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Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease

Yousry K. Mohamady, Vincent Geudens, Charlotte De Fays, Marta Zapata, Omar Hagrass, Lucia Aversa, Marie Vermant, Xin Jin, Lynn Willems, Iwein Gyselinck, et al.
(2025) EBIOMEDICINE. 114.
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Abstract
Background Small airways (<2 mm diameter) are major sites of airflow obstruction in chronic obstructive pulmonary disease (COPD). This study aimed to quantify the impact of small airway disease, characterized by narrowing, occlusion, and obliteration, on airflow parameters in smokers and end-stage patients with COPDs. Methods We performed computational fluid dynamics (CFD) simulations of inspiratory airflow in three lung groups: control non-used donor lungs (no smoking/emphysema history), non-used donor lungs with a smoking history and emphysema, and explanted end-stage COPD lungs. Each group included four lungs, with two tissue cylinders. Micro-CT-scanned small airways were segmented into 3D models for CFD simulations to quantify pressure, resistance, and shear stress. CFD results were benchmarked against simplified linear and Weibel models. Findings CFD simulations showed higher pressures in COPD vs. controls (p = 0.0091) and smokers (p = 0.015), along with increased resistance (p = 0.0057 vs. controls; p = 0.0083 vs. smokers) and up to a tenfold rise in shear stress (p = 0.010 vs. controls). Narrowing and occlusion were shown to independently increase pressure, resistance, and shear stress, which were validated through segmentation corrections. Pressures and resistance assessed with simplified models were up to seven-fold higher for smokers and even 72 higher for COPD compared with CFD values. Interpretation These findings show that increased airflow parameters can explain the association between small airway disease and airflow limitation in COPD, underscoring small airway vulnerability. Additionally, they highlight the limitations of theoretical models in accurately capturing small airway disease. Copyright (c) 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords
Chronic obstructive pulmonary disease (COPD), Small airway disease, Computational fluid dynamics (CFD), Airway remodelling, Airway resistance, Obstruction, BRONCHIAL TREE, FLOW, RESISTANCE, MECHANISMS, LUNGS, SITE

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MLA
Mohamady, Yousry K., et al. “Computational Fluid Dynamics of Small Airway Disease in Chronic Obstructive Pulmonary Disease.” EBIOMEDICINE, vol. 114, 2025, doi:10.1016/j.ebiom.2025.105670.
APA
Mohamady, Y. K., Geudens, V., De Fays, C., Zapata, M., Hagrass, O., Aversa, L., … Vanaudenaerde, B. M. (2025). Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease. EBIOMEDICINE, 114. https://doi.org/10.1016/j.ebiom.2025.105670
Chicago author-date
Mohamady, Yousry K., Vincent Geudens, Charlotte De Fays, Marta Zapata, Omar Hagrass, Lucia Aversa, Marie Vermant, et al. 2025. “Computational Fluid Dynamics of Small Airway Disease in Chronic Obstructive Pulmonary Disease.” EBIOMEDICINE 114. https://doi.org/10.1016/j.ebiom.2025.105670.
Chicago author-date (all authors)
Mohamady, Yousry K., Vincent Geudens, Charlotte De Fays, Marta Zapata, Omar Hagrass, Lucia Aversa, Marie Vermant, Xin Jin, Lynn Willems, Iwein Gyselinck, Charlotte Hooft, Astrid Vermaut, Hanne Beeckmans, Pieterjan Kerckhof, Gitte Aerts, Celine Aelbrecht, Janne Verhaegen, Andrew Higham, Walter Coudyzer, Emanuela E. Cortesi, Arno Vanstapel, John E. McDonough, Marianne S. Carlon, Rozenn Quarck, Matthieu Boone, Lieven Dupont, Stephanie Everaerts, Dirk E. Van Raemdonck, Laurens J. Ceulemans, Tillie-Louise Hackett, Robin Vos, Yasser Abuouf, Joseph Jacob, Wim A. Wuyts, James C. Hogg, Marcel Filoche, Ghislaine Gayan-Ramirez, Wim Janssens, and Bart M. Vanaudenaerde. 2025. “Computational Fluid Dynamics of Small Airway Disease in Chronic Obstructive Pulmonary Disease.” EBIOMEDICINE 114. doi:10.1016/j.ebiom.2025.105670.
Vancouver
1.
Mohamady YK, Geudens V, De Fays C, Zapata M, Hagrass O, Aversa L, et al. Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease. EBIOMEDICINE. 2025;114.
IEEE
[1]
Y. K. Mohamady et al., “Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease,” EBIOMEDICINE, vol. 114, 2025.
@article{01K2F2AJYZQ139G8S76NYTF7YP,
  abstract     = {{Background Small airways (<2 mm diameter) are major sites of airflow obstruction in chronic obstructive pulmonary disease (COPD). This study aimed to quantify the impact of small airway disease, characterized by narrowing, occlusion, and obliteration, on airflow parameters in smokers and end-stage patients with COPDs. Methods We performed computational fluid dynamics (CFD) simulations of inspiratory airflow in three lung groups: control non-used donor lungs (no smoking/emphysema history), non-used donor lungs with a smoking history and emphysema, and explanted end-stage COPD lungs. Each group included four lungs, with two tissue cylinders. Micro-CT-scanned small airways were segmented into 3D models for CFD simulations to quantify pressure, resistance, and shear stress. CFD results were benchmarked against simplified linear and Weibel models. Findings CFD simulations showed higher pressures in COPD vs. controls (p = 0.0091) and smokers (p = 0.015), along with increased resistance (p = 0.0057 vs. controls; p = 0.0083 vs. smokers) and up to a tenfold rise in shear stress (p = 0.010 vs. controls). Narrowing and occlusion were shown to independently increase pressure, resistance, and shear stress, which were validated through segmentation corrections. Pressures and resistance assessed with simplified models were up to seven-fold higher for smokers and even 72 higher for COPD compared with CFD values. Interpretation These findings show that increased airflow parameters can explain the association between small airway disease and airflow limitation in COPD, underscoring small airway vulnerability. Additionally, they highlight the limitations of theoretical models in accurately capturing small airway disease. Copyright (c) 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).}},
  articleno    = {{105670}},
  author       = {{Mohamady, Yousry K. and Geudens, Vincent and De Fays, Charlotte and Zapata, Marta and Hagrass, Omar and Aversa, Lucia and Vermant, Marie and Jin, Xin and Willems, Lynn and Gyselinck, Iwein and Hooft, Charlotte and Vermaut, Astrid and Beeckmans, Hanne and Kerckhof, Pieterjan and Aerts, Gitte and Aelbrecht, Celine and Verhaegen, Janne and Higham, Andrew and Coudyzer, Walter and Cortesi, Emanuela E. and Vanstapel, Arno and McDonough, John E. and Carlon, Marianne S. and Quarck, Rozenn and Boone, Matthieu and Dupont, Lieven and Everaerts, Stephanie and Van Raemdonck, Dirk E. and Ceulemans, Laurens J. and Hackett, Tillie-Louise and Vos, Robin and Abuouf, Yasser and Jacob, Joseph and Wuyts, Wim A. and Hogg, James C. and Filoche, Marcel and Gayan-Ramirez, Ghislaine and Janssens, Wim and Vanaudenaerde, Bart M.}},
  issn         = {{2352-3964}},
  journal      = {{EBIOMEDICINE}},
  keywords     = {{Chronic obstructive pulmonary disease (COPD),Small airway disease,Computational fluid dynamics (CFD),Airway remodelling,Airway resistance,Obstruction,BRONCHIAL TREE,FLOW,RESISTANCE,MECHANISMS,LUNGS,SITE}},
  language     = {{eng}},
  pages        = {{14}},
  title        = {{Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease}},
  url          = {{http://doi.org/10.1016/j.ebiom.2025.105670}},
  volume       = {{114}},
  year         = {{2025}},
}
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