![]() Intrinsic therapy refers to the delivery of small molecules (retinoid compounds have been the most studied) that can stimulate the endogenous lung stem/progenitor cells to regenerate and replace damaged structures (See Sun et al review paper below).Īs mentioned above, human trials to date have largely failed in showing any benefit but there remain questions about appropriate candidates for such therapy, type of therapy, timing of therapy, dosing issues and a host of other variables that require further study. ![]() Extrinsic cell therapy refers to infusing (or endotracheal installation) of stem cells including embryonic stem cells (ESCs), induced pleuripotent stem cells (iPSs), mesenchymal stem cells (MSCs), and human lung stem cells (hLSCs). There has been some work looking at the potential to bioengineer fully intact 3-D lung units that could be transplanted but this is not a likely prospect for the near future. Currently, regenerative therapies are divided into extrinsic therapeutic strategies and intrinsic cell therapy methods. The greatest success has been in acute lung injury models, however. Pre-clinical trials in animal models have suggested regeneration of alveolar-like structures, repair of emphysematous lungs, and reduction of inflammatory responses. Stem cells can differentiate into several different lung cell types such as the alveolar epithelial cells that are destroyed by cigarette smoke leading to emphysematous changes and reduced tethering of small airways causing hyperinflation and gas exchange abnormalities. It is also postulated that by replacing these damaged cells there can be a restoration of normal immune function and a reduction in the inflammatory response to variable exposures such as cigarette smoke, air pollution and airway pathogens in susceptible individuals who develop COPD. With these limitations of standard modalities of therapy, it is attractive to pursue novel regenerative therapies that may be capable of restoring pulmonary function and structures such as airways, terminal bronchioles and alveoli. Lung transplantation is limited by availability, age restrictions, complications and rejection issues. Lung volume reduction surgery is reserved often for those with severe disease and has only modest benefits. There has been no definitive evidence that they impact mortality. Indeed, current standard therapies including bronchodilators and inhaled corticosteroids and the phosphodiesterase-4 inhibitor, roflumilast, show modest efficacy at best in reducing exacerbations and improving lung function. Despite this, there remains keen interest in continuing to study so-called “regenerative therapy” for COPD. There have been several phase I clinical trials, mostly looking at safety, and a handful of small phase II clinical trials that essentially have been negative. There are clinics currently offering this therapy, (typically at exorbitant out of pocket cost to the patient), even though there are no phase III randomized controlled trials or Food and Drug Administration approval. Over the last year I have had several patients ask me about stem cell therapy for chronic obstructive pulmonary disease (COPD). Stem cell therapy for COPD: where are we? Chronic Obstr Pulm Dis. Stem Cell Therapy procedures are performed at both our Dallas and Fort Worth locations.Ĭall (214) 643-8665 or request a consultation to learn more.Running Head: Journal Club: Stem Cell TherapyĪbbreviations: chronic obstructive pulmonary disease, COPD embryonic stem cells, ESCs induced pleuripotent stem cells, iPSs mesenchymal stem cells, MSCs human lung stem cells, hLSCs adipocyte mesenchymal cells, AD-MSCs bone marrow mesenchymal stem cells, BM-MSCs Wharton’s jelly mesenchymal stem cells, WJ-MSCsĬitation: Balkissoon R. For many people the initial treatment is all that is needed however, for some conditions, subsequent treatments may be required and these are done at a reduced fee. For example, spine conditions require multiple physicians to deliver the cells back to your body and this requires an increase in cost as multiple doctors are involved in the procedure. The range in cost is dependent on the complexity of delivering the cells back to you. The cost of the initial treatment ranges from $5,000 to $10,000. Click on the links to learn about those diseases and stem cell treatments What are Stem Cells? and Understanding Adipose-Derived Stem Cells. While patients with many lung diseases such as cystic fibrosis and scleroderma have seen improvement, asthma, COPD and pulmonary fibrosis are the best studied. Not only have patients seen improvement in symptoms, but measurements of lung function called Pulmonary Function Tests (PFT) have also been shown to improve. Stem cells can have significant effects on lung diseases.
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