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Re: “Harmonizing the Nomenclature for Therapeutic Aerosol Particle Size: A Proposal” by Hillyer et al. (J Aerosol Med Pulm Drug Deliv. 2018 31(2):111–113; DOI: 10/1089/jamp.2017.1396)
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Re: “Harmonizing the Nomenclature for Therapeutic Aerosol Particle Size: A Proposal” by Hillyer et al. (J Aerosol Med Pulm Drug Deliv. 2018 31(2):111–113; DOI: 10/1089/jamp.2017.1396)
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Re: “Harmonizing the Nomenclature for Therapeutic Aerosol Particle Size: A Proposal” by Hillyer et al. (J Aerosol Med Pulm Drug Deliv. 2018 31(2):111–113; DOI: 10/1089/jamp.2017.1396)
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Journal Article
Re: “Harmonizing the Nomenclature for Therapeutic Aerosol Particle Size: A Proposal” by Hillyer et al. (J Aerosol Med Pulm Drug Deliv. 2018 31(2):111–113; DOI: 10/1089/jamp.2017.1396)
2018
Overview
The aerosol literature has properly identified aerodynamic size of the inhaled product as one of many competing factors influencing aerosol behavior in the lung. Since there are many influences on clinical response, we believe that the approach advocated by these members of the Small Airways Study Group of the Respiratory Effectiveness Group is not helpful at all to the practicing clinician. [...]factors that determine where a therapeutic aerosol deposits within the respiratory tract, thereby affecting in vivo outcomes, include the inspiratory flow rate profile, the temperature and humidity within the respiratory tract (which influence particle growth), and more complex aspects associated with the differing types and degrees of lung disease (airway obstruction, changes to airway morphology, parenchymal destruction, etc.). (13) Setting rigid limits for the different sized fractions of an inhaled aerosol, therefore, takes no account of differences in particle regional deposition behavior associated with age-related airway development and also ignores the changes resulting from disease in these neonatal and pediatric patients. [...]we assert that the particle size property of therapeutic aerosols is always a continuum with no convenient boundaries between subfractions extrafine, fine, and coarse particles.
