Stem cell therapy: the great promise in lung disease
Therapeutic Advances in Respiratory Disease
Therapeutic Advances in Respiratory Disease (2008) 2(3) 173–177 DOI: 10.1177/ 175346580809234
Dario Siniscalco, Nikol Sullo, Sabatino Maione, Francesco Rossi and Bruno D’Agostino
Lung injuries are leading causes of morbidity and mortality worldwide. Pulmonary diseases such as asthma or chronic obstructive pulmonary disease characterized by loss of lung elasticity, small airway tethers, and luminal obstruction with inflammatory mucoid secretions, or idiopathic pulmonary fibrosis characterized by excessive matrix deposition and destruction of the normal lung architecture, have essentially symptomatic treatments and their management is costly to the health care system.
Regeneration of tissue by stem cells from endogenous, exogenous, and even genetically modified cells is a promising novel therapy. The use of adult stem cells to help with lung regeneration and repair could be a newer technology in clinical and regenerative medicine. In fact, different studies have shown that bone marrow progenitor cells contribute to repair and remodeling of lung in animal models of progressive pulmonary hypertension.
Therefore, lung stem cell biology may provide novel approaches to therapy and could represent a great promise for the future of molecular medicine. In fact, several diseases can be slowed or even blocked by stem cell transplantation.
Overall, stem cell therapy could show some problems: side effects, bacterial, and viral infections carried by the donor cells, allergic reactions. For example, Streptococcus pneumoniae (S. pneumoniae) may cause severe and lethal infections months and years following SCT, especially in allogeneic patients, and particularly those with GVHD (Benjamin et al. 2002; Engelhard et al. 2002; Runde et al. 2001).
Moreover, Bronchiolitis obliterans organizing pneumonia (BOOP) has been reported following hematopoietic stem cell (HSC) transplantation (Hildebrandt et al. 2008). Histologic BOOP may be idiopathic or it may be associated with bacterial and viral infections, drugs, collagen vascular diseases, aspiration, irradiation, inflam- matory bowel disease, myelodysplastic syndrome, common variable immunodeficiency syndrome, and lung transplantation (Freudenberger et al.2003). However, there remains little information about the clinical presentation of BOOP in this population, and the risk factors for the development of this condition have not been defined and quantified in an analytic study. Therefore, deep and exhaustive studies to find out the exact biology of stem cells are absolutely needed in the near future for a better use of these stem cells in regenerative medicine, as well as in lung disease treatment.