Stem Cell-Based Regenerative Therapy and Derived Products in COPD: A Systematic Review and Meta-Analysis

Abstract

COPD is an incurable disorder, characterized by a progressive alveolar tissue destruction and defective mechanisms of repair and defense leading to emphysema. Currently, treatment for COPD is exclusively symptomatic; therefore, stem cell-based therapies represent a promising therapeutic approach to regenerate damaged structures of the respiratory system and restore lung function. The aim of this study was to provide a quantitative synthesis of the efficacy profile of stem cell-based regenerative therapies and derived products in COPD patients. A systematic review and meta-analysis was performed according to PRISMA-P. Data from 371 COPD patients were extracted from 11 studies. Active treatments elicited a strong tendency towards significance in FEV1 improvement (+71 mL 95%CI −2–145; p = 0.056) and significantly increased 6MWT (52 m 95%CI 18–87; p < 0.05) vs. baseline or control. Active treatments did not reduce the risk of hospitalization due to acute exacerbations (RR 0.77 CI95% 0.40–1.49; p > 0.05). This study suggests stem cell-based regenerative therapies and derived products may be effective to treat COPD patients, but the current evidence comes from small clinical trials. Large and well-designed randomized clinical trials are needed to really quantify the beneficial impact of stem cell-based regenerative therapy and derived products in COPD.

Effects of Ipratropium Bromide Combined with Traditional Chinese Medicine Intervention on the Pulmonary Function and Psychological Status of Patients with Chronic Obstructive Pulmonary Disease

“…COPD is a common and preventable respiratory disease characterized by persistent airfow limitation. Except β2 agonist and glucocorticoid, growing novel strategies, such as Nrf2 agonist, prebiotics, stem cell transplantation, and oligonucleotides have been considered [34][35][36][37][38][39][40], but there is no efcient treatment to prevent its progression. Patients are treated with drugs to keep the airway unobstructed and improve the symptoms of dyspnea, chest tightness, and wheezing [13].…”

Lung regeneration: diverse cell types and the therapeutic potential

“…216 Progressive destruction of alveolar tissue is one of the hallmarks of COPD, so there is increasing research on regenerative therapy based on stem cells and their derived products for repairing alveolar structure and restoring function. 217 A study of a rat COPD model induced by cigarette exposure has shown that human umbilical cord mesenchymal stem cell (hUC-MSC)-derived extracellular vesicles (EVs) are effective in ameliorating COPD-induced inflammation.…”

“…The results of a 52‐week randomized clinical trial have shown that triple therapy with twice‐daily inhaled glucocorticoid (160 or 320 μg of budesonide), long‐acting muscarinic antagonist (18 μg of glycopyrrolate), and long‐acting β2‐agonist (9.6 μg of formoterol) causes a lower rate of moderate‐to‐very‐severe COPD exacerbations than glycopyrrolate–formoterol or budesonide–formoterol 216 . Progressive destruction of alveolar tissue is one of the hallmarks of COPD, so there is increasing research on regenerative therapy based on stem cells and their derived products for repairing alveolar structure and restoring function 217 . A study of a rat COPD model induced by cigarette exposure has shown that human umbilical cord mesenchymal stem cell (hUC‐MSC)‐derived extracellular vesicles (EVs) are effective in ameliorating COPD‐induced inflammation.…”

Regenerative and translational medicine in COPD: hype and hope

“…As shown in figure 2, we attempted to synthesise the therapeutic potential resulting from different factors secreted by mesenchymal stromal/stem cells (MSCs) (secretome), as well as the physiological processes of these different factors that can act directly or indirectly as potential targets for cell-based therapy for COPD and other chronic diseases, through a paracrine mechanism or distant from the originating cell (MSC extracellular vesicles) or by cell-to-cell contact. This understanding of COPD in a broader context of pathogenesis and pathophysiology opens up new avenues of opportunity for early diagnosis, effective forms of prevention, the possibility of early intervention and new therapeutic approaches [22][23][24][25][26][27][28][29][30][31][32][33]. In this context, cell-based therapies have arisen as potentially promising new therapeutic approaches and different cell-based therapies have been proposed and tested in pre-clinical models of COPD/emphysema.…”