Stem cells for respiratory failure

Curr Opin Crit Care. 2015 Feb;21(1):42-9. doi: 10.1097/MCC.0000000000000171.

Abstract

Purpose of review: The prognosis of patients with respiratory failure in the ICU remains poor, while current therapeutic approaches are aimed at minimizing ventilator-induced lung injury. Stem cell-based therapies have the potential to transform respiratory failure treatment by achieving lung repair. The purpose of this article is to critically review the large body of clinical and experimental work performed with respect to the use of stem/progenitor cells in respiratory failure, and to discuss current challenges and future directions.

Recent findings: Since the initial report of cell therapy for lung injury in 2005, numerous preclinical and clinical studies have been performed that support the ability of various stem cell populations to improve physiologic lung function and reduce inflammation in both infective and sterile acute respiratory distress syndrome. Nevertheless, many important issues (e.g., mechanism of action, long-term engraftment, optimal cell type, dose, route of administration) remain to be resolved.

Summary: Cell-based therapeutics hold promise, particularly for acute respiratory distress syndrome, and early preclinical testing has been encouraging. To advance clinical testing of cell therapies in respiratory failure, and to help ensure that this approach will facilitate bench-to-bedside and bedside-to-bench discoveries, parallel paths of basic and clinical research are needed, including measures of cell therapy effectiveness in vivo and in vitro.

Trial registration: ClinicalTrials.gov NCT01659307.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Lung Injury / therapy
  • Bone Marrow Transplantation
  • Critical Illness
  • Humans
  • Mesenchymal Stem Cell Transplantation
  • Pluripotent Stem Cells / transplantation
  • Respiratory Distress Syndrome / therapy
  • Respiratory Insufficiency / therapy*
  • Stem Cell Transplantation*

Associated data

  • ClinicalTrials.gov/NCT01659307