Bronchoscopic lung volume reduction - A novel tissue engineering treatment for advanced emphysema

Emphysema is a progressive, disabling pulmonary disease characterized by destruction of elastic lung tissue. It results in hyperinflation, and loss of recoil, and medical therapies are of limited benefit. Lung volume reduction surgery (LVRS) has recently emerged as an effective therapy for emphysema. LVRS involves surgical resection of diseased lung, allowing more space within the chest cavity for the remaining lung to expand and function. Unfortunately, LVRS is associated with substantial mortality (5-10%), morbidity (20-40%) and cost ($25-35,000 per operation). We have recently developed a safer, effective, and less costly approach to lung volume reduction therapy based on tissue engineering principles that can be administered through a bronchoscope. Testing of this procedure required the development of a large animal model that accurately reproduces the physiology of emphysema. This report summarizes the development and validation of such a model, and the testing of our approach, known as Bronchoscopic Lung Volume Reduction (BLVR). The model has facilitated refinement of the procedure in preparation for clinical trials.