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PubMed1989

Anti-neutrophil-elastase defenses of the lower respiratory tract in alpha 1-antitrypsin deficiency directly augmented with an aerosol of alpha 1-antitrypsin.

STUDY OBJECTIVE: To determine if aerosolization of purified human plasma alpha 1-antitrypsin is an effective means for increasing lower respiratory anti-neutrophil-elastase defenses in alpha 1-antitrypsin deficiency. DESIGN: Nonrandomized, before-and-after trial with a 7-day treatment period. Companion studies in animals to determine lung epithelial permeability to alpha 1-antitrypsin. PATIENTS: Twelve patients with homozygous Z-type alpha 1-antitrypsin deficiency and mild to moderate emphysema. INTERVENTIONS: Aerosol administration of human plasma alpha 1-antitrypsin, 100 mg every 12 hours for 7 days. Single, 100-mg aerosol dose to anesthetized sheep with indwelling thoracic lymph duct catheters for direct assessment of lung permeability. MEASUREMENTS AND MAIN RESULTS: Treatment resulted in increased alpha 1-antitrypsin levels in the lung epithelial lining fluid (0.28 +/- 0.07 microM before therapy to 5.86 +/- 1.03 microM after therapy) and increased anti-neutrophil-elastase capacity (0.78 +/- 0.38 microM before therapy to 4.16 +/- 0.95 microM after therapy). Aerosolized alpha 1-antitrypsin diffused across the respiratory epithelium and entered lung interstitial lymph (in sheep) and reached the systemic circulation (in sheep and humans). No side effects were noted. CONCLUSION: Short-term aerosol administration of human plasma alpha 1-antitrypsin to patients with alpha 1-antitrypsin deficiency is safe and feasible, resulting in a return to normal of anti-neutrophil-elastase defenses in the lower respiratory tract. The aerosol approach, therefore, merits serious long-term evaluation as an alternative to other parenteral forms of administering therapeutic proteins.

Aerosols↗
PubMed1990

Regional deposition of aerosolized pentamidine. Effects of body position and breathing pattern.

OBJECTIVE: To evaluate the effects of varying body position and breathing pattern on overall lung distribution of aerosolized pentamidine. DESIGN: Nonrandomized control trial with four weekly inhalational treatments. SETTING: The nuclear medicine department of a voluntary hospital. PATIENTS: Sixteen men with the acquired immunodeficiency syndrome (AIDS) or positive serology for the human immunodeficiency virus (HIV). Thirteen patients (81%) completed the study. INTERVENTIONS: Patients inhaled a solution of either saline and technetium-99m bound to diethylenetriamine penta-acetic acid or sterile water, pentamidine (60 mg), and technetium-99m bound to human serum albumin. On weekly visits, the patients inhaled the aerosol solution using four methods: sitting, supine, sitting with an abdominal binder, and sitting and breathing from residual volume with a shallow inspiration. MEASUREMENTS AND MAIN RESULTS: Deposition scans, obtained after each aerosol inhalation, were superimposed on each patient's equilibrium xenon scan, and a frequency distribution histogram was constructed. An asymmetry index was determined from this histogram. The lower the asymmetry index, the more homogeneous the aerosol distribution. Only use of the supine position showed a significant decrease in the asymmetry index (mean, 0.34 +/- 0.02 in the supine position, 0.48 +/- 0.03 in the sitting position; P less than 0.001). CONCLUSIONS: Aerosol distribution in the lungs was more uniform when administered to patients in the supine position. Patients receiving aerosolized pentamidine may benefit from inhalation in the supine position; these results should be verified by clinical study.

Adult↗
PubMed1980

Bronchial response to oral versus aerosol metaproterenol in asthma.

We tested the relative efficacy of bronchodilators delivered in aerosol and in oral form in 17 patients with asthma in a double-blind randomized sequence. Treatment consisted of a 20-mg tablet of metaproterenol sulfate, five puffs of metaproterenol aerosol (0.65 mg in each puff for a total of 3.25 mg) administered 20 minutes apart between puffs, a combination of both, and placebos. Bronchodilator response measured by forced expiratory volume in 1 second (FEV1) was significantly greater on the aerosol and the combined regimen than on the oral and placebo regimen. The combined regimen produced a greater bronchodilator response than the aerosol alone, but the difference was not significant. Side effects were frequent after oral medication but absent after the aerosol. Sequential inhalation of aerosol is the preferred route of administration of adrenergic bronchodilator drugs in asthma.

Administration, Oral↗
PubMed1999

Control of dengue fever with active surveillance and the use of insecticidal aerosol cans.

An interventional study was conducted in southern Vietnam to evaluate the feasibility and effectiveness of a new approach to control dengue fever. The approach consisted of active surveillance of dengue patients and the use of insecticidal aerosol cans. Febrile patients were tested serologically at local health centers and insecticidal aerosol cans were given to the family and employed in the neighborhood of dengue patients instead of ultra low volume (ULV) fogging with insecticide. The number of dengue IgM antibody positive cases among febrile patients, the number of reported dengue hemorrhagic fever patients and the total cost were compared in the 2 approaches (prompt focal ULV fogging and the use of insecticidal aerosol cans) in 1997. The aerosol cans were employed 5 times (in June, July, August, September and October) in the study area. ULV fogging in the control area was performed 5 times (in March, May, July, August and September). Twenty-two serologically positive cases were found in the study area which was about half that found in the control area (43 cases). A total of 16 dengue hemorrhagic fever patients was reported in the study area and 43 in the control area. Compared with the reported numbers of the previous year, the reduction rate in the number of dengue hemorrhagic fever cases was 71.4% in the study area and 51.7% in the control area. There were statistically significant differences in the morbidity of dengue fever and the reduction rate of dengue hemorrhagic fever. The cost of the insecticidal aerosol cans was US$393 which was lower than the cost of US$553 for ULV fogging. The findings suggest that insecticidal aerosol cans were effective and feasible for dengue fever control.

Aerosols↗
PubMed2000

Aerosolized medications for altering lung surface active properties.

Surface active material is important in the function of both the infant and adult lung. In the premature infant, surfactant depletion results in the requirement for very high distending pressures to open alveoli. As a consequence, shunt, hypoxemia, and right ventricular dysfunction occur. Surfactant replacement, especially by the direct instillation approach, has been proven effective in improving clinical outcome under these circumstances. Problems with surfactant instillation include the "fluid bolus" effect and concerns about optimal distribution of the instilled material. Recent improvements in aerosol systems have created interest in using aerosol delivery to reduce the total dose of surfactant required to treat RDS. In adult acute lung injury, surfactant dysfunction, rather than depletion, is the problem. Simple phospholipid replacement strategies thus may not be effective. Instead, surfactant delivery strategies aimed at regional targeting with surfactants having the necessary associated proteins may be the goal in ARDS. In adults, several instillation trials are underway, but there is also a hope that an aerosol strategy might also be tried. The aerosol route may be particularly useful if a high-efficiency aerosol system (eg, one distal to an endotracheal tube) can be shown to be effective. Other surface active materials exist and there are small studies showing benefit when large instilled doses of these materials are given. These materials, however, have never been studied as aerosols.

Aerosols↗
PubMed2000

Methods of calculating lung delivery and deposition of aerosol particles.

Lung deposition of aerosol is measured by a variety of methods. Total lung deposition can be measured by monitoring inhaled and exhaled aerosols in situ by laser photometry or by collecting the aerosols on filters. The measurements can be performed accurately for stable monodisperse aerosols. However, for polydisperse and/or unstable hygroscopic aerosols, measurement methods are limited and often unreliable. Regional deposition is assessed primarily by gamma scintigraphy. The scintigraphic method is useful for a general description of deposition patterns, but may not be adequate for quantitative regional dose estimation. New emerging three-dimensional lung imaging methods such as SPECT and PET, and innovative bolus aerosol delivery methods, have great potential for measuring detailed regional deposition. An accurate assessment of regional lung dose is difficult to achieve by the current methods. A multi-prong approach may be needed, with various methods and techniques, both in theory and experiment, to measure site-specific deposition dose.

Aerosols↗
PubMedDate not supplied

[The scientific validation and outlook for the practical use of halo-aerosol therapy].

The paper describes a new medical technique--halo-aerosol therapy, the main acting factor of which is dry highly dispersed aerosol of sodium chloride in natural concentration. Halo-aerosol therapy represents a new trend in aerosol medicine. It includes two methods: halotherapy and halo-inhalation. Biophysical and pathophysiological foundations of the new method, how it can be realized are outlined. Clinical reasons are provided for application of halo-aerosol therapy for prevention, treatment and rehabilitation of patients with respiratory diseases. Characteristics and differences of the two halo-aerosol therapy variants are analysed.

Administration, Inhalation↗
PubMed2001

Paclitaxel liposome aerosol treatment induces inhibition of pulmonary metastases in murine renal carcinoma model.

The present studies were undertaken to evaluate the pulmonary pharmacokinetics and therapeutic efficacy of paclitaxel (PTX) administered by aerosol. PTX was encapsulated into dilauroylphosphatidylcholine liposomal formulations (PTX-DLPC). The deposition and clearance of PTX-DLPC in the lungs administered by aerosol or i.v. at comparative doses was performed, and PTX was quantitatively determined in tissue extracts by high-performance liquid chromatography analysis. The murine renal carcinoma (Renca) pulmonary metastases model was used to determine the therapeutic effect of drug formulation administered by aerosol. PTX-DLPC aerosols were generated with the Aero-Mist jet nebulizer (cis-USA). The most effective schedule of treatment was when mice inhaled the drug for 30 min 3 days per week. There was a significant reduction of the lung weights and reduced number of visible tumor foci on the lung surfaces of mice treated with PTX aerosol (P < 0.004 and P < 0.01, respectively) compared with control groups. Inhalation of PTX-DLPC also led to prolonged survival in mice inoculated with Renca cells. The results of the present studies demonstrate the therapeutic potential of aerosol technology for lung cancer treatment.

Administration, Inhalation↗
PubMed2002

Chemical composition of aerosols in winter/spring in Beijing.

In 1999 aerosol samples were collected by cascade at Meteorological Tower in Beijing. The 12 group aerosol samples obtained were analyzed using PIXE method, which resulted in 20 elemental concentrations and size distribution of elemental concentrations. From the observation, the elemental concentrations, size distribution of elemental concentrations and their variations are analyzed. It shows that concentrations of the most elements in aerosols increase greatly compared with those in the past except that the concentrations of V, K, Sr, and the source of aerosols has changed greatly in the past decade. Fine mode aerosols increase more rapidly in the past decade, which may be due to the contribution of coal combustion and automobile exhaust. Pb content in aerosol is much higher than that at the beginning of 1980s, and has a decreasing trend in recent years because of using non-leaded gasoline.

Aerosols↗
PubMed1962

Aerosol therapy in bronchopulmonary disease. A critical evaluation.

AEROSOL THERAPY HAS THREE PRINCIPAL OBJECTIVES: Mobilization of bronchial secretions, relief of bronchospasm and topical chemotherapy. It has become an important tool in the treatment of bronchopulmonary diseases. The equipment for inhalation therapy, however, should be adequate. Both large-capacity and small-capacity nebulizers must be available, and they must be the kind that will produce a mist with most of its particles only 0.5 to 2.5 micra in diameter. These nebulizers may be used alone or in conjunction with a variety of appliances that will deliver the aerosols to the respiratory tract. The use of humidifying agents as aerosols is extremely helpful in patients with retained bronchopulmonary secretions. In some patients who have particularly thick or gelatinous secretions and in patients with mucoviscidosis, ordinary water or saline solution is often not enough. Hypertonic saline may be of value in these cases, and it is suggested that half-molar (2.9 per cent) saline be administered in 10 per cent propylene glycol. In these cases, preparations containing detergents (tyloxypal) or other preparations containing enzymes (desoxyribonuclease or trypsin) may be given by the aerosol technique, with care not to cause irritation. The bronchodilator aerosol agents are of proved benefit in the treatment of bronchospastic disorders and are indicated in most cases of asthma and in those cases of emphysema in which there is definite evidence of associated bronchospasm. The value of the aerosol method of administering chemotherapeutic and antibiotic drugs has probably been overrated, and it is suspected that much of the benefit previously attributed to the therapeutic agent was actually a result of humidification and liquefaction.

Aerosols↗
PubMed2004

Automatic and continuous measurement of aerosol properties in Dunhuang, China.

Ground-based simultaneous observations of sun direct and scattering radiation were carried out in Dunhuang for nearly 2 years. Aerosol optical depth, Angstrom wavelength exponent and size distribution were obtained from solar extinction and sky radiation. Water vapor content was obtained from sun direct radiation measurement at 940 nm. Relationship between aerosol properties and water vapor was discussed. Results showed that distinct seasonality of aerosol optical depth and Angstrom wavelength exponent was corresponding to seasonal variation of dust activity. Aerosol relative size distribution kept stable and volume concentration change was the reason resulting in variation of aerosol optical depth. Water vapor had minor effects on aerosol optical and physical properties.

Aerosols↗
PubMed1977

[Experimental study of a gentamicin aerosol].

The study of gentamicin aerosol showed its relative innocuousness: it did not inhibit the growth and development of young animals, did not induce pathological changes in the upper respiratory tract, kidneys, liver, heart and spleen on its prolonged use. Pathohistological examination revealed slight irritating effect of the gentamicin aerosol in the lungs after its use in a dose of 8 or 25 mg/kg for 6 weeks. A procedure for investigating the effect of the aerosol on the activity of the trachea ciliated epithelium of warm blooded animals was developed. The gentamicin aerosols prepared from solutions of different concentrations (1 to 50 mg/ml) induced ingibition of the ciliated epithelium function at average from 15 to 35 per cent which was associated with the solution acidity (pH 4.54 to 4.82). Such a decrease in the function of the ciliated epithelium due to the antibiotic aerosol use was a factor prolonging the antibiotic retention time in the respiratory organs. It was found that aqueous solutions of drugs used for inhalation, such as ephedrin, euphelin, dimedrol, N-acetyl-L-cystein and others had no effect on the activity of gentamicin and may be used with it in a form of aerosols.

Aerosols↗
PubMed2004

Qualitative and quantitative analysis of bacterial aerosols.

The objective of this study was to investigate qualitatively and quantitatively the bacterial aerosols before, during, and after clinical work sessions in different areas within a multichair dental clinic, an isolation clinic, the sterilization center, and the prosthetic laboratory in the College of Dentistry, King Saud University. Also, the contributions of aerosols generated by different types of dental procedures were investigated. Air sampling using blood and heart infusion agar plates at four selected areas was performed three times per day over a 2-week period before, during, and after clinical sessions. The concentration of total bacterial aerosols was 5 times higher in the multichair clinic, 3.6 times higher in the prosthetic laboratory, 2 times higher in the sterilization center and isolation clinic during working sessions as compared to before the working sessions. At the end of the working day, aerosols decreased 50-70% in all areas. Staphylococcus epidermidis had the highest prevalence (37.12q%) of colony composition of bacteria examined. This study demonstrates that aerosols increase during and after work sessions and, therefore, increase the chance for infectious agent transmission. Preventive measures should be instituted to reduce or disrupt aerosols as a transmission route in the multichair dental clinic, sterilization center, prosthetic laboratory, and isolation clinic.

Aerosols↗
PubMed1992

[Antibiotics in aerosols].

The treatment of bronchopulmonary infections using antibiotics administered by aerosol should enable a better local concentration of the drug to be achieved whilst reducing the side effects. The parameters of the aerosol kinetics in the airways lead to an interaction of the physico-chemical characteristics of the molecule, the material used for the aerosolisation and also the conditions on inhalation. Intrabronchial concentrations are lower than after endotracheal instillation but remain 10 to 40 times greater than after parenteral administration. Antibiotic aerosols are relatively well tolerated but should be used with care and caution in patients susceptible to bronchial hyperreactivity. Aerosol treatment is currently little used outside those patients with mucoviscidosis and dilatation of the bronchi. In mucoviscidosis aerosol antibiotics are used in the acute situation to achieve cures of infection and in the chronic situation to prevent colonisation by Pseudomonas. Antibiotic aerosols are efficacious in the treatment of acute infectious episodes but do not seem to carry any additional clinical benefit which is superior to antibiotics administered parenterally. It could nonetheless constitute a useful alternative in simplifying treatment in the home. This style of treatment remains to be further explored in a more complete fashion in bronchial dilatation.

Aerosols↗
PubMed2005

Positive expiratory pressure changes aerosol distribution in patients with cystic fibrosis.

HYPOTHESIS: We hypothesized that aerosol distribution in the lungs of patients with cystic fibrosis changes with positive expiratory pressure (PEP). METHODS: Eight patients were randomized to one of 2 conditions. On one study day, patients inhaled saline aerosol containing 99mtechnetium generated by a Pari LC Plus nebulizer and exhaled through a Pari PEP device. On another day, the same patients exhaled through a low-resistance Pari filter (no PEP). Afterwards, they underwent gamma-camera lung imaging. Images were analyzed for lung deposition fraction, expressed as a percent of the initial nebulizer activity, and deposition pattern, expressed in terms of inner-outer and apical-basal ratios. RESULTS: Lung deposition fraction was significantly lower with the Pari PEP device; the mean + SD deposition fraction was 6.10 + 3.05% (median 6.20%) with PEP, compared to 10.76 + 4.52% (median 10.32%) (p = 0.0078) without PEP. The inner-outer ratio was 2.01 + 0.69 (median 2.23) with PEP, which was significantly lower than without PEP (2.76 + 1.33, median 2.55) (p = 0.004). The apical-basal ratio was 0.82 + 0.31 (median 0.80) with PEP, which was not significantly different from no PEP (1.00 + 0.49, median 0.90). CONCLUSION: These results indicate that less aerosol is deposited in the lungs of patients with cystic fibrosis when the Pari LC Plus nebulizer is used with the Pari PEP device, as described in these experiments. Nevertheless, aerosol administration with this nebulizer and PEP device also results in a proportional redistribution of aerosol to the peripheral airways, compared to nebulization without the PEP device. The clinical relevance of this subtle redistribution of aerosol in cystic fibrosis patients will probably depend on the drug administered and disease severity.

Administration, Inhalation↗
PubMedDate not supplied

[Protective effect of the aerosol immunization of mice with the polycomponent vaccine Immunovac VP-4 after the challenge of the animals with Klebsiella pneumoniae virulent strain].

Used four schemes of the administration of the preparation with different time of the exposition of the animals in an aerosol chamber were tested with their subsequent intraperitoneal challenge with K. pneumoniae virulent strain K16. Irrespective of the number of immunization courses, the administration of the preparation made at intervals of 1 day, or daily, did not ensure any protective effect, but only led to an insignificant increase in their survival time in comparison with nonimmunized animals. After intervals between immunizations were increased to 3 days the protective effect of aerosol immumization was obtained (the survival rate was 65-80 % and considerably differed from that of the controls). The protective effect of aerosol immunization thus obtained was comparable with the effectiveness immunization made in a single subcutaneous injection. Aerosol immunization resulted in low antibody titers to the antigens contained in the vaccine, while after a single subcutaneous injection high antibody titers to Klebsiella and Proteus antigens were detected. The antigen-stimulated blast transformation of spleen lymphocytes in mice subjected to aerosol immunizations in 5 exposures was high. After subcutaneous immunization significant changes in such characteristics were detected on day 15. The data thus obtained were indicative of good prospects in the development Immunovac VP-4 as the medicinal form intended for use in aerosols.

Aerosols↗
PubMed2007

Influence of isolate pathogenicity on the aerosol transmission of Porcine reproductive and respiratory syndrome virus.

The objectives of this study were to evaluate the role of isolate pathogenicity in the aerosol transmission of Porcine reproductive and respiratory syndrome virus (PRRSV) and to determine whether PRRSV could be detected in air samples. To assess transmission, we exposed naive recipient pigs to aerosols from pigs inoculated with PRRSV MN-30100, an isolate of low pathogenicity, or MN-184, a highly pathogenic isolate. Blood samples and nasal-swab samples were collected from the inoculated pigs during the exposure period and tested for the presence of PRRSV RNA by quantitative (real-time) reverse-transcriptase polymerase chain reaction (RT-PCR); the amount of RNA was expressed as the median tissue culture dose per milliliter (TCID50/mL). The recipient pigs were clinically evaluated for 14 d after exposure and tested on days 7 and 14 by qualitative RT-PCR and enzyme-linked immunosorbent assay (ELISA). To prove the presence of PRRSV in aerosols, air samples were collected from each recipient-pig chamber by means of an air sampler. The PRRSV RNA concentrations were significantly higher (P = 0.01) in the blood samples from the pigs infected with PRRSV MN-184 than in the blood samples from those infected with PRRSV MN-30100; however, the concentrations in the nasal-swab samples were not significantly different (P = 0.26). Recipient pigs exposed to aerosols from pigs infected with PRRSV MN-184 became infected, whereas those exposed to aerosols from pigs infected with PRRSV MN-30100 did not; the difference in transmission rate was significant at P = 0.04. We detected PRRSV MN-184 RNA but not PRRSV MN-30100 RNA in air samples by PCR. Under the conditions of this study, PRRSV isolate pathogenicity may influence aerosol transmission of the virus.

Aerosols↗
PubMed1991

Synergistic effects of air pollutants: ozone plus a respirable aerosol.

Rats were concurrently exposed to mixtures of ozone or nitrogen dioxide and respirable-sized aerosols of sulfuric acid, ammonium sulfate, or sodium chloride, or to each pollutant individually. Their responses to such exposures were evaluated by various quantitative biochemical analyses of lung tissue or lavage fluids, or by morphometric analyses. Such studies were performed in the acute time frame, generally involving exposures of from one to nine days, depending on the assays used. Correlations between the biochemical and morphometric results were examined over a wide range of pollutant concentrations in the exposure chambers. Good correlations were found between the most sensitive biochemical indicators of lung damage--the protein content of lung lavage fluid or whole lung tissue and the rate of lung collagen synthesis--and the morphometric estimation of volume density or volume percent of the centriacinar lung lesion characteristically observed in animals exposed to ozone. Synergistic interaction between ozone and sulfuric acid aerosol was demonstrated to occur at environmentally relevant concentrations of both pollutants by several of the analytical methods used. Such interactions were demonstrated at concentrations of ozone as low as 0.12 parts per million (ppm)2 and of sulfuric acid aerosol at concentrations as low as 5 to 20 micrograms/m3. The acidity of the aerosol is a necessary (and apparently a sufficient) condition for such a synergistic interaction between an oxidant gas and a respirable aerosol to occur. A hitherto unexpected synergistic interaction between nitrogen dioxide and sodium chloride aerosol was found during these studies; it is hypothesized that this was due to formation of their acidic (anhydride) reaction product, nitrosyl chloride, in the chambers during exposure to the mixture. Preliminary experiments treating exposed animals in vivo with various free-radical scavengers suggested that dimethylthiourea, a hydroxyl-radical scavenger, might be protective against effects of ozone on rat lungs. This observation might have mechanistic implications, but further studies will be necessary to determine the significance of these findings.

Aerosols↗