Department of Genetics, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil.
Laboratory of Genetics and Cell Therapy - GenTe Cel, Department of Biotechnology, São Paulo State University (UNESP), Assis, Brazil.
Eur Respir Rev. 2023 Jul 26;32(169). doi: 10.1183/16000617.0223-2022. Print 2023 Sep 30.
COPD is a common, preventable and usually progressive disease associated with an enhanced chronic inflammatory response in the airways and lung, generally caused by exposure to noxious particles and gases. It is a treatable disease characterised by persistent respiratory symptoms and airflow limitation due to abnormalities in the airways and/or alveoli. COPD is currently the third leading cause of death worldwide, representing a serious public health problem and a high social and economic burden. Despite significant advances, effective clinical treatments have not yet been achieved. In this scenario, cell-based therapies have emerged as potentially promising therapeutic approaches. However, there are only a few published studies of cell-based therapies in human patients with COPD and a small number of ongoing clinical trials registered on clinicaltrials.gov Despite the advances and interesting results, numerous doubts and questions remain about efficacy, mechanisms of action, culture conditions, doses, timing, route of administration and conditions related to homing and engraftment of the infused cells. This article presents the state of the art of cell-based therapy in COPD. Clinical trials that have already been completed and with published results are discussed in detail. We also discuss the questions that remain unanswered about cell-based regenerative and translational medicine for COPD.
COPD 是一种常见的、可预防的、通常呈进行性发展的疾病,与气道和肺部的慢性炎症反应增强有关,通常由接触有害颗粒和气体引起。它是一种可治疗的疾病,其特征是持续性呼吸道症状和气流受限,这是由于气道和/或肺泡的异常所致。COPD 目前是全球第三大致死原因,是一个严重的公共卫生问题,也是一个高社会和经济负担。尽管取得了重大进展,但尚未实现有效的临床治疗。在这种情况下,基于细胞的疗法已成为有前途的治疗方法。然而,在 COPD 人类患者中,只有少数关于细胞疗法的已发表研究,并且在 clinicaltrials.gov 上注册的正在进行的临床试验数量较少。尽管取得了进展和有趣的结果,但关于疗效、作用机制、培养条件、剂量、时间、给药途径以及与输注细胞归巢和植入相关的条件,仍存在许多疑问和问题。本文介绍了 COPD 中基于细胞的治疗的最新进展。详细讨论了已经完成并公布结果的临床试验。我们还讨论了 COPD 的基于细胞的再生和转化医学中仍然存在的未解决的问题。