Engineering of a complex organ: progress toward development of a tissue-engineered lung.

Although there has been slow progress in the engineering of the lung, recent advances in the use of stem or progenitor cells leading to the reliable production of component parts of the lung show promise for the future development of engineered lung tissue. Progress toward the goal of developing an engineered lung will only be accomplished through the parallel development of effective and functional tissue-engineered components that include both upper and lower respiratory tract as well as scaffold material suitable for use in the lung. The knowledge acquired from developing each individual component of lung will, over time, be integrated to allow for the development of larger complex organ structures. To accomplish the goal of developing engineered lung for regenerative medicine, many advances will be required in scaffold design and production, including improved biocompatibility, improved elasticity, and better control of scaffold ultrastructure and porosity. Development of new materials designed to meet the anatomic and physiologic needs of the lung must occur before we can begin to realize the goal of engineering functional lung tissue. Better understanding of factors promoting cell adhesion, migration, differentiation, and vascularization of grafts and lung regeneration as a whole is also needed. Advances in the development of mathematical models to examine the conditions that promote lung morphogenesis and tissue growth for computational investigations of tissue development will also be necessary if we are to realistically evaluate the production of lung tissue strictly from the engineering perspective. It is obvious that engineering of lung tissue will require a multidisciplinary approach if we are to eventually succeed in our attempts to produce tissues worthy of clinical application in the future.