Intensive Care Medicine

, Volume 37, Issue 9, pp 1421–1431 | Cite as

Mechanisms of cellular therapy in respiratory diseases

  • Soraia C. Abreu
  • Mariana A. Antunes
  • Paolo Pelosi
  • Marcelo M. Morales
  • Patricia R. M. Rocco
Review

Abstract

Purpose

Stem cells present a variety of clinical implications in the lungs. According to their origin, these cells can be divided into embryonic and adult stem cells; however, due to the important ethical and safety limitations that are involved in the embryonic stem cell use, most studies have chosen to focus on adult stem cell therapy. This article aims to present and clarify the recent advances in the field of stem cell biology, as well as to highlight the effects of mesenchymal stem cell (MSC) therapy in the context of acute lung injury/acute respiratory distress syndrome and chronic disorders such as lung fibrosis and chronic obstructive pulmonary disease.

Methods

For this purpose, we performed a critical review of adult stem cell therapies, covering the main clinical and experimental studies published in Pubmed databases in the past 11 years. Different characteristics were extracted from these articles, such as: the experimental model, strain, cellular type and administration route used as well as the positive or negative effects obtained.

Results

There is evidence for beneficial effects of MSC on lung development, repair, and remodeling. The engraftment in the injured lung does not occur easily, but several studies report that paracrine factors can be effective in reducing inflammation and promoting tissue repair. MSC releases several growth factors and anti-inflammatory cytokines that regulate endothelial and epithelial permeability and reduce the severity of inflammation.

Conclusion

A better understanding of the mechanisms that control cell division and differentiation, as well as of their paracrine effects, is required to enable the optimal use of bone marrow-derived stem cell therapy to treat human respiratory diseases.

Keywords

Bone marrow Acute respiratory distress syndrome Chronic obstructive pulmonary disease Fibrosis Paracrine effects Tissue repair 

Abbreviations

ALI

Acute lung injury

ARDS

Acute respiratory distress syndrome

ASC

Adult stem cells

BMDMC

Bone marrow-derived mononuclear cells

COPD

Chronic obstructive pulmonary disease

ESC

Embryonic stem cells

FACS

Fluorescence-activated cell sorting

FGF-2

Fibroblast growth factor-2

G-CSF

Granulocyte colony-stimulating factor

GM-CSF

Granulocyte-monocyte colony-stimulating factor

HGF

Hepatocyte growth factor

HSC

Hematopoietic stem cells

IGF-1

Insulin-like factor-1

IFN-γ

Interferon-γ

KGF

Keratinocyte growth factor

MAPC

Multipotent adult progenitor cells

MSC

Mesenchymal stem cells

PC

Progenitor cells

PDGF

Platelet-derived stem cells

SDF-1α

Stromal cell-derived factor-1α

SLC

Secondary lymphoid chemokine

TNF-α

Tumor necrosis factor-α

VEGF

Vascular endothelial growth factor

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Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Soraia C. Abreu
    • 1
  • Mariana A. Antunes
    • 1
  • Paolo Pelosi
    • 2
  • Marcelo M. Morales
    • 3
  • Patricia R. M. Rocco
    • 1
  1. 1.Laboratório de Investigação Pulmonar, Centro de Ciências da Saúde, Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Department of Surgical Sciences and Integrated DiagnosticsUniversity of GenoaGenoaItaly
  3. 3.Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Biophysics InstituteFederal University of Rio de JaneiroRio de JaneiroBrazil

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