Cell therapy for the preterm infant: promise and practicalities

Arch Dis Child Fetal Neonatal Ed. 2020 Sep;105(5):563-568. doi: 10.1136/archdischild-2019-317896. Epub 2020 Apr 6.


Recent decades have seen the rapid progress of neonatal intensive care, and the survival rates of the most preterm infants are improving. This improvement is associated with changing patterns of morbidity and new phenotypes of bronchopulmonary dysplasia and preterm brain injury are recognised. Inflammation and immaturity are known contributors to their pathogenesis. However, a new phenomenon, the exhaustion of progenitor cells is emerging as an important factor. Current therapeutic approaches do not adequately address these new mechanisms of injury. Cell therapy, that is the use of stem and stem-like cells, with its potential to both repair and prevent injury, offers a new approach to these challenging conditions. This review will examine the rationale for cell therapy in the extremely preterm infant, the preclinical and early clinical evidence to support its use in bronchopulmonary dysplasia and preterm brain injury. Finally, it will address the challenges in translating cell therapy from the laboratory to early clinical trials.

Keywords: intensive care; neonatology; neurodevelopment; respiratory.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain Injuries / therapy*
  • Bronchopulmonary Dysplasia / therapy*
  • Cell Transplantation / adverse effects
  • Cell Transplantation / methods*
  • Clinical Protocols
  • Clinical Trials as Topic
  • Cord Blood Stem Cell Transplantation / adverse effects
  • Cord Blood Stem Cell Transplantation / methods
  • Fetal Blood
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Premature, Diseases / therapy*
  • Infant, Very Low Birth Weight
  • Intensive Care, Neonatal / methods
  • Mesenchymal Stem Cell Transplantation / adverse effects
  • Mesenchymal Stem Cell Transplantation / methods
  • Time Factors