Abstract
Recent discoveries in stem cell biology have generated excitement about the possibility of harnessing stem cells for repair and regeneration of lung diseases. Although initial emphasis was on engraftment of stem cells in lung, more recent studies demonstrate that mesenchymal stem cells (MSCs) can modulate local inflammatory and immune responses in experimental lung disease models including acute lung injury and pulmonary fibrosis via a paracrine activity. Endothelial progenitor cells (EPCs) also seem to contribute to lung repair and are used in clinical trials for the treatment of pulmonary hypertension. The ability to produce stem cells by induced pluripotency may relieve many ethical concerns related to the use of embryonic stem cells and may open the way to large-scale production and evaluation of pluripotent stem cells for lung regeneration and repair. The aim of this review is to provide a summary of the recent progress made in the field of lung regeneration using different approaches including stem cell-based therapy and lung tissue bioengineering.
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Abe S et al (2003) Transplanted BM and BM side population cells contribute progeny to the lung and liver in irradiated mice. Cytotherapy 5:523–533
Abe S et al (2004) Cells derived from the circulation contribute to the repair of lung injury. Am J Respir Crit Care Med 170:1158–1163
Adamson IY, Bowden DH (1974) The type 2 cell as progenitor of alveolar epithelial regeneration. A cytodynamic study in mice after exposure to oxygen. Lab Invest 30:35–42
Aguilar S et al (2007) Murine but not human mesenchymal stem cells generate osteosarcoma-like lesions in the lung. Stem Cells 25(6):1586–1594
Alison MR, Lebrenne AC, Islam S (2009) Stem cells and lung cancer: future therapeutic targets? Expert Opin Biol Ther 9:1127–1141
Alvarez DF et al (2008) Lung microvascular endothelium is enriched with progenitor cells that exhibit vasculogenic capacity. Am J Physiol Lung Cell Mol Physiol 294(3):L419–L430
Amariglio N et al (2009) Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient. PLoS Med 6(2):e1000029
Aslam M et al (2009) Bone marrow stromal cells attenuate lung injury in a murine model of neonatal chronic lung disease. Am J Respir Crit Care Med 180(11):1122–1130. doi:10.1164/rccm.200902-0242OC
Atala A (2007) Engineering tissues, organs and cells. J Tissue Eng Regen Med 1(2):83–96
Balasubramaniam V et al (2007) Hyperoxia reduces bone marrow, circulating, and lung endothelial progenitor cells in the developing lung: implications for the pathogenesis of bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol 292:L1073–L1084
Barrilleaux B et al (2006) Review: ex vivo engineering of living tissues with adult stem cells. Tissue Eng 12(11):3007–3019
Bertolini G et al (2009) Highly tumorigenic lung cancer CD133+ cells display stem-like features and are spared by cisplatin treatment. Proc Natl Acad Sci USA 106:16281–16286
Bertoncello I, McQualter J (2010) Endogenous lung stem cells: what is their potential for use in regenerative medicine? Expert Rev Respir Med 4(3):349–362
Block GJ et al (2009) Multipotent stromal cells are activated to reduce apoptosis in part by upregulation and secretion of stanniocalcin-1. Stem Cells 27(3):670–681
Borthwick DW et al (2001) Evidence for stem-cell niches in the tracheal epithelium. Am J Respir Cell Mol Biol 24(6):662–670
Bruscia EM et al (2009) Macrophages directly contribute to the exaggerated inflammatory response in cystic fibrosis transmembrane conductance regulator−/− mice. Am J Respir Cell Mol Biol 40(3):295–304
Burnham EL et al (2005) Increased circulating endothelial progenitor cells are associated with survival in acute lung injury. Am J Respir Crit Care Med 172(7):854–860
Burri PH (2006) Structural aspects of postnatal lung development – alveolar formation and growth. Biol Neonate 89(4):313–322
Cardoso WV, Whitsett JA (2008) Resident cellular components of the lung: developmental aspects. Proc Am Thorac Soc 5:767–771
Coraux C et al (2005) Embryonic stem cells generate airway epithelial tissue. Am J Respir Cell Mol Biol 32(2):87–92
Crain BJ, Tran SD, Mezey E (2005) Transplanted human bone marrow cells generate new brain cells. J Neurol Sci 233(1–2):121–123
Crystal RG et al (2008) Airway epithelial cells: current concepts and challenges. Proc Am Thorac Soc 5:772–777
Danto SI et al (1995) Reversible transdifferentiation of alveolar epithelial cells. Am J Respir Cell Mol Biol 12(5):497–502
Deb A et al (2003) Bone marrow-derived cardiomyocytes are present in adult human heart: a study of gender-mismatched bone marrow transplantation patients. Circulation 107(9):1247–1249
Dominici M et al (2006) Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy 8(4):315–317
Dovey JS et al (2008) Bmi1 is critical for lung tumorigenesis and bronchioalveolar stem cell expansion. Proc Natl Acad Sci USA 105:11857–11862
Eramo A et al (2007) Identification and expansion of the tumorigenic lung cancer stem cell population. Cell Death Differ 15:504–514
Fadini GP et al (2006) Circulating progenitor cells are reduced in patients with severe lung disease. Stem Cells 24(7):1806–1813
Fadini GP et al (2007) The emerging role of endothelial progenitor cells in pulmonary hypertension and diffuse lung diseases. Sarcoidosis Vasc Diffuse Lung Dis 24:85–93
Fischer S et al (2006) Bridge to lung transplantation with the novel pumpless interventional lung assist device NovaLung. J Thorac Cardiovasc Surg 131(3):719–723
Gao D, Mittal V (2009) The role of bone-marrow-derived cells in tumor growth, metastasis initiation and progression. Trends Mol Med 15:333–343
Giangreco A, Reynolds SD, Stripp BR (2002) Terminal bronchioles harbor a unique airway stem cell population that localizes to the bronchoalveolar duct junction. Am J Pathol 161:173–182
Giangreco A et al (2004) Molecular phenotype of airway side population cells. Am J Physiol Lung Cell Mol Physiol 286(4):L624–L630
Giangreco A, Groot KR, Janes SM (2007) Lung cancer and lung stem cells: strange bedfellows? Am J Respir Crit Care Med 175:547–553
Gomperts BN, Strieter RM (2007) Stem cells and chronic lung disease. Annu Rev Med 58:285–298
Gupta N et al (2007) Intrapulmonary delivery of bone marrow-derived mesenchymal stem cells improves survival and attenuates endotoxin-induced acute lung injury in mice. J Immunol 179:1855–1863
Hildebrandt GC et al (2008) Recipient NOD2/CARD15 variants: a novel independent risk factor for the development of bronchiolitis obliterans after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 14(1):67–74
Hong KU et al (2001) Clara cell secretory protein-expressing cells of the airway neuroepithelial body microenvironment include a label-retaining subset and are critical for epithelial renewal after progenitor cell depletion. Am J Respir Cell Mol Biol 24(6):671–681
Huh D et al (2010) Reconstituting organ-level lung functions on a chip. Science 328(5986):1662–1668
Hung SC et al (2007) Angiogenic effects of human multipotent stromal cell conditioned medium activate the PI3K-Akt pathway in hypoxic endothelial cells to inhibit apoptosis, increase survival, and stimulate angiogenesis. Stem Cells 25(9):2363–2370
Ingemansson R et al (2009) Clinical transplantation of initially rejected donor lungs after reconditioning ex vivo. Ann Thorac Surg 87(1):255–260
Ingram DA, Caplice NM, Yoder MC (2005) Unresolved questions, changing definitions, and novel paradigms for defining endothelial progenitor cells. Blood 106(5):1525–1531
Ionescu LI et al (2012a) Airway delivery of soluble factors from plastic-adherent bone marrow cells prevents murine asthma. Am J Respir Cell Mol Biol 46(2):207–216
Ionescu L et al (2012b) Stem cell conditioned medium improves acute lung injury in mice: in vivo evidence for stem cell paracrine action. Am J Physiol Lung Cell Mol Physiol 303(11):L967–977
Irwin D et al (2007) Neonatal lung side population cells demonstrate endothelial potential and are altered in response to hyperoxia-induced lung simplification. Am J Physiol Lung Cell Mol Physiol 293(4):L941–L951
Ishizawa K, Kubo H, Yamada M et al (2004a) Bone marrow-derived cells contribute to lung regeneration after elastase-induced pulmonary emphysema. FEBS Lett 556:249–252
Ishizawa K, Kubo H, Yamada M et al (2004b) Hepatocyte growth factor induces angiogenesis in injured lungs through mobilizing endothelial progenitor cells. Biochem Biophys Res Commun 324:276–280
Iyer SS, Rojas M (2008) Anti-inflammatory effects of mesenchymal stem cells: novel concept for future therapies. Expert Opin Biol Ther 8:569–581
Johnson L et al (2001) Somatic activation of the K-ras oncogene causes early onset lung cancer in mice. Nature 410:1111–1116
JunHui Z et al (2008) Reduced number and activity of circulating endothelial progenitor cells in patients with idiopathic pulmonary arterial hypertension. Respir Med 102:1073–1079
Kajstura J et al (2011) Evidence for human lung stem cells. N Engl J Med 364(19):1795–1806
Kim CF (2007) Paving the road for lung stem cell biology: bronchioalveolar stem cells and other putative distal lung stem cells. Am J Physiol Lung Cell Mol Physiol 293:L1092–L1098
Kim CFB et al (2005) Identification of bronchioalveolar stem cells in normal lung and lung cancer. Cell 121:823–835
Kitaoka H, Burri PH, Weibel ER (1996) Development of the human fetal airway tree: analysis of the numerical density of airway endtips. Anat Rec 244:207–213
Kotton DN et al (2001) Bone marrow-derived cells as progenitors of lung alveolar epithelium. Development 128:5181–5188
Krause DS et al (2001) Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem cell. Cell 105:369–377
Kunig AM (2005) Recombinant human VEGF treatment enhances alveolarization after hyperoxic lung injury in neonatal rats. Am J Physiol Lung Cell Mol Physiol 289:L529–L535
Lane S, Rippon HJ, Bishop AE (2007) Stem cells in lung repair and regeneration. Regen Med 2(4):407–415
Le Blanc K et al (2008) Mesenchymal stem cells for treatment of steroid-resistant, severe, acute graft-versus-host disease: a phase II study. Lancet 371:1579–1586
Lee JW et al (2009) Allogeneic human mesenchymal stem cells for treatment of E. coli endotoxin-induced acute lung injury in the ex vivo perfused human lung. Proc Natl Acad Sci USA 106:16357–16362
Liu X, Engelhardt JF (2008) The glandular stem/progenitor cell niche in airway development and repair. Proc Am Thorac Soc 5:682–688
Macchiarini P et al (2008) Clinical transplantation of a tissue-engineered airway. Lancet 372:2023–2030
Maeda Y, Davé V, Whitsett JA (2007) Transcriptional control of lung morphogenesis. Physiol Rev 87:219–244
Martin U (2008) Methods for studying stem cells: adult stem cells for lung repair. Methods 45:121–132
Martin J et al (2008) Adult lung side population cells have mesenchymal stem cell potential. Cytotherapy 10(2):140–151
McQualter JL et al (2010) Evidence of an epithelial stem/progenitor cell hierarchy in the adult mouse lung. Proc Natl Acad Sci USA 107(4):1414–1419
Mei SH et al (2007) Prevention of LPS-induced acute lung injury in mice by mesenchymal stem cells overexpressing angiopoietin 1. PLoS Med 4(9):e269
Mezey E et al (2003) Transplanted bone marrow generates new neurons in human brains. Proc Natl Acad Sci USA 100(3):1364–1369
Mora AL, Rojas M (2008) Aging and lung injury repair: a role for bone marrow derived mesenchymal stem cells. J Cell Biochem 105:641–647
Németh K et al (2009) Bone marrow stromal cells attenuate sepsis via prostaglandin E(2)-dependent reprogramming of host macrophages to increase their interleukin-10 production. Nat Med 15(1):42–49
Nemeth K et al (2010) Bone marrow stromal cells use TGF-beta to suppress allergic responses in a mouse model of ragweed-induced asthma. Proc Natl Acad Sci USA 107(12):5652–5657
Neuringer IP, Randell SH (2004) Stem cells and repair of lung injuries. Respir Res 5:6
Nichols JE, Cortiella J (2008) Engineering of a complex organ: progress toward development of a tissue-engineered lung. Proc Am Thorac Soc 5:723–730
Ortiz LA et al (2007) Interleukin 1 receptor antagonist mediates the antiinflammatory and antifibrotic effect of mesenchymal stem cells during lung injury. Proc Natl Acad Sci USA 104(26):11002–11007
Ortiz LA et al (2008) Mesenchymal stem cell engraftment in lung is enhanced in response to bleomycin exposure and ameliorates its fibrotic effects. Proc Natl Acad Sci USA 100:8407–8411
Ott HC et al (2010) Regeneration and orthotopic transplantation of a bioartificial lung. Nat Med 16(8):927–933
Otto WR (2002) Lung epithelial stem cells. J Pathol 197(4):527–535
Parekkadan B, van Poll D, Suganuma K et al (2007) Mesenchymal stem cell-derived molecules reverse fulminant hepatic failure. PLoS One 2(9):e941
Peacock CD, Watkins DN (2008) Cancer stem cells and the ontogeny of lung cancer. J Clin Oncol 26(17):2883–2889
Petersen TH et al (2010) Tissue-engineered lungs for in vivo implantation. Science 329(5991):538–541
Pine SR, Marshall B, Varticovski L (2008) Lung cancer stem cells. Dis Markers 24:257–266
Poulsom R et al (2001) Bone marrow contributes to renal parenchymal turnover and regeneration. J Pathol 195(2):229–235
Prockop DJ (2009) Repair of tissues by adult stem/progenitor cells (MSCs): controversies, myths, and changing paradigms. Mol Ther 17:939–946
Prockop DJ, Gregory CA, Spees JL (2003) One strategy for cell and gene therapy: harnessing the power of adult stem cells to repair tissues. Proc Natl Acad Sci USA 100(Suppl 1):11917–11923
Punch JD et al (2007) Organ donation and utilization in the United States, 1996–2005. Am J Transplant 7(5 Pt 2):1327–1338
Rawlins EL (2008) Lung epithelial progenitor cells: lessons from development. Proc Am Thorac Soc 5:675–681
Rawlins EL, Hogan BL (2006) Epithelial stem cells of the lung: privileged few or opportunities for many? Development 133(13):2455–2465
Rawlins EL et al (2008) Epithelial stem/progenitor cells in lung postnatal growth, maintenance, and repair. Cold Spring Harb Symp Quant Biol 73:291–295
Reddy R et al (2004) Isolation of a putative progenitor subpopulation of alveolar epithelial type 2 cells. Am J Physiol Lung Cell Mol Physiol 286:L658–L667
Reynolds SD et al (2000) Neuroepithelial bodies of pulmonary airways serve as a reservoir of progenitor cells capable of epithelial regeneration. Am J Pathol 156:269–278
Rippon HJ et al (2006) Derivation of distal lung epithelial progenitors from murine embryonic stem cells using a novel three-step differentiation protocol. Stem Cells 24:1389–1398
Rippon HJ, Lane S, Qin M et al (2008) Embryonic stem cells as a source of pulmonary epithelium in vitro and in vivo. Proc Am Thorac Soc 5(6):717–722
Rojas M et al (2005) Bone marrow-derived mesenchymal stem cells in the repair of the injured lung. Am J Respir Cell Mol Biol 33(2):145–152
Runde V et al (2001) Adenoviral infection after allogeneic stem cell transplantation (SCT): report on 130 patients from a single SCT unit involved in a prospective multi center surveillance study. Bone Marrow Transplant 28(1):51–57
Salnikov AV et al (2009) CD133 is indicative for a resistance phenotype but does not represent a prognostic marker for survival of non-small cell lung cancer patients. Int J Cancer. doi:10.1002/ijc.24822
Samadikuchaksaraei A, Bishop AE (2006) Derivation and characterization of alveolar epithelial cells from murine embryonic stem cells in vitro. Methods Mol Biol 330:233–248
Schoch KG et al (2004) A subset of mouse tracheal epithelial basal cells generates large colonies in vitro. Am J Physiol Lung Cell Mol Physiol 286(4):L631–L642
Serikov VB et al (2007) Evidence of temporary airway epithelial repopulation and rare clonal formation by BM-derived cells following naphthalene injury in mice. Anat Rec (Hoboken) 290:1033–1045
Siniscalco D et al (2008) Stem cell therapy: the great promise in lung disease. Ther Adv Respir Dis 2:173–177
Snyder JC, Teisanu RM, Stripp BR (2009) Endogenous lung stem cells and contribution to disease. J Pathol 217:254–264
Song JJ et al (2011) Enhanced in vivo function of bioartificial lungs in rats. Ann Thorac Surg 92(3):998–1006
Steen S et al (2007) First human transplantation of a nonacceptable donor lung after reconditioning ex vivo. Ann Thorac Surg 83:2191–2194
Stripp BR (2008) Hierarchical organization of lung progenitor cells: is there an adult lung tissue stem cell? Proc Am Thorac Soc 5:695–698
Sueblinvong V, Weiss DJ (2009) Cell therapy approaches for lung diseases: current status. Curr Opin Pharmacol 9:268–273
Summer R, Fine A (2008) Mesenchymal progenitor cell research: limitations and recommendations. Proc Am Thorac Soc 5:707–710
Summer R et al (2004) Translational physiology: origin and phenotype of lung side population cells. Am J Physiol Lung Cell Mol Physiol 287:L477–L483
Suratt BT et al (2003) Human pulmonary chimerism after hematopoietic stem cell transplantation. Am J Respir Crit Care Med 168(3):318–322
Takahashi K, Yamanaka S (2006) Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell 126:663–676
Taylor K, Holtby H (2009) Emergency interventional lung assist for pulmonary hypertension. Anesth Analg 109(2):382–385
Thébaud B et al (2005) Vascular endothelial growth factor gene therapy increases survival, promotes lung angiogenesis, and prevents alveolar damage in hyperoxia-induced lung injury: evidence that angiogenesis participates in alveolarization. Circulation 112:2477–2486
Theise ND et al (2000) Liver from bone marrow in humans. Hepatology 32(1):11–16
Tolar J et al (2007) Sarcoma derived from cultured mesenchymal stem cells. Stem Cells 25(2):371–379
Toshner M et al (2009) Evidence of dysfunction of endothelial progenitors in pulmonary arterial hypertension. Am J Respir Crit Care Med 180:780–787
van Haaften T et al (2009) Airway delivery of mesenchymal stem cells prevents arrested alveolar growth in neonatal lung injury in rats. Am J Respir Crit Care Med 180(11):1131–1142. doi:10.1164/rccm.200902-0179OC
Van Vranken BE et al (2005) Coculture of embryonic stem cells with pulmonary mesenchyme: a microenvironment that promotes differentiation of pulmonary epithelium. Tissue Eng 11(7–8):1177–1187
Varanou A, Page CP, Minger SL (2008) Human embryonic stem cells and lung regeneration. Br J Pharmacol 155:316–325
von Mach MA et al (2006) An update on interventional lung assist devices and their role in acute respiratory distress syndrome. Lung 184(3):169–175
Walles T (2007) Clinical experience with the iLA Membrane Ventilator pumpless extracorporeal lung-assist device. Expert Rev Med Devices 4(3):297–305
Wang G et al (2005) Adult stem cells from bone marrow stroma differentiate into airway epithelial cells: potential therapy for cystic fibrosis. Proc Natl Acad Sci USA 102(1):186–191
Wang D et al (2007a) A pure population of lung alveolar epithelial type II cells derived from human embryonic stem cells. Proc Natl Acad Sci USA 104(11):4449–4454
Wang XX et al (2007b) Transplantation of autologous endothelial progenitor cells may be beneficial in patients with idiopathic pulmonary arterial hypertension: a pilot randomized controlled trial. J Am Coll Cardiol 49(14):1566–1571
Warburton D et al (2001) Do lung remodeling, repair, and regeneration recapitulate respiratory ontogeny? Am J Respir Crit Care Med 164(10 Pt 2):S59–S62
Warburton D et al (2008) Stem/progenitor cells in lung development, injury repair, and regeneration. Proc Am Thorac Soc 5:703–706
Weiss DJ et al (2006) Adult stem cells, lung biology, and lung disease. NHLBI/Cystic Fibrosis Foundation workshop. Proc Am Thorac Soc 3:193–207
Weiss DJ et al (2008) Stem cells and cell therapies in lung biology and lung diseases. Proc Am Thorac Soc 5:637–667
Wetsel RA, Wang D, Calame DG (2011) Therapeutic potential of lung epithelial progenitor cells derived from embryonic and induced pluripotent stem cells. Annu Rev Med 62:95–105
Wierup P et al (2006) Ex vivo evaluation of nonacceptable donor lungs. Ann Thorac Surg 81(2):460–466
Wong AP et al (2007) Targeted cell replacement with bone marrow cells for airway epithelial regeneration. Am J Physiol Lung Cell Mol Physiol 293:L740–L752
Wong PM et al (2008) Emphysema in young adult survivors of moderate-to-severe bronchopulmonary dysplasia. Eur Respir J 32(2):321–328
Wong AP et al (2009) Identification of a bone marrow-derived epithelial-like population capable of repopulating injured mouse airway epithelium. J Clin Invest 119:336–348
World Health Organization (WHO) World Health Report (2000)
Xu J et al (2007) Prevention of endotoxin-induced systemic response by bone marrow-derived mesenchymal stem cells in mice. Am J Physiol Lung Cell Mol Physiol 293(1):L131–L141
Yagui-Beltrán A, He B, Jablons DM (2008) The role of cancer stem cells in neoplasia of the lung: past, present and future. Clin Transl Oncol 10:719–725
Yamada M et al (2004) Bone marrow-derived progenitor cells are important for lung repair after lipopolysaccharide-induced lung injury. J Immunol 172:1266–1272
Yamada M et al (2005) Increased circulating endothelial progenitor cells in patients with bacterial pneumonia: evidence that bone marrow derived cells contribute to lung repair. Thorax 60:410–413
Yanagi S et al (2007) Pten controls lung morphogenesis, bronchioalveolar stem cells, and onset of lung adenocarcinomas in mice. J Clin Invest 117:2929–2940
Yoder MC, Ingram DA (2009) Endothelial progenitor cell: ongoing controversy for defining these cells and their role in neoangiogenesis in the murine system. Curr Opin Hematol 16(4):269–273
Yoder MC et al (2007) Redefining endothelial progenitor cells via clonal analysis and hematopoietic stem/progenitor cell principals. Blood 109(5):1801–1809
Youngson C (1993) Oxygen sensing in airway chemoreceptors. Nature 365(6442):153–155
Zeltner TB, Burri PH (1987) The postnatal development and growth of the human lung. II. Morphology. Respir Physiol 67:269–282
Zhou BB et al (2009) Tumour-initiating cells: challenges and opportunities for anticancer drug discovery. Nat Rev Drug Discov 8(10):806–823
Zhu JH et al (2008) Safety and efficacy of autologous endothelial progenitor cells transplantation in children with idiopathic pulmonary arterial hypertension: open-label pilot study. Pediatr Transplant 12(6):650–655
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Ionescu, L.I., Thébaud, B., Thébaud, B. (2013). Lung. In: Steinhoff, G. (eds) Regenerative Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5690-8_34
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