Thébaud Bernard
Regenerative Medicine Program, The Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Neonatology, Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO) and CHEO Research Institute, Ottawa, Ontario, Canada.
Semin Perinatol. 2023 Apr;47(3):151724. doi: 10.1016/j.semperi.2023.151724. Epub 2023 Mar 12.
Lung diseases are a main cause of mortality and morbidity in neonates. Despite major breakthroughs, therapies remain supportive and, in some instances, contribute to lung injury. Because the neonatal lung is still developing, the ideal therapy should be capable of preventing/repairing lung injury while at the same time, promoting lung growth. Cell-based therapies hold high hopes based on laboratory experiments in animal models of neonatal lung injury. Mesenchymal stromal cells and amnion epithelial cells are now in early phase clinical trials to test the feasibility, safety and early signs of efficacy in preterm infants at risk of developing bronchopulmonary dysplasia. Other cell-based therapies are being explored in experimental models of congenital diaphragmatic hernia and alveolar capillary dysplasia. This review will summarize current evidence that has lead to the clinical translation of cell-based therapies and highlights controversies and the numerous questions that remain to be addressed to harness the putative repair potential of cell-based therapies.
肺部疾病是新生儿死亡和发病的主要原因。尽管取得了重大突破,但治疗方法仍以支持性治疗为主,在某些情况下,还会导致肺损伤。由于新生儿肺仍在发育,理想的治疗方法应能够预防/修复肺损伤,同时促进肺生长。基于新生儿肺损伤动物模型的实验室实验,细胞疗法寄予了厚望。间充质基质细胞和羊膜上皮细胞目前正处于早期临床试验阶段,以测试对有发生支气管肺发育不良风险的早产儿的可行性、安全性和早期疗效迹象。其他基于细胞的疗法正在先天性膈疝和肺泡毛细血管发育不良的实验模型中进行探索。本综述将总结目前已导致细胞疗法临床转化的证据,并突出争议以及为利用细胞疗法的假定修复潜力仍有待解决的众多问题。