una amplia gama de estados de demografía y enfermedades de los pacientes. Tanto la geometría del modelo pulmonar impreso en 3D como el ajuste del perfil de flujo de aire se pueden modular fácilmente para reflejar datos clínicos de pacientes con diferentes edades, raza y género. Los dispositivos de administración de fármacos clínicamente relevantes, como el tubo endotraqueal que se muestra aquí, se pueden incorporar a la configuración de pruebas para predecir con mayor precisión la capacidad de un dispositivo para dirigir el parto terapéutico a una región enferma del pulmón. La versatilidad de esta configuración experimental permite personalizarla para reflejar multitud de condiciones de inhalación, mejorando el rigor de las pruebas terapéuticas preclínicas.

Las partículas en este rango de tamaño (1-5 μm) y las condiciones de flujo (1-10 L/min) siguen las líneas de flujo de fluidos basadas tanto en su número teórico de Stokes como en los datos in vivo; por lo tanto, en ausencia de un dispositivo de entrega dirigido, se espera que las partículas liberadas en el modelo pulmonar se depositen de acuerdo con el porcentaje de flujo de aire total desviado a cada lóbulo. Las cantidades relativas de administración de partículas a cada lóbulo se pueden comparar con los dato...

Watch this Scientific Journal Video about Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models at JoVE.com

Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models

Presentamos un método in vitro de alto rendimiento para cuantificar la deposición pulmonar regional a nivel del lóbulo utilizando modelos pulmonares impresos en 3D derivados de tomografía computarizada con perfiles de flujo de aire ajustable.

Evaluación de la deposición pulmonar regional utilizando modelos pulmonares impresos en 3D específicos del paciente

Development of targeted therapies for pulmonary diseases is limited by the availability of preclinical testing methods with the ability to predict ...

This protocol has the potential to drive the development of new targeted pulmonary therapeutics by enabling the pre-clinical predictions of regional deposition. This technique incorporates anatomically accurate lung models, 3D printed from patient's CT scans for the rapid generation of personalized predictive results regarding the efficacy of potential treatments. This technique can be used to develop targeted therapies that minimize off target effects for diseases that are characterized by regional area obstructions such as lung cancer or COPD.After printing the experimental components and completing post-processing as per the manufacturer's instructions, carefully wash the parts printed in soft resin with at least 99%purity isopropyl alcohol to remove any excess uncured resin before thermal curing the parts in a convection oven for eight hours according to the manufacturer's specifications. Then, wash the parts printed in hard resin with the alcohol to remove any excess uncured resin and cure the parts in a UV oven for one minute per side. For lobe outlet cap assembly, insert one end of the oval barbed tubing connection base into the cap before carefully stretching the flexible cap over the other end of the oval base, taking special care not to crack the thin base and with the nozzle protruding through the opening in the cap base.Next, cut 10 microliter filter paper to a size slightly larger than the outlet area and fold the filter paper over the lobe outlet, holding the paper in place with one hand. Then use tweezers in the other hand, to stretch the cap with the barbed tubing connection over the outlet and press the cap down until the notch matches the corresponding notch on the lobe outlet. Before each experimental run, connect each lung model lobe outlet to the tubing of the corresponding flow meter and valve taking care not to apply too much lateral pressure to the barbed tubing connection.Attach the electronic flow meter to the lung model mouth inlet to measure the total airflow rate to the lung model and turn on the flow controller and vacuum pump. In the flow controller, select the test setup setting and slowly increase the flow rate until the electronic flow meter displays the desired total flow rate. Use the valves to adjust the flow rate through the right upper, right middle, right lower, left upper and left lower lung lobes.Once the load flow rates shown on the flow meters are steady at the desired value, check the overall flow rate again on the electronic flow meter to verify that there are no leaks in the system. Then, exit the test setup in the flow controller leaving the vacuum pump on. For aerosol delivery to the lung model, fill a nebulizer with a solution of the desired fluorescent particles and connect the nebulizer to the lung model inlet.To measure the efficacy of the targeting device, insert the device into the lung model and connect the nebulizer to the device. Connect the compressed airline to the nebulizer. Set the flow controller to run for one ten second trial and open the compressed air valve slightly to begin generating an aerosol within the nebulizer.Press start on the flow controller and immediately open the compressed air valve fully. When the flow controller reaches about nine seconds, begin closing the compressed air valve and close the fume hood sash as much as possible. Once the valve is fully closed, disconnect the nebulizer from the compressed airline.Fully close the fume hood sash, shut off the vacuum pump and let any aerosols clear from the fume hood. After about 10 minutes, disconnect the lung model from the tubing system, taking care not to crack the barbed tubing connections and run a pair of tweezers under the edge of each lobe outlet cap to remove the caps from the outlets. Then transfer the filter paper from each cap into individual wells of a 24-well plate particle depositions side down.When all of the filter paper has been collected, place the plate onto the stage of a digital fluorescence microscope and set the microscope to a 4X magnification and the appropriate fluorescence channel. Then take at least three images of the filter paper from each lobe at random locations and save the images as TIF files. Under one liter per minute collection conditions in a healthy lung, ended along effected by COPD, the experimentally determined deposition profile is not statistically different from the clinical data demonstrating that the setup accurately mimics the distribution of air flow to each of the lung lobes.Compared to the non-targeted particle deposition profile, the use of a modified endotracheal tube generates a nearly four fold increase in left lower lobe delivery. In addition to diverting over 96%of the delivered particles to the left lung. Altering the release location setting to target the right lower lobe, this device generates more than double the particle delivery to the right lobe and diverts 94%of the delivered particles to the right lung.Compared to the non-targeted particle deposition profile, the concentric cylinder device causes a nearly three fold increase in left upper lobe delivery in addition to diverting over 87%of the delivered particles to the left lung. Targeting efficiency can also be observed qualitatively by comparing the images of the target lobe filter to the other outlet filters. As illustrated, the most effective targeting method will yield a high particle deposition at the intended lobe of interest and a low deposition at the remaining lobe outlets.It is essential to make sure that components are properly connected to prevent leaks within the system as leaks will impact deposition results. This protocol permits researchers to test potential drug delivery devices for targeting specific regions of the lung prior to clinical trials reducing the cost associated with drug development and efficacy enhancement in human patients.

Research

JoVE Journal

Bioengineering

Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

Modelado específico del paciente del corazón: Estimación de las orientaciones de las fibras ventriculares

Patient-specific  simulations of heart (dys)function aimed at personalizing cardiac therapy are hampered  by the absence of in vivo imaging technology for ...

Investigación

Bioingeniería

Rapid and Low-cost Prototyping of Medical Devices Using 3D Printed Molds for Liquid Injection Molding

Prototipado rápido y de bajo costo de los dispositivos médicos Utilizando 3D Impreso Moldes para moldeo por inyección de líquido

Biologically inert elastomers such as silicone are favorable materials for medical device fabrication, but forming and curing these elastomers using ...

Improving 2D and 3D Skin In Vitro Models Using Macromolecular Crowding

Improving 2D and 3D Skin In Vitro Models Using Macromolecular Crowding

La mejora en 2D y 3D de la piel<em&gt; In Vitro</em&gt; Uso de modelos macromoleculares hacinamiento

The glycoprotein family of collagens represents the main structural proteins in the human body, and are key components of biomaterials used in modern ...

Scaling of Engineered Vascular Grafts Using 3D Printed Guides and the Ring Stacking Method

El escalado de Engineered injertos vasculares Usando 3D Impreso guías y el método de anillo de apilamiento

Coronary artery disease remains a leading cause of death, affecting millions of Americans. With the lack of autologous vascular grafts available, ...

Fabrication of Custom Agarose Wells for Cell Seeding and Tissue Ring Self-assembly Using 3D-Printed Molds

Fabricación de pozos de agarosa personalizado para la siembra de células y tejido anillo autoensamblaje con moldes impresa en 3D

Engineered tissues are being used clinically for tissue repair and replacement, and are being developed as tools for drug screening and human disease ...

Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models

Dirigidos a los tractos de fibras neuronales para la terapia de estimulación cerebral profunda mediante modelos interactivos, específico para cada paciente

Deep brain stimulation (DBS), which involves insertion of an electrode to deliver stimulation to a localized brain region, is an established therapy for ...

High-resolution Patterned Biofilm Deposition Using pDawn-Ag43

Alta resolución con motivos Biofilm deposición utilizando pDawn-Ag43

Spatial structure and patterning play an important role in bacterial biofilms. Here we demonstrate an accessible method for culturing E. coli biofilms ...

3D Printed Porous Cellulose Nanocomposite Hydrogel Scaffolds

3D impreso celulosa poroso nanocompuesto hidrogel andamios

This work demonstrates the use of three-dimensional (3D) printing to produce porous cubic scaffolds using cellulose nanocomposite hydrogel ink, with ...

3D Cell-Printed Hypoxic Cancer-on-a-Chip for Recapitulating Pathologic Progression of Solid Cancer

3D Cell-Printed Hypoxic Cancer-on-a-Chip Para Recapitular la Progresión Patológica Del Cáncer Sólido

Cancer microenvironment has a significant impact on the progression of the disease. In particular, hypoxia is the key driver of cancer survival, invasion, ...

Creation of Patient-Specific Silicone Cardiac Models with Applications in Pre-surgical Plans and Hands-on Training

Creación de modelos cardíacos de silicona específicos del paciente con aplicaciones en planes prequirúrgicos y capacitación práctica

Three dimensional&#160;models can be a valuable tool for surgeons as they develop surgical plans and medical fellows as they learn about complex cases. In ...