TY - JOUR T1 - Crosslink bio-adhesives for bronchoscopic lung volume reduction: current status and future direction JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0142-2021 VL - 30 IS - 162 SP - 210142 AU - Mugdha M. Joglekar AU - Dirk-Jan Slebos AU - Jeroen Leijten AU - Janette K. Burgess AU - Simon D. Pouwels Y1 - 2021/12/31 UR - http://err.ersjournals.com/content/30/162/210142.abstract N2 - 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.We present an overview of current literature on tissue sealants and haemostats used for lung repair and regeneration. Furthermore, an in-depth description of different lung tissue adhesives and the characteristics of an ideal lung adhesive is provided. https://bit.ly/2YmPhre ER -