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An investigation of the influence of cell topography on epithelial mechanical stresses during pulmonary airway reopening.

The goal of this study is to assess the local mechanical environment of the pulmonary epithelium in a computational model of airway reopening. To this end, the boundary element method (BEM) in conjunction with lubrication theory is implemented to assess the stationary-state behavior of a semi-infinite bubble traveling through a liquid-occluded parallel plate flow chamber lined with epithelial cells. The fluid occlusion is assumed to be Newtonian and inertia is neglected. The interactions between the microgeometry of the model airway's walls and the interfacial kinematics surrounding the bubble's tip result in a complex, spatially and temporally dependent stress distribution. The walls' nonplanar topography magnifies the normal and shear stresses and stress gradients. We find that decreasing the bubble's speed serves to increase the maximum normal stress and stress gradient but decrease the maximum shear stress and stress gradient. Our results give credence to the pressure-gradient-induced epithelial damage theory recently proposed by Bilek et al. [J. Appl. Physiol. 94, 770 (2003)] and Kay et al. [J. Appl. Physiol. 97, 269 (2004)]. We conclude that the amplified pressure gradients found in this study may be even more detrimental to the airway's cellular epithelium during airway reopening.