ADVENT OF STEM CELLS AS THE ONLY TREATMENT FOR COPD

What is COPD?


Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent airflow limitation that is
usually progressive and associated with an enhanced chronic inflammatory response in the airways and
lung due to harmful gases and particles. Within the spectrum of COPD, two nosological entities are
defined,
• Chronic bronchitis and,
• Emphysema
Chronic bronchitis, a small airway disease, is characterized by increased airways inflammation,
airways resistance and secretory cell hyperplasia, which culminates in increased bronchial secretions
and broncho-constriction.
Pulmonary emphysema in turn is characterized by the destruction of the alveolar walls with
enlargement of air spaces distal to terminal bronchioles but without apparent fibrosis.
This condition results in and is clinically expressed by progressive dyspnea (difficulty in breathing) . In
the later stages of the disease, dyspnea becomes disabling. The patient has difficulty to carry out simple
everyday tasks which require little effort, such as bathing, dressing and shaving.
In addition a significant inflammatory spillover into systemic circulation has been suggested to be
responsible for a wide range of fatal co-morbidities.

Why Stem cell therapy arose as a mode of treatment?


The therapeutic options are only palliative (Symptomatic) and thus ineffective, unable to promote the
morphological/functional regeneration of the alveolar tissue and, consequently, unable to determine a
change in the course of the natural history and outcomes of obstructive pulmonary disease.
Regenerative medicine based on stem cells’ properties represents one promising option with several
fruitful therapeutic applications in patients with COPD. It has been demonstrated that transplanted bone
marrow-derived cells or, mesenchymal stem cell adapt to the lung tissue in response to lung injury and
adopt phenotypes of alveolar epithelial cells, endothelial cells, fibroblasts and bronchial epithelial cells.

Who are the ideal COPD candidates for receiving adult stem cell therapy?

• Patients who have not responded very well to their medical treatment
• Patients who responded earlier to treatment but are no longer responding
• Patients who cannot tolerate the recommended treatment
• Patients wishing to avoid the recommended treatment such as surgery
• Patients for whom nothing has been effective.

Route of administration & immediate benefits:
• Intravenous
• Nebulization

The earliest response observed is an increase in exercise ability. Patients feel they can walk further
without becoming winded. Patients also note an increase in their oxygen saturation levels.
Most patients respond to only one deployment. Some require a repeat deployment in 3-6 months.

How exactly do Stem cells promote lung tissue regenerattion?


Several hypotheses have been proposed about the mechanism of action of adult stem cells in different
tissues, including in the lung. Cellular events such as fusion, transdifferentiation and paracrine
modulation may be associated with a morphofunctional recovery process in the lung.
The molecular events which promote improvement in lung function may be related to a modulation
process governed by the local paracrine effect of transplanted cells. These cells showed a significant
reduction in levels of inflammation-associated proteins (C-reactive protein, fibrinogen, a1-antitrypsin,
haptoglobin, ceruloplasmin and orosomucoid).
Hence, the observed beneficial effects on the progression of emphysema might be explained by an antiinflammatory
effect exerted by the pool of Bone marrow derived mesenchymal cells on the pulmonary
parenchyma.

FURTHER READINGS:

1) https://copdnewstoday.com/2016/06/28/lung-institute-review-stem-cells-not-a-miracle-cure-for-copd-but-still-improvinglives/
2) http://www.foxnews.com/health/2016/02/02/how-stem-cell-therapy-may-help-treat-copd.html

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