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Culturing cells at the ALI is an important method in respiratory research due to its ability to more accurately represent in vivo airway conditions compared to traditional submerged cultures19. Culturing at ALI allows lung epithelial cells to be exposed directly to the air on their apical surface while maintaining essential nutrients from the culture medium on the basolateral side. This setup enables cells to produce surfactant or mucus, key components of the respiratory defense mechanism that are critical for trapping and removing inhaled particles and pathogens20,21,22. A549 cells are commonly employed for in vitro studies but are just one of the many respiratory epithelial cell cultures that can be used for ALI. Silva et al. have reviewed cell lines and primary cultures of the respiratory epithelium for ALI from the nasal cavity to the alveoli22. The flexibility of the presented ALI exposure system allows it to be adapted for different cell lines and primary cells.
ALI cultures are increasingly regarded as the "gold standard" for in vitro inhalation studies, particularly for research on air pollutants, particulate matter, and other inhalable agents23. A primary advantage of ALI models lies in their ability to provide insights that are more translatable to in vivo human effects. However, a notable drawback is the lack of standardized protocols for ALI exposures, which affects reproducibility and comparability across studies. One of the gaps is a standardized exposure workflow. By exposing cells to cannabis vapor at the ALI, the impacts of cannabis on cellular function, viability, and cytotoxicity can be evaluated. These exposures allow for a detailed assessment of biological outcomes, including markers of cytotoxicity, inflammation, and oxidative stress. The precise quantification of deposited cannabinoids enables reproducible studies on the cellular effects of cannabis vapor (and other forms of cannabis products), advancing our understanding of its potential health impacts in a controlled laboratory environment.
Advanced exposure systems address limitations in traditional submerged cultures by enabling direct particle deposition onto the cell surface, thereby providing more physiologically relevant exposures. This also reduces the potential effects of the solvents or carriers. By allowing for direct particle deposition without the need for these solvents, exposure systems help minimize vehicle-related effects. Nonetheless, some vehicle-related considerations remain. For example, uncontrolled humidity levels can cause unwanted cell stress24, potentially impacting experimental results. Ensuring that humidity is carefully regulated to reach optimal levels is essential to maintain cell stability and accuracy in results. Additionally, each particle, aerosol, or gas mixture has its own unique physicochemical properties, which could alter deposition on the cell surface25. It is, therefore, important to characterize an exposure regimen for each unique product. The factors that could impact particle deposition include thermophoresis, the movement of particles from a region of higher to lower temperature26. Thermophoresis aids in directing particles toward the cells and enhances deposition efficiency.
Dosing consistency and precision are additional challenges when working with exposure systems at the ALI, particularly when aerosols or particles are involved. In vivo particle deposition in the lung is a complex process influenced by particle size, shape, density, and solubility, as well as the specific region of the lung being exposed27. These factors result in varied deposition rates that can be difficult to replicate in vitro. Mathematical models, such as multi-path particle dosimetry (MPPD), are useful tools for estimating in vivo deposition rates and guiding in vitro dose translation28. However, matching in vitro dosing to in vivo exposure scenarios remains a challenge, particularly for complex aerosols with heterogeneous compositions.
For cell-free dose characterization, it is important to note that stainless steel insert washes tend to overestimate deposition, as compounds can adhere to both the walls of the insert and the base where cells would typically be located. The QCM offers an advantage here by measuring only the mass deposited directly at the cell culture location, providing a more accurate assessment of deposition specifically relevant to cell exposure.
As toxicology moves toward more physiologically relevant models, the adoption of unified ALI exposure protocols will be fundamental in bridging the gap between in vitro findings and in vivo human responses, ultimately supporting more reliable assessments of respiratory toxicants and their impacts on health.