Team Inserm 3 : UMR1100 "Aerosoltherapy and Biologics for respiratory medicine
Leader : N. Heuzé-Vourc'h
In the respiratory health context, inhalation/aerosol therapy consists in directly administering therapeutic molecules in aerosol form into the respiratory tract. This administration route has the advantage of increasing the drug’s delivery to the diseased organ, while allowing for topical administration.
From a pharmacological point of view, inhalation improves the therapeutic index of some drugs, by increasing their concentration and exposure time in the target anatomical regions and by limiting systemic passage. Furthermore, it is a non-invasive administration route, enabling patients with chronic diseases to be treated as outpatients or at home, thereby improving their quality of life and reducing the cost to society. While inhalation has been in use for a long time, particularly for the administration of “conventional” drugs such as bronchodilators, it encountered limitations due to knowledge gaps, technological obstacles and a lack of rationality in clinical practice:
- the aerosol devices in current use are not suitable for specifically targeting certain anatomical regions of the respiratory system, where severe inflammatory/infectious respiratory diseases are located. This is particularly true for some naso-sinusal cavities and the alveolar region which receives only a small fraction of the aerosol. The team is examining this issue by attempting to identify the physical phenomena associated with aerosol generation which influence aerosol deposition to a specific area.
- current practices in aerosol therapy mainly do not take into account the emergence of new classes of drugs such as biotherapeutics which nonetheless offer new opportunities for treating respiratory diseases. Only Dornase alfa (Pulmozyme™) is currently administered via inhalation, in patients with cystic fibrosis. This is accounted for by the complexity involved in stabilising biotherapeutics during the aerosolisation process and the lack of pharmacological data on these molecules after their deposition in the lungs. The team therefore focused on biologics inhalation, particularly the inhalation of therapeutic antibodies
- lastly, clinical application of inhalation therapy is often empirical, involving various random configurations, particularly when performed on patients on ventilation support. This said, the efficacy of inhalation depends on the reliability and reproducibility of aerosol deposition. Solid scientific studies are therefore required to substantiate practical application, predetermine the configurations for optimal targeting and, ultimately, put forward recommendations.
The team is affiliated with LabEx MAbImprove (Tours-Montpellier), Bio3 Institute (Tours) and has developed close interactions with certain the medical device industry (Diffusion Technique Française, Aptar Pharma,…) and biopharmaceutical companies (Sanofi,…) in order to obtain the resources (devices, biotherapeutics) to test its scientific hypotheses and accelerate its research to the clinics.