{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T14:22:06Z","timestamp":1773498126379,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008980","name":"Medical College of Wisconsin","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008980","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002486","name":"Bank of America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002486","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Approximately 25% of Americans suffer from laryngopharyngeal reflux (LPR), a disease for which no effective medical therapy exists. Pepsin is a predominant source of damage during LPR and a key therapeutic target. Fosamprenavir (FOS) inhibits pepsin and prevents damage in an LPR mouse model. Inhaled FOS protects at a lower dose than oral; however, the safety of inhaled FOS is unknown and there are no inhalers for laryngopharyngeal delivery. A pre\u2010Good Lab Practice (GLP) study of inhaled FOS was performed to assess safety and computational fluid dynamics (CFD) modeling used to predict the optimal particle size for a laryngopharyngeal dry powder inhaler (DPI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Aerosolized FOS, amprenavir (APR), or air (control) were provided 5\u2009days\/week for 4\u2009weeks (<jats:italic>n<\/jats:italic>\u2009=\u20096) in an LPR mouse model. Organs (nasal cavity, larynx, esophagus, trachea, lung, liver, heart, and kidney) were assessed by a pathologist and bronchoalveolar lavage cytokines and plasma cardiotoxicity markers were assessed by Luminex assay. CFD simulations were conducted in a model of a healthy 49\u2010year\u2010old female.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No significant increase was observed in histologic lesions, cytokines, or cardiotoxicity markers in FOS or APR groups relative to the control. CFD predicted that laryngopharyngeal deposition was maximized with aerodynamic diameters of 8.1\u201311.5\u2009\u03bcm for inhalation rates of 30\u201360\u2009L\/min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A 4\u2010week pre\u2010GLP study supports the safety of inhaled FOS. A formal GLP assessment is underway to support a phase I clinical trial of an FOS DPI for LPR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1219","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T10:59:29Z","timestamp":1706093969000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Inhaled fosamprenavir for laryngopharyngeal reflux: Toxicology and fluid dynamics modeling"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7052-7762","authenticated-orcid":false,"given":"Alexandra","family":"Lesnick","sequence":"first","affiliation":[{"name":"Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7045-357X","authenticated-orcid":false,"given":"Tina L.","family":"Samuels","sequence":"additional","affiliation":[{"name":"Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Seabloom","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly","family":"Wuertz","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhilash","family":"Ojha","sequence":"additional","affiliation":[{"name":"Mechanical Engineering University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davis","family":"Seelig","sequence":"additional","affiliation":[{"name":"Comparative Pathology Shared Resource Masonic Cancer Center, University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Ondrey","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy S.","family":"Wiedmann","sequence":"additional","affiliation":[{"name":"Pharmaceutics University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Hogan","sequence":"additional","affiliation":[{"name":"Mechanical Engineering University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Torii","sequence":"additional","affiliation":[{"name":"Comparative Pathology Shared Resource Masonic Cancer Center, University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Mechanical Engineering University of Texas\u2010Dallas  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Yan","sequence":"additional","affiliation":[{"name":"Pediatrics Quantitative Health Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-9226","authenticated-orcid":false,"given":"Guilherme J. 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