For patients facing a lung disease, including COPD, current and traditional therapeutic options may not be as effective in managing symptoms or slowing the progression of the condition so researchers have turned their attention to the potential benefits of stem cell therapy and ex vivo lung bioengineering in hopes of developing new and effective therapeutic approaches to treat lung disease.

Demonstrating a rapid progression over the last decade, the development of stem cell therapies and bioengineering approaches for lung disease has primarily shifted focus to the application of immunomodulatory and paracrine actions of mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) and the field of ex vivo lung bioengineering.

In this manuscript, Weiss reviews clinical trials in lung disease and provides the current progress for a variety of therapeutic options. Specific treatments reviewed include:

  • Structural Engraftment of Circulating or Exogenously Administered Stem Cells
  • Ex Vivo Derivation of Lung Epithelial Cells from Embryonic Stem Cells or Induced Pluripotent Stem Cells (iPS)
  • Endogenous Lung Stem and Progenitor Cells
  • Circulating Fibrocytes
  • Endothelial Progenitor Cells
  • MSCs and Immunomodulation of Lung Disease

The author points out that although preclinical literature supports the use of EPCs and MSCs in acute lung injury and/or chronic inflammatory and immune-mediated conditions (including asthma, bronchiolitis, obliterans, and bronchopulmonary dysplasia), these preclinical models are not always predictive of clinical behaviors. As such, clinical investigations of these cell-based therapies for lung disease have been slow to develop.

Currently, the only effective treatment for severe lung diseases, including BPD, CF, COPD, and IPF, is lung transplantation.  With a 50% five-year post-transplant mortality rate, essential lifelong immunosuppression (to prevent chronic lung rejection), and a critical shortage of donor’s lungs, research has turned its attention toward manufacturing surgically implantable ex vivo (or “outside the living body”) lung tissue. While several challenges still exist, recent significant progress has been made using both synthetic and donor tissue in generating ex vivo tissue for use in various lung treatment applications.

The author concludes that while exciting progress has been made in the field of stem cell therapy and ex vivo generation of tissue to treat lung diseases, much research is still on the horizon.  Within future research, they hope to better understand the identity of endogenous lung airway, the development of functional airway and alveolar epithelial cells from ESCs and iPS cells, and a better understanding of the physiologic and pathophysiologic roles of EPC and Fibrocytes in lung diseases.

The use of stem cell therapy and ex vivo lung bioengineering offers tremendous potential for the treatment of lung diseases, however, the clinical use of artificial engineered or decellularized scaffolds for use in treating lung disease is likely to be several years off.

Source:  (n.d.). Current Status of Stem Cells and Regenerative Medicine in Lung …. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208500/

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