Revisiting Pulmonary Diseases using Microfluidic
IntroductionThe human respiratory system consists of nose, pharynx (throat), larynx (voice box), trachea (windpipe), bronchi, and the lungs [1]. The nose, pharynx, larynx, trachea and bronchi together form the respiratory airways. The bronchus continues to divide within lung into many narrower and shorter airways known as bronchioles [2]. The branching networks of pulmonary airways are lined with a viscous liquid film secreted by airway epithelial cells [3]. Terminal bronchioles are clustered in grapelike sacs, the alveoli. Gaseous exchange between air and blood takes place in the alveoli. The lungs contain approximately 500 million alveoli, each about 200 to 300 μm in diameter. The alveolar wall consists of a single layer of type I alveolar cells. Each alveolus is surrounded by a network of pulmonary capillaries. The interstitial space between pulmonary capillaries and alveolus forms a very thin barrier which facilitates gaseous exchange. Apart from type I alveolar cells, 5 % of the alveolar surface epithelium is covered by type II alveolar cells, which secrete a phosphor lipoprotein complex known as pulmonary surfactant that facilitates lung expansion [2]. In addition to type II alveolar cells, surfactant proteins are also produced by Clara cells of peripheral airways. The pulmonary surfactant produced from these cells is absorbed into the luminal air-liquid interface of the pulmonary airways and thus reduces the surface tension to values as low as zero during expiration. This in turn prevents the airway closure [4]. Lung epithelium is a highly complex tissue where epithelial cells, sub epithelial fibroblasts and the extracellular matrix of the airway wall are intricately involved in maintaining and regulating the structure and function of the lung [5].
Lung diseasesRespiratory diseases and disorders encompass pathological conditions that mostly affect the organs and tissues that take part in gaseous exchange (Figure 1). Notably, such abnormalities affect the airways, the physiology structure of lung tissue, and the pulmonary circulation [6]. The lung diseases are broadly classified into obstructive, restrictive and infectious diseases (Table 1).Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world. The COPD burden is projected to increase globally in the coming decades because of continued exposure to COPD risk factors and aging of the population [7]. COPD, a chronic inflammatory disease, is generally an adult age problem [8] and characterized by breathing difficulty as a consequence of narrowed airways. Long term exposure of lungs to noxious particles or gases, such as cigarette smoke, is considered as the main cause of COPD. According to WHO, COPD will become third leading cause of death by 2030 [9].Similarly, asthma is also amongst the chronic inflammatory disorders characterized by active hyper responsiveness to a variety of stimuli e.g. airborne allergens. It results from a complex interaction among inflammatory cel...