Local pulmonary drug delivery in the preterm rabbit: feasibility and efficacy of daily intratracheal injections

Salaets T, Gie A, Jimenez J, Aertgeerts M, Gheysens O, Vande Velde G, Koole M, Murgia X, Casiraghi C, Ricci F, Salomone F, Villetti G, Allegaert K, Deprest J, Toelen J. Local pulmonary drug delivery in the preterm rabbit: feasibility and efficacy of daily intratracheal injections. Am J Physiol Lung Cell Mol Physiol 316: L589-L597, 2019. First published January 24, 2019; doi: 10.1152/ajplung.00255.2018.-Recent clinical trials in newborns have successfully used surfactant as a drug carrier for an active compound, to minimize systemic exposure. To investigate the translational potential of surfactant-compound mixtures and other local therapeutics, a relevant animal model is required in which intratracheal administration for maximal local deposition is technically possible and well tolerated. Preterm rabbit pups (born at 28 days of gestation) were exposed to either hyperoxia or normoxia and randomized to receive daily intra-tracheal surfactant, daily intratracheal saline, or no injections for 7 days. At day 7, the overall lung function and morphology were assessed. Efficacy in terms of distribution was assessed by micro-PET-CT on both day 0 and day 7. Lung function as well as parenchymal and vascular structure were altered by hyperoxia, thereby reproducing a phenotype reminiscent of bronchopulmonary dysplasia (BPD). Neither intratracheal surfactant nor saline affected the survival or the hyperoxia-induced BPD phenotype of the pups. Using PET-CT, we demonstrate that 82.5% of the injected radioactive tracer goes and remains in the lungs, with a decrease of only 4% after 150 min. Surfactant and saline can safely and effectively be administered in spontaneously breathing preterm rabbits. The described model and method enable researchers to evaluate intratracheal pharmacological interventions for the treatment of BPD.