Crosslink bio-adhesives for bronchoscopic lung volume reduction: current status and future direction

Area of Science:

• Pulmonary Medicine
• Biomaterials Science
• Regenerative Medicine

Background:

• Emphysema treatment often involves bronchoscopic lung volume reduction (BLVR) to manage hyperinflation.
• Lung bio-adhesives are emerging as a potentially permanent, single-application BLVR solution.
• Current bio-adhesives, primarily used as sealants, face challenges due to induced inflammatory responses and adverse events.

Purpose of the Study:

• To review natural, semi-synthetic, and synthetic tissue sealants for pulmonary applications.
• To provide an overview of materials used for lung volume reduction, such as AeriSeal and autologous blood.
• To identify ideal characteristics for lung bio-adhesives to overcome limitations of current technologies.

Main Methods:

• Literature review of bio-adhesives used in pulmonary applications.
• Analysis of materials for sealing air/fluid leaks and achieving lung volume reduction.
• Discussion of biological and biomechanical properties essential for ideal lung bio-adhesives.

Main Results:

• Various natural, semi-synthetic, and synthetic haemostats and sealants have been explored for pulmonary use.
• AeriSeal and autologous blood are examples of materials investigated for BLVR, each with distinct pros and cons.
• Key characteristics for ideal lung bio-adhesives include therapeutic benefit, biocompatibility, degradability, adhesive strength, stiffness, viscoelasticity, tunability, and self-healing capacity.

Conclusions:

• Lung bio-adhesives represent a novel approach to BLVR, offering potential for permanent emphysema treatment.
• Addressing inflammatory responses and adverse events is critical for advancing bio-adhesive technology in pulmonology.
• Defining optimal biological and biomechanical properties will guide the development of next-generation lung bio-adhesives.