Therapeutic Potential and Mechanisms of Action of Mesenchymal Stromal Cells for Acute Respiratory Distress Syndrome
Gerard F. Curley, Jeremy A. Scott and John G. Laffey
Affiliation: Department of Anesthesia, Keenan Research Centre at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Mesenchymal stem/stromal cells (MSCs) have become the focus of intense research effort over the past 10
years, in an effort to harness their regenerative and immune-modulating capacity for a variety of clinical conditions. In
Acute Respiratory Distress Syndrome (ARDS), pre-clinical studies point towards a therapy that modulates multiple aspects
of a complex disease process. Almost universally, these cells have demonstrated an immune modulating phenotype,
balancing protective host responses with a reduction in damaging inflammation, while enhancing bacterial killing. MSCs
also lead to more efficient tissue repair, and MSC-mediated lung tissue repair and regeneration after ARDS are some of
the exciting clinical prospects. Recent investigation into the role of endogenous MSCs has led to new insights into MSC
physiology and its role in regulating the immune system. However, significant deficits remain in our knowledge regarding
the mechanisms of action of MSCs, their efficacy in relevant pre-clinical models, and their safety in critically ill patients.
These gaps need to be addressed before the enormous therapeutic potential of stem cells for ALI/ARDS can be realized.
Keywords: Acute lung injury, keratinocyte growth factor, lung repair, microvesicles, paracrine, pneumonia, sepsis, stem cells,
ventilation-induced lung injury.
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