Getting bioartificial lungs

Will we one day replace lung transplants by the implantation of bioartificial lungs, reconstituted in the laboratory from patients? U.S. researchers from Yale University have at least taken a promising first step in managing this feat in rats.

Their work was published last week in the journal Science. Researches in tissue engineering, very active in repairing organs such as the heart, kidney or liver, have a particularly crucial issue in pulmonology.

Thomas Petersen (Department of Biomedical Engineering at Yale) and his team have proceeded in several stages. Initially, they took the lungs of adult rats and then removed all the cells - with a detergent - just to keep the matrix, ie the structure of this organ. It was then placed in a bioreactor. In this phase, several types of cells were injected, to re-colonize the airways and blood vessels.

A week later, these structures had acquired the same characteristics as normal lungs and were ready for transplantation. Rooted in rats for periods of forty-five minutes to two hours, they did fulfill their mission: to gorge themselves to air and to ensure gas exchange (oxygen and carbon dioxide). The blood leaving the lung had an oxygen saturation of 100%, and CO2 content was reduced, the researchers said, confirming the effectiveness of the system.

"For the first time we see a concept of artificial lung, which approximates the normal lung, and it's very interesting," enthuses Professor Similowski Thomas, chief of pulmonology and intensive care at the Hospital La Pitie-Salpetriere (Paris). And to clarify, that breathing aids such as transitional ECMO (extracorporeal membrane oxygenation), recently used during serious H1N1, which operates very differently from the human respiratory system 15,000 liters of air per day.

Although exciting, the preliminary work probably still require years or even decades of research to result in bioartificial lungs that could be implanted in humans. "Our results are encouraging but many problems remain to be solved," warned the authors of the article. They will thus improve the system to reduce the risk of bleeding disorders, and prevent damage to the cells during the stage of "decellularization.

The pulmonologist also emphasizes another key feature of lung compared to other organs such as the heart or the kidney: it is in contact with the outside. We breathe each day 15,000 liters of air and the lungs are 150 square meters, 75 times more than the skin. An artificial lung must be able to ensure gas exchange but also to filter particles from the outside.

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