Title:Stem Cell Therapy in Chronic Obstructive Pulmonary Disease. Seeking the Prometheus Effect
VOLUME: 14 ISSUE: 2
Author(s):Argyris Tzouvelekis, Geoff Laurent and Demosthenes Bouros
Affiliation:Medical School, Democritus University of Thrace, Department of Pneumonology, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece.
Keywords:COPD, endothelial progenitors, epithelial progenitors, mesenchymal stem cells stem cells, therapy
Abstract:Chronic obstructive pulmonary disease is characterized by dramatic alterations in lung architecture associated
to an exaggerated inflammatory process, alveolar epithelial cell apoptosis, endothelial dysfunction and extracellular matrix
destruction due to a protease and anti-protease imbalance. In addition a significant inflammatory spillover into systemic
circulation has been suggested to be responsible for a wide range of fatal comorbidities. In view of the current disappointing
status of available pharmaceutical agents, there is an urgent need for alternative more effective therapeutic approaches
that will fulfill the unmet need of modulating both local and systemic inflammation and at the same time accelerate
alveolar epithelial and endothelial turnover intervening into disease natural course and not only relieving patient’s
symptoms. Regenerative medicine based on stem cells properties represents one promising option with several fruitful
therapeutic applications in patients with COPD.
Nevertheless, despite relative enthusiasm arising from experimental data, application of stem cell therapy in the clinical
setting has been severely hampered by several safety concerns arising from the major lack of knowledge on the fate of exogenously
administrated stem cells within the COPD lung as well as the mechanisms regulating activation of resident
progenitor cells. The above evidence coupled with the rather disappointing results emerging from the first stem cell clinical
trials in COPD patients underline the need for careful study design by setting realistic goals to assess efficacy such as
biomarkers that reflect clinically inconspicuous alterations of the disease molecular phenotype before rigid conclusions
can be safely drawn.
