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Related Experiment Videos

Bronchoscopic lung volume reduction using tissue engineering principles.

Edward P Ingenito1, Robert L Berger, A Cortney Henderson

  • 1Division of Pulmonary and Critical Care Medicine and Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. eingenito@partners.org

American Journal of Respiratory and Critical Care Medicine
|October 31, 2002
PubMed
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Bronchoscopic lung volume reduction (BLVR) safely improved respiratory function in sheep with emphysema by creating scar tissue. This minimally invasive procedure reduced lung volumes and enhanced vital capacity, paving the way for human trials.

Area of Science:

  • Pulmonary Medicine
  • Tissue Engineering
  • Interventional Pulmonology

Background:

  • Emphysema (EMPH) is characterized by lung hyperinflation and reduced gas exchange.
  • Current treatments for advanced emphysema have limitations.
  • Minimally invasive tissue engineering approaches are being explored for lung volume reduction.

Purpose of the Study:

  • To evaluate the safety and efficacy of bronchoscopic lung volume reduction (BLVR) in an experimental emphysema model.
  • To assess the impact of BLVR on lung volumes, respiratory mechanics, and gas exchange.
  • To investigate the tissue response to BLVR.

Main Methods:

  • Six sheep with papain-induced emphysema underwent BLVR.
  • Physiologic measurements (lung volumes, DL(CO), pressure-volume relationships, resistance, elastance) were recorded at baseline, post-emphysema induction, and at 3 and 9 weeks post-BLVR.

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  • Autopsy was performed to evaluate tissue response at treated sites.

    • Main Results:

    • The emphysema model exhibited hyperinflation, reduced diffusing capacity (DL(CO)), and increased airway resistance, mimicking human EMPH.
    • BLVR was well-tolerated, with no complications observed.
    • BLVR significantly reduced lung volumes (total lung capacity -16%, residual volume -55%) and improved vital capacity (+10%).
    • Histopathology revealed well-organized scar tissue at 91% of treated sites, replacing hyperinflated lung without adverse reactions.

    Conclusions:

    • BLVR is a safe and effective procedure for reducing lung volume in experimental emphysema.
    • The generated scar tissue effectively remodeled hyperinflated lung tissue.
    • BLVR demonstrated significant improvements in respiratory function and warrants further investigation in human clinical trials.