By Yan Ostrovski, PhD Josué Sznitman, Dr. Sc.
Faculty of Biomedical Engineering
The global spread of the coronavirus COVID-19 is a wake-up call underscoring a general and ongoing lack of existing therapies to treat respiratory disorders. Broadly speaking, and unlike many other disease areas (e.g. cardiovascular, neurological), pulmonary medicine has witnessed substantially fewer drugs approved over the last decades; a situation coinciding with comparatively less drug candidates and a higher failure rate. At the same time, pulmonary diseases represent a vast and growing health-care financial burden worldwide, associated with high morbidity and mortality.
As a biomedical engineering research group focusing on respiratory physiology and pulmonary drug delivery, we have been actively pursuing two concurrent strategies to address some of the shortcomings in the field: developing so-called human-like in vitro models of the lungs for preclinical research and in parallel, engineering novel pulmonary drug delivery techniques. The concept of human-like in vitro models attempts to recreate biological functions specific to human lungs. Such tools can help deepen our understanding of lung diseases as well as strengthen future prevention strategies. Such approaches can also accelerate therapeutic drug screening assays to establish new therapies that are critically lacking. Hopefully, our efforts in tandem with that of other researchers around the world can help anticipate and accommodate a “next time”. In parallel, engineering novel pulmonary drug delivery techniques have potentially direct applications in tackling COVID-19. Many of the most severe COVID-19 infections witnessed in patients have led to severe lung inflammation (e.g. pneumonia), where the patient’s status may deteriorate to Acute Respiratory Distress Syndrome (ARDS); a situation that requires assisted ventilation (often via intubation) and oxygenation in the intensive care unit (ICU). With a complete lack of existing therapies to tackle ARDS, this disorder has a notoriously high mortality rate and thus many of the severe coronavirus related deaths are the outcome of ARDS. These mortality rates are expected to rise with a growing number of COVID-19 patients, as ICUs run out of beds and ventilators.
Over the past few years, and with disorders such as ARDS in our line of sight, we have been developing Liquid Foam Therapy (LIFT) for pulmonary drug delivery of potentially life-saving treatments of currently untreatable lung disorders. Namely, we are exploring the administration of pulmonary surfactant, for example, with the hope to reduce inflammation and ultimately help patients recover lung function as oxygenation alone typically fails. A pressing goal would be for LIFT to act as a rescue therapy for those developing COVID-19 pneumonia/ARDS.