REVIEW
Age-dependence and intersubject variability of tracheobronchial particle clearance
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Division of Physics and Biophysics Department of Material Science and Physics University of Salzburg Hellbrunner Strasse 34 A-5020 Salzburg Austria
Corresponding author
Robert Sturm
Brunnleitenweg 41
A-5061 Elsbethen
Salzburg/Austria
Pneumon 2011;24(1):77-85
KEYWORDS
ABSTRACT
Background:
The detailed study of tracheobronchial clearance
of inhaled particles represents one of the basic research questions
in lung medicine. The clearance efficiency varies in different age
groups and between males and females.The differences can be
partly clarified by the application of a well validated theoretical
approach. This study applied a relevant model to children (1 year,
5 years, 10 years), juveniles (15 years), and adults of different ages
(18, 21, 25, 34, 50, and 60 years) and to both sexes.
Methods:
The
mathematical model used for clearance simulation is based on the
concept of a stochastic lung structure and considers both early fast
mucociliary clearance and a later, slow clearance fraction, fs, effected
by particular uptake by tracheobronchial cells, e.g., macrophages
and epithelial cells. According to this model, the calculated mucus
velocities for each airway generation of the tracheobronchial compartment are normalized to a respective tracheal mucus velocity
that is estimated for each of the age groups studied from an allometric function.
Results:
In general, tracheobronchial clearance
efficiency undergoes a significant increase from childhood to young
adulthood, reaching a maximum at 25-30 years and decreasing
again from about 30 years to 60 years. Conversely to the improvement of clearance, the continuous change of airway morphometry
with increasing age causes a decrease of the filtering effect in the
trachea and main bronchi, which is of marked importance in infants.
The modelling results demonstrate differences in tracheobronchial
clearance between males and females, generally in the range from
0 to 5%, which are exclusively determined by the individual lung
geometry.
Conclusions:
Based on theoretical computations it
can be concluded that tracheobronchial clearance is a phenomenon
that depends on both age and sex. Biological studies are necessary
to determine the cellular and molecular mechanisms underlying
the age-dependent development of tracheobronchial clearance.
ABBREVIATIONS
Ai-1: cross section area of airway i-1,
Ai: cross section area of airway i,
dg: geometric diameter of a deposited particle,
FRC: functional residual capacity,
FRCreference: functional residual capacity of a reference subject,
FRCsubject: functional residual capacity of a subject
of interest,
fs: fraction of slowly cleared particles,
ICRP: International Commission on Radiological,
Protection
Li: length of airway i,
sf: scaling factor,
td: mucus delay time,
TLC: total lung capacity,
tr,i: total residence time of particle in airway i,
VC: vital capacity
vi-1: mucus velocity in airway i-1
vi: mucus velocity in airway i
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