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Mesenchymal Stem Cell Administration in Patients with Chronic Obstructive Pulmonary Disease: State of the Science.

ABSTRACT: Patients with chronic obstructive pulmonary disease (COPD) have chronic, irreversible airway inflammation; currently, there is no effective or curative treatment and the main goals of COPD management are to mitigate symptoms and improve patients' quality of life. Stem cell based therapy offers a promising therapeutic approach that has shown potential in diverse degenerative lung diseases. Preclinical studies have demonstrated encouraging outcomes of mesenchymal stem/stromal cells (MSCs) therapy for lung disorders including emphysema, bronchopulmonary dysplasia, fibrosis, and acute respiratory distress syndrome. This review summarizes available data on 15 studies currently registered by the ClinicalTrials.gov repository, which used different stem cell therapy protocols for COPD; these included bone marrow mononuclear cells (BMMCs), bone marrow-derived MSCs, adipose-derived stem/stromal cells (ADSCs), and adipose-derived MSCs. Published results of three trials indicate that administering BMMCs or MSCs in the setting of degenerative lung disease is safe and may improve patients' condition and quality of life; however, larger-scale studies are needed to evaluate efficacy. Results of another completed trial (NCT01872624) are not yet published, and eleven other studies are ongoing; these include MSCs therapy in emphysema, several studies of ADSCs in COPD, another in idiopathic pulmonary fibrosis, and plerixafor mobilization of CD117 stem cells to peripheral blood.

SUBMITTER: Cheng SL

PROVIDER: S-EPMC5337878 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Mesenchymal Stem Cell Administration in Patients with Chronic Obstructive Pulmonary Disease: State of the Science.

Cheng Shih-Lung SL Lin Ching-Hsiung CH Yao Chao-Ling CL

Stem cells international 20170220

Patients with chronic obstructive pulmonary disease (COPD) have chronic, irreversible airway inflammation; currently, there is no effective or curative treatment and the main goals of COPD management are to mitigate symptoms and improve patients' quality of life. Stem cell based therapy offers a promising therapeutic approach that has shown potential in diverse degenerative lung diseases. Preclinical studies have demonstrated encouraging outcomes of mesenchymal stem/stromal cells (MSCs) therapy ...[more]

PMID: 28303154

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Project description:In the last two decades, mesenchymal stem cells (MSCs) have been pre-clinically utilized in the treatment of a variety of kinds of diseases including chronic obstructive pulmonary disease (COPD). The aim of the current study was to systematically review and conduct a meta-analysis on the published pre-clinical studies of MSC administration in the treatment of COPD in animal models.A systematic search of electronic databases was performed. Statistical analysis was performed using the Comprehensive Meta-Analysis software (Version 3). The pooled Hedges's g with 95% confidence intervals (95% CIs) was adopted to assess the effect size. Random effect model was used due to the heterogeneity between the studies. A total of 20 eligible studies were included in the current systematic review. The overall meta-analysis showed that MSC administration was significantly in favor of attenuating acute lung injury (Hedges's g = -2.325 ± 0.145 with 95% CI: -2.609 ~ -2.040, P < 0.001 for mean linear intercept, MLI; Hedges's g = -3.488 ± 0.504 with 95% CI: -4.476 ~ -2.501, P < 0.001 for TUNEL staining), stimulating lung tissue repair (Hedges's g = 3.249 ± 0.586 with 95% CI: 2.103~ 4.394, P < 0.001) and improving lung function (Hedges's g = 2.053 ± 0.408 with 95% CI: 1.253 ~ 2.854, P< 0.001). The mechanism of MSC therapy in COPD is through ameliorating airway inflammation (Hedges's g = -2.956 ± 0.371 with 95% CI: -3.683 ~ -2.229, P< 0.001) and stimulating cytokine synthesis that involves lung tissue repair (Hedges's g = 3.103 ± 0.734 with 95% CI: 1.664 ~ 4.541, P< 0.001).This systematic review and meta-analysis suggest a promising role for MSCs in COPD treatment. Although the COPD models may not truly mimic COPD patients, these pre-clinical studies demonstrate that MSC hold promise in the treatment of chronic lung diseases including COPD. The mechanisms of MSCs role in preclinical COPD treatment may be associated with attenuating airway inflammation as well as stimulating lung tissue repair.

Project description:BACKGROUND:Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients' lives, which leads to physical and psychological limitations. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence. OBJECTIVE:The objective of this study is to design an innovative mobile health (mHealth) app system called "MyLung" that provides complete solutions in order to increase self-awareness and promote better self-care management. This system, an information technology artifact, includes three novel integrative modules: education, risk reduction, and monitoring. METHODS:The utility and effectiveness of the assistive mobile-based technology were evaluated using a mixed-methods approach. The study combined quantitative and qualitative research methods to thoroughly understand how the assistive mobile-based technology can influence patients' behavioral intention to change their lifestyle. Thirty patients were categorized into two groups (intervention group and control group). RESULTS:The results from the quantitative analysis led to four follow-up interviews in the qualitative study. The results of the quantitative study provided significant evidence to show that the design of MyLung leads to a change in the awareness level, self-efficacy, and behavioral intention for patients with COPD. The t tests revealed a significant difference before and after using the mobile-based app with regard to the awareness level (mean 3.28 vs 4.56; t10=6.062; P<.001), self-efficacy (mean 3.11 vs 5.56; t10=2.96; P=.01), and behavioral intention (mean 2.91 vs 4.55; t10=3.212; P=.009). Independent sample t tests revealed significant differences between the intervention group and the control group in terms of the awareness level (mean 4.56 vs 3.31; t19=4.80; P<.001) and self-efficacy (mean 5.56 vs 3.66; t19=2.8; P<.01). Integration of findings from quantitative and qualitative studies reveled the impact of the design in a comprehensive manner. These inferences are referred to as "meta-inferences" in this study. CONCLUSIONS:We designed an innovative assistive mobile-based technology to empower patients with COPD, which helped increase awareness and engage patients in self-care management activities. The assistive technology aims to inform patients about the risk factors of COPD and to improve access to relevant information. Meta-inferences that emerge from the research outputs contribute to research into chronic management information systems by helping us gain a more complete understanding of the potential impacts of this proposed mobile-based design on patients with chronic disease.

Dataset Information

Mesenchymal Stem Cell Administration in Patients with Chronic Obstructive Pulmonary Disease: State of the Science.

Publications

Mesenchymal Stem Cell Administration in Patients with Chronic Obstructive Pulmonary Disease: State of the Science.

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