University of Groningen, University Medical Center Groningen, Dept of Pathology and Medical Biology, Groningen, The Netherlands.
University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, The Netherlands.
Eur Respir Rev. 2021 Nov 30;30(162). doi: 10.1183/16000617.0142-2021. Print 2021 Dec 31.
Several bronchoscopic lung volume reduction (BLVR) treatments have been developed to reduce hyperinflation in emphysema patients. Lung bio-adhesives are among the most promising new BLVR treatment options, as they potentially provide a permanent solution for emphysematous patients after only a single application. To date, bio-adhesives have mainly been used as haemostats and tissue sealants, while their application in permanently contracting and sealing hyperinflated lung tissue has recently been identified as a novel and enticing opportunity. However, a major drawback of the current adhesive technology is the induction of severe inflammatory responses and adverse events upon administration. In our review, we distinguish between and discuss various natural, semi-synthetic and synthetic tissue haemostats and sealants that have been used for pulmonary applications such as sealing air/fluid leaks. Furthermore, we present an overview of the different materials including AeriSeal and autologous blood that have been used to achieve lung volume reduction and discuss their respective advantages and drawbacks. In conclusion, we describe the key biological (therapeutic benefit and biocompatibility) and biomechanical (degradability, adhesive strength, stiffness, viscoelasticity, tunability and self-healing capacity) characteristics that are essential for an ideal lung bio-adhesive material with the potential to overcome the concerns related to current adhesives.
已经开发出几种支气管镜肺减容术（BLVR）来减少肺气肿患者的过度充气。肺生物黏合剂是最有前途的新 BLVR 治疗选择之一，因为它们在单次应用后可能为肺气肿患者提供永久性解决方案。迄今为止，生物黏合剂主要用作止血剂和组织密封剂，而最近发现其在永久性收缩和密封过度充气的肺组织方面具有新颖而诱人的机会。然而，当前黏合剂技术的一个主要缺点是在给药时会引起严重的炎症反应和不良事件。在我们的综述中，我们区分并讨论了用于肺应用（如密封空气/液体泄漏）的各种天然、半合成和合成组织止血剂和密封剂。此外，我们还介绍了不同材料的概述，包括 AeriSeal 和自体血液，这些材料已被用于实现肺减容，并讨论了它们各自的优点和缺点。总之，我们描述了理想的肺生物黏合剂材料所必需的关键生物学（治疗益处和生物相容性）和生物力学（可降解性、黏附强度、刚度、黏弹性、可调节性和自修复能力）特性，这些特性有可能克服与当前黏合剂相关的担忧。
