Functional Mechanics of a Pectin-Based Pleural Sealant after Lung Injury

Tissue Eng Part A. 2018 May;24(9-10):695-702. doi: 10.1089/ten.tea.2017.0299. Epub 2018 Jan 5.


Pleural injury and associated air leaks are a major influence on patient morbidity and healthcare costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal (weight%) mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products. The pectin-based polymer demonstrated significantly greater adhesion to the lung pleura than the comparison products (p < 0.001). In a 25 g needle-induced lung injury model, pleural injury resulted in an air leak and a loss of airway pressures. After application of the pectin-based polymer, there was a restoration of airway pressure and no measurable air leak. Despite the application of large sheets (50 mm2) of the pectin-based polymer, multifrequency lung impedance studies demonstrated no significant increase in tissue damping (G) or hysteresivity (η)(p > 0.05). In 7-day survival experiments, the application of the pectin-based polymer after pleural injury was associated with no observable toxicity, 100% survival (N = 5), and restored lung function. We conclude that this pectin-based polymer is a strong and nontoxic bioadhesive with the potential for clinical application in the treatment of pleural injuries.

Keywords: adhesion; mesothelium; pectin; pleura; pneumothorax.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Epithelium / metabolism
  • Epithelium / surgery
  • Lung Injury / surgery*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Microscopy, Electron, Scanning
  • Pectins / chemistry*
  • Pleura / metabolism*
  • Pleura / surgery*
  • Tissue Adhesives / chemistry*
  • Tissue Adhesives / metabolism*


  • Tissue Adhesives
  • Pectins