The emerging role of mesenchymal stromal cells among therapeutic options for chronic obstructive pulmonary disease

• Main Author: Gorman, Daniel E.
• Other Authors: Symes, Karen
• Language: en_US
• Published: 2021
• Subjects: Medicine
• Online Access: https://hdl.handle.net/2144/43376

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Smoking is the primary known risk factor in the development of COPD. Noxious particle or gas exposure to cells in the lungs leads to a chronic and sometimes irreversible state of airway inflammation, resulting in airflow limitation, hyper production of mucous, and destruction of distal lung tissue including gas exchange surfaces. COPD patients often develop dyspnea (difficult or labored breathing) and can become hospitalized during acute exacerbations. Current treatment options for COPD include exercise therapy, oxygen therapy, and multiple drugs with bronchodilation activity. These therapies aim to reduce dyspnea and exacerbation frequency. Steroid resistance in COPD patients has made treatment of underlying chronic inflammation difficult. Multiple targeted non-steroidal anti-inflammatory drugs (NSAIDs) are under investigation as potential therapeutic options. To this point, there is no approved treatment which adequately combats chronic inflammation in COPD. Mesenchymal stromal/stem cells (MSCs) have become increasingly of interest in recent years as a potential therapeutic option for multiple different diseases in the body due to their demonstrated anti-inflammatory, immunomodulatory, tissue regenerative, and trophic signaling capacities. In the search for better ways to treat COPD, researchers have turned to MSC therapy as a potential solution. Preclinical studies demonstrated an ability of transplanted MSCs to ameliorate alveolar destruction and suppress inflammation in rodent models of COPD. Phase I clinical studies have identified safety, tolerability, and feasibility of MSC therapy in COPD, and preliminary findings suggest potential anti-inflammatory capacities which allow for improved lung function and quality of life. Many questions are still left unanswered in the study of MSC therapy in COPD, including the proper cell source and delivery route, and whether MSC-derived products might deliver equal or better results than transplanted cells. Currently, there is much optimism surrounding MSC therapy in COPD, as it has demonstrated a potential to relieve chronic inflammation through a multitude of signaling pathways as well as aid in regeneration of lung tissue. Further research is needed to uncover the optimal mechanism of MSC therapy in COPD and whether it will become a new standard of care.