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



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.


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.


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.


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.


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



Acute lung injury


Acute respiratory distress syndrome


Adult stem cells


Bone marrow-derived mononuclear cells


Chronic obstructive pulmonary disease


Embryonic stem cells


Fluorescence-activated cell sorting


Fibroblast growth factor-2


Granulocyte colony-stimulating factor


Granulocyte-monocyte colony-stimulating factor


Hepatocyte growth factor


Hematopoietic stem cells


Insulin-like factor-1




Keratinocyte growth factor


Multipotent adult progenitor cells


Mesenchymal stem cells


Progenitor cells


Platelet-derived stem cells


Stromal cell-derived factor-1α


Secondary lymphoid chemokine


Tumor necrosis factor-α


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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