August 1, 2018

expert reaction to study attempting to create better bioengineered lungs in pigs

A new study, published in Science Transnational Medicine, demonstrates the production and transplantation of a bioengineered lunch into a large-animal model.

Prof John Hunt, Strategic Research Theme Lead for Medical Technologies and Advanced Materials, Nottingham Trent University, said:

Does the press release accurately reflect the science?

“Yes, but I absolutely would not use the word “mimic”.  The bioengineered lung facilitates the development of a blood supply and provides for the establishment of natural lung microbial flora.  It does not mimic either of these, it provides the right environment for these to develop.

Is this good quality research?  Are the conclusions backed up by solid data?

“Yes, the paper presents a well-founded robust piece of research.  It is a from a large team collaborating to produce the results from four pigs.  The conclusions are backed up in the study and the authors themselves accept that having a sample size of four means they need to do more research, but nevertheless given the complexity of the model, the authors should be congratulated on their approach and success to date.

How does this work fit with the existing evidence?

“The authors clearly present this as a future model to possibly accelerate our progress towards lung transplants without the need for human donors in the future.  This is current ‘hot’ area where the fundamental principles and requirements are well established.  It is wonderful this team took on this research and the right kind of complex model, and have added to our knowledge in the field.

Have the authors accounted for confounders?  Are there important limitations to be aware of?

“The authors identify the weaknesses in the research to date, address and discuss their progress and what it means in terms of impact very realistically.  They will satisfy the confounders in that they are not presenting this as the solution to this problem – they are stating this is significant progress towards developing this approach and utilising it as the solution.  This is well supported from the research and the data.

Have bioengineered lungs been tried in pigs before?

“This is a decellularised lung transplantation – this is not ‘pig-to-human transplants’.  There has been significant research to date on xenotransplantation the use of pig organs in humans, and then since around 2008 onwards decellularised approaches using animal models have been developed and tested.  This does address the known critical issue and emphasies it and tests it.  The microvasculature and the development of one is essential, the development of the right microbiome and microflora is also essential.  Their model works in these critical areas, it’s really valuable research, it’s wonderful it has been a success in four animals.

“There is a need for longer term studies – it’s fantastic it looks great up to two months, because without getting to two months, there will be no longer term studies.  It could be a big step, I hope it will be, there are enough of us working in this area of revitalising decellularised tissues and the critical pinch points in that process that success like this which enables us to substantiate the need for more and longer studies is a wonderful result and motivator that we’re working on the right things and heading in the right direction.”

* ‘Production and transplantation of bioengineered lung into a large-animal model’ by Joan E. Nichols et al. published in Science Translational Medicine on Wednesday 1 August 2018.

Declared interests

Prof John Hunt: “I have no known conflicts of interest or known direct or indirect connections with anyone or anything in this study.”