Stem Cells and Cell Therapies in Lung Biology and Lung Diseases
Vermont Stem Cell Conference
Proc Am Thorac Soc Vol 8. pp 223–272, 2011 DOI: 10.1513/pats.201012-071DW
Internet address: www.atsjournals.org
Daniel J. Weiss1, Ivan Bertoncello2, Zea Borok3, Carla Kim4, Angela Panoskaltsis-Mortari5, Susan Reynolds6, Mauricio Rojas7, Barry Stripp8, David Warburton9, and Darwin J. Prockop10
1University of Vermont College of Medicine, Burlington, Vermont; 2University of Melbourne, Victoria, Australia; 3University of Southern California, Los Angeles, California; 4Boston Children’s Hospital, Boston, MA; 5University of Minnesota, Minneapolis, MN; 6National Jewish Health, Denver, CO;7University of Pittsburgh, Pittsburgh, PA; 8Duke University Medical Center, Durham, NC; 9Children’s Hospital of Loas Angeles, Los Angeles, CA; and 10Texas A&M Health Science Center, Temple, TX
Background: Experimental data suggest that transplantation of EPCs attenuates monocrotaline-induced pulmonary hypertension in rats and dogs. In addition, clinical studies suggest that autologous progenitor cell transplantation is feasible and safe in patients with ischemic diseases.
Methods: We conducted a prospective, randomized trial comparing the effects of EPC transplantation plus conventional therapy with those of conventional therapy alone in patients with IPAH. The primary end point was change in the 6-minute- walk distance using a standardized protocol. The secondary end points were changes in hemodynamic variables as assessed by right heart catheterization.
Results: After 12 weeks of follow-up, the mean distance walked in 6 minutes increased by 48.2 m in the cell infusion group (from 263 6 42 m to 312 6 34 m), and an increase of 5.7 m occurred in the conventional therapy group (from264 6 42 m to 270 6 44 m). The mean difference between the two groups was 42.5 m (95% confidence interval 28.7 to 56.3 m, P , 0.001). The patients in the cell infusion group also had significant improvement in mean pulmonary artery pressure, pulmonary vascular resistance, and cardiac output. There were
no severe adverse events with cell infusion.
This preliminary study showed that intravenous infusion of autologous EPCs seemed to be feasible and safe, and might have beneficial effects on exercise capacity and pulmonary hemodynamics in patients with IPAH.