Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil.
Expert Rev Respir Med. 2023 Mar;17(3):223-235. doi: 10.1080/17476348.2023.2196015. Epub 2023 Mar 28.
Cell therapy has emerged as an alternative option for chronic lung diseases with the highest rates of morbidity and mortality rates worldwide.
This review addresses the definition of mesenchymal stromal cells (MSCs), their properties, mechanisms of action, as well as preclinical and clinical studies that have used cell therapy in chronic lung diseases such as asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, pulmonary arterial hypertension, and silicosis. Ongoing clinical trials are also presented.
Experimental evidence has shown that MSCs have immunomodulatory and regenerative properties that could rescue impaired lung function and histoarchitecture. Their beneficial effects have been mainly associated with their ability to communicate with target cells through the secretion of soluble mediators and extracellular vesicles or even through transfer of organelles (e.g. mitochondria). MSC-derived conditioned medium, extracellular vesicles and mitochondria induce beneficial effects in selected scenarios. The initial results in clinical trials were modest compared with the experimental results, therefore researchers were encouraged to move from bedside back to bench to develop new strategies able to potentiate the effects of MSCs.
细胞疗法已成为全球发病率和死亡率最高的慢性肺部疾病的一种替代治疗选择。
本文综述了间充质基质细胞（MSCs）的定义、特性、作用机制，以及在哮喘、慢性阻塞性肺疾病、特发性肺纤维化、肺动脉高压和矽肺等慢性肺部疾病中应用细胞疗法的临床前和临床研究。同时还介绍了正在进行的临床试验。
实验证据表明，MSCs 具有免疫调节和再生特性，可挽救受损的肺功能和组织学结构。它们的有益作用主要与其通过分泌可溶性介质和细胞外囊泡，甚至通过细胞器（如线粒体）转移与靶细胞进行通讯的能力有关。MSC 来源的条件培养基、细胞外囊泡和线粒体在特定情况下可诱导有益作用。与实验结果相比，临床试验的初步结果较为温和，因此鼓励研究人员从床边回到实验室，制定新的策略以增强 MSCs 的作用。
