Department of Surgery, University Hospital Regensburg, Regensburg, Germany.
Stem Cells Transl Med. 2017 Apr;6(4):1141-1151. doi: 10.1002/sctm.16-0415. Epub 2017 Jan 9.
Despite extensive research on candidate pharmacological treatments and a significant and increasing prevalence, sepsis syndrome, and acute respiratory distress syndrome (ARDS) remain areas of unmet clinical need. Preclinical studies examining mesenchymal stromal cell (MSCs) based-therapies have provided compelling evidence of potential benefit; however, the precise mechanism by which MSCs exert a therapeutic influence, and whether MSC application is efficacious in humans, remains unknown. Detailed evaluation of the limited number of human trials so far completed is further hampered as a result of variations in trial design and biomarker selection. This review provides a concise summary of current preclinical and clinical knowledge of MSCs as a cell therapy for sepsis syndrome and ARDS. The challenges of modeling such heterogeneous and rapidly progressive disease states are considered and we discuss how lessons from previous studies of pharmacological treatments for sepsis syndrome and ARDS might be used to inform and refine the design of the next generation of MSC clinical trials. Stem Cells Translational Medicine 2017;6:1141-1151.
尽管针对候选药物治疗方法进行了广泛的研究,并且脓毒症综合征和急性呼吸窘迫综合征 (ARDS) 的发病率显著增加,但这些疾病仍然存在临床需求未得到满足的情况。对间充质基质细胞 (MSCs) 为基础的治疗方法的临床前研究提供了令人信服的潜在获益证据;然而,MSC 发挥治疗作用的确切机制,以及 MSC 应用在人体中的疗效,仍然未知。由于试验设计和生物标志物选择的差异,对迄今为止完成的为数不多的人类试验进行详细评估进一步受到阻碍。本文简要综述了 MSCs 作为脓毒症综合征和 ARDS 细胞治疗的临床前和临床知识。考虑到对这种异质性和快速进展性疾病状态进行建模的挑战,我们讨论了如何利用脓毒症综合征和 ARDS 药物治疗的先前研究中的经验教训来为下一代 MSC 临床试验的设计提供信息并加以改进。《干细胞转化医学》2017 年;6:1141-1151.