Overcoming the translational barriers of tissue adhesives

Abstract

For the past few decades, tissue sealants and adhesives have been developed as an alternative to sutures and staples to close and seal wounds or incisions. These materials are advantageous because of their ease of use, short application time and minimal tissue damage, making them suitable for minimally invasive procedures. However, there is a large gap between the amount of research into tissue adhesives and the number of products available. To bridge this gap, there is a need to better understand the challenges to clinical translation of tissue adhesives. In particular, adhesive design must be informed by a deep understanding of the target tissue’s surface characteristics and environment, which vary considerably among tissue types. Moreover, understanding and monitoring the long-term performance of a material post-implantation is crucial; this includes monitoring the chemical and physical properties of the implanted adhesives over time, tissue responses and the resultant changes in adhesion and cohesion. In addition, early-stage consideration of the unmet clinical need and the regulatory and development paths could lower the barriers in the development cost and effort, facilitating clinical translation. In this Review, we identify challenges in the development of tissue adhesives and provide design criteria to translate tissue-adhesive technologies into clinical practice.

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Fig. 1: A brief history of tissue adhesive research and development.
Fig. 2: Rational material design for clinical applications.
Fig. 3: Potential interactions between tissue adhesives and the surrounding tissues.
Fig. 4: The key steps in the translational process and the regulatory pathways for different classes of tissue adhesives.

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Acknowledgements

This work was supported by the Korea Institute for Advancement of Technology (N0002123) to Y.L., the MIT Deshpande Center and BioDevek to N.A. and the National Institutes of Health through the R01 grant HL095722 to J.M.K.

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All authors researched data and contributed to the discussion, writing and revising of the content.

Correspondence to Jeffrey M. Karp or Natalie Artzi or Yuhan Lee.

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Competing interests

G.M.T. is employed by BioDevek, a company that has filed patents based on materials described in this manuscript. G.M.T benefits from the stock options compensation plan from BioDevek. M.J.N.P. is an employee and holds stock options in TISSIUM, a company that further licensed intellectual property (IP) generated by M.J.N.P. and that may benefit financially if the IP is further validated. M.J.N.P. has filed patents based on materials described in this manuscript. J.M.K. holds equity in TISSIUM, a company that has an option to license IP generated by J.M.K. and that may benefit financially if the IP is licensed and further validated. The interests of J.M.K. were reviewed and are subject to a management plan overseen by their institutions in accordance with their conflict of interest policies. J.M.K. has filed patents based on materials described in this manuscript. N.A. holds equity in BioDevek, a company that has an option to license IP generated by N.A. and that may benefit financially if the IP is licensed and further validated. The interests of N.A. were reviewed and are subject to a management plan overseen by their institutions in accordance with their conflict of interest policies. N.A. has filed patents based on materials described in this manuscript. Y.L. has filed patents based on materials described in this manuscript. The other authors declare no competing interests.

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Taboada, G.M., Yang, K., Pereira, M.J.N. et al. Overcoming the translational barriers of tissue adhesives. Nat Rev Mater 5, 310–329 (2020). https://doi.org/10.1038/s41578-019-0171-7

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