Home » COPD, is it possible to “repair” the lungs with stem cells?

COPD, is it possible to “repair” the lungs with stem cells?

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COPD, is it possible to “repair” the lungs with stem cells?

The panorama of treatments against COPD, one of the most common respiratory diseases and the cause of over three million deaths a year in the world, could – in the future – also include lung stem cell transplants. We are only at the beginning, but this is the direction of the results just presented by Yujia Wang’s team from the Tongji University School of Medicine in Shanghai, which aims to “repair” diseased lungs.

COPD, over three million patients in Italy

All the symptoms of COPD, in fact, have to do with a “crippled” respiratory system that is no longer able to do its job well. The origin of the disease is the narrowing, inflammation, swelling of the airways, as well as the destruction of lung tissue. I am the engine of this destruction first smoking and pollutants, but also some genetic conditions, asthma, and prematurity can play a role, the World Health Organization recalls. The results, in terms of symptoms, are chronic cough, difficulty breathing, shortness of breath, phlegm, tiredness and risk of recurrent infections, typical of the disease. Medicines, oxygen and pulmonary rehabilitation are the pillars on which the treatment of chronic obstructive pulmonary disease (COPD) is based today, which affects more than three million patients in Italy alone.

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Damaged lungs: evidence of regeneration

The idea of ​​Wang and colleagues – they explain from the pages of Science Translational Medicine – was to counteract the destruction underlying the disease by exploiting the regenerative potential of the lungs, still present even in sick people (albeit to a very small extent). The regenerative potential in practice is represented by some stem cells, i.e. progenitor cells capable of generating new epithelial tissue. Thus, after some studies conducted in mice and monkeys and a pilot phase in two patients, Wang’s team set up a small clinical study to test the safety of a lung stem cell transplant in humans. It did so by recruiting a small group of patients, with more or less severe COPD, who received transplants of adult progenitor cells taken from their own lungs (a particular type, P63+ progenitor cells, isolated via bronchoscopy and cultured for a few weeks in the laboratory ). Seventeen received the cells (again via bronchoscopy) and were compared with three patients as controls (not subjected to bronchoscopy and treated in a standard way).

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Indications of effectiveness and future prospects

The analyzes and observations conducted by the researchers highlighted problems that the researchers defined as “minimal” on the safety front and also allowed us to observe some indications of effectiveness. In particular, in the transplanted patients the ability of the lungs to exchange gases improved (in detail the alveolo-capillary diffusion of carbon monoxide, DLCO, increased) and they were also able to walk a little further for the same amount of time (about thirty meters more in six minutes in the test that is commonly performed to assess the severity of the disease).

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To overcome the limitations of the study – such as the small number of participants, the fact that they were all male, the absence of a real placebo and the follow-up limited to 24 weeks – the researchers are now conducting a larger trial, so as to clarify the real potential of this type of transplant against COPD and delve deeper into the mechanisms of action of these cells.

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