Division of Pulmonary, Critical Care, and Sleep, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ.
Memorial Sloan Kettering Cancer Center, New York, NY.
Chest. 2021 Oct;160(4):1271-1281. doi: 10.1016/j.chest.2021.04.020. Epub 2021 Apr 21.
COPD is a chronic inflammatory and destructive disease characterized by progressive decline in lung function that can accelerate with aging. Preclinical studies suggest that mesenchymal stem cells (MSCs) may provide a therapeutic option for this incurable disease because of their antiinflammatory, reparative, and immunomodulatory properties. To date, clinical trials using MSCs demonstrate safety in patients with COPD. However, because of the notable absence of large, multicenter randomized trials, no efficacy or evidence exists to support the possibility that MSCs can restore lung function in patients with COPD. Unfortunately, the investigational status of cell-based interventions for lung diseases has not hindered the propagation of commercial businesses, exploitation of the public, and explosion of medical tourism to promote unproven and potentially harmful cell-based interventions for COPD in the United States and worldwide. Patients with COPD constitute the largest group of patients with lung disease flocking to these unregulated clinics. This review highlights the numerous questions and concerns that remain before the establishment of cell-based interventions as safe and efficacious treatments for patients with COPD.
COPD 是一种慢性炎症性和破坏性疾病，其特征是肺功能进行性下降，这种下降会随着年龄的增长而加速。临床前研究表明，间充质干细胞（MSCs）由于具有抗炎、修复和免疫调节特性，可能为这种无法治愈的疾病提供一种治疗选择。迄今为止，使用间充质干细胞的临床试验已证明在 COPD 患者中是安全的。然而，由于缺乏大型、多中心随机试验，尚无疗效或证据表明 MSCs 可以恢复 COPD 患者的肺功能。不幸的是，细胞干预肺病的研究状况并没有阻碍商业企业的传播、对公众的利用以及医疗旅游的爆发，这些都在促进未经证实且可能对 COPD 有害的细胞干预在美国和全球范围内的应用。COPD 患者构成了涌向这些不受监管的诊所的最大一组肺病患者群体。本综述强调了在将细胞干预作为 COPD 患者安全有效的治疗方法确立之前，仍存在许多悬而未决的问题和担忧。
