Nanomedicine for Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome

Sadikot, Ruxana T.; Kolanjiyil, Arun V.; Kleinstreuer, Clement; Rubinstein, Israel

Optimal delivery of drugs depends on a given patient-specific lung-airway configuration and suitable delivery devices, as well as best aerosol characteristics and inhalation conditions. A suitable delivery device helps in generating drug aerosols of sufficient size and mass to be delivered to the distal lung regions along with the inhaled air/carrier-gas. In recent years, several technical advancements have led to inhalers with efficient drug delivery to localized lung regions. Novel features, such as dose measuring, breath actuation, and predetermined drug release, can significantly improve drug delivery. The development of such drug delivery methodologies, and subsequently device prototyping, require computational fluid-particle dynamic analysis of complex transport phenomena as well as experimental and (ultimately) clinical testing [61, 62] . Delivering nanomedicine to predetermined sites of human lung airways is challenging, but offers much promise in combating ALI/ARDS successfully. Observational studies have suggested that the incidence of adverse events is minimized by aerosol delivery; however, there is potential to cause systemic or local toxicity in the form of airway irritation, cough, and often bronchospasms, as well as pulmonary injury when using aerosol therapies [63] . Further research including defining the safety profile of nanoparticles that are delivered via aerosol therapy is necessary. In the future, we anticipate that these nanomicelles will also be applicable to treat other inflammatory lung conditions such as COPD, asthma, bronchiectasis, and pulmonary fibrosis, which are major health concerns in the military and general population. Further studies are needed to establish the role of aerosolized nanopreparations for inhalational therapy.