Waiting to Exhale: Lung tissue does not regenerate, so, when it is damaged by disease and/or surgically removed, lung transplantation is often the only treatment option. Because donor tissue is in short supply, there has been a long-standing interest in engineering functional and transplantable lung tissue in the laboratory. Petersen et al. (p. 538 , published online 24 June; see the Perspective by Wagner and Griffith ) now report an important step in this direction. After gently removing the cellular constituents of rat lungs with detergent, the residual scaffold of extracellular matrix—which retained the compliance and mechanical properties of the original lung—was re-seeded with a mixture of lung epithelial and endothelial cells and cultured in a bioreactor. Within a few days, the engineered lung tissue contained alveoli, microvessels, and small airways that were repopulated with the appropriate cell types. When transplanted into a rat for short time periods, the engineered lung showed evidence of gas exchange.

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are the earliest tissue-engineered vascular grafts (TEVGs) to be used clinically. These TEVGs transform into living blood vessels in vivo, with an endothelial cell (EC) lining invested by smooth muscle cells (SMCs); however, the process by which this occurs is unclear. To test if the seeded BMCs differentiate into the mature vascular cells of the neovessel, we implanted an immunodeficient mouse recipient with human BMC (hBMC)-seeded scaffolds. As in humans, TEVGs implanted in a mouse host as venous interposition grafts gradually transformed into living blood vessels over a 6-month time course. Seeded hBMCs, however, were no longer detectable within a few days of implantation. Instead, scaffolds were initially repopulated by mouse monocytes and subsequently repopulated by mouse SMCs and ECs. Seeded BMCs secreted significant amounts of monocyte chemoattractant protein-1 and increased early monocyte recruitment. These findings suggest TEVGs transform into functional neovessels via an inflammatory process of vascular remodeling.