Ikrama Muhammad, Usama Muhammad, Israr Shifa, Humayon Maryam
Services Institute of Medical Sciences, Department of Medicine, Lahore, Pakistan.
J Taibah Univ Med Sci. 2023 Oct 11;19(1):82-89. doi: 10.1016/j.jtumed.2023.09.009. eCollection 2024 Feb.
Pulmonary fibrosis, a chronic and fatal lung disease affecting millions of people worldwide, is characterized by the scarring of lung tissue, thereby impairing oxygen exchange between the lungs and blood. The etiology of pulmonary fibrosis is multifactorial, involving environmental exposures, comorbidities, and genetic mutations. Current pharmacological treatments can only slow the disease progression, and lung transplantation is limited by donor availability and complications. Stem cell therapy has emerged as a potential alternative treatment for pulmonary fibrosis, in which stem cells modulate the inflammatory response, differentiate into lung epithelial cells, secrete growth factors and extracellular matrix components, and enhance vascularization and tissue regeneration. Various sources of stem cells, such as endogenous lung stem cells, embryonic stem cells, induced pluripotent stem cells, and mesenchymal stem cells, have been investigated in animal models and human trials. Various delivery routes, such as intravenous injection, intratracheal instillation, and inhalation, have been tested for safety and efficacy. However, several challenges and limitations remain to be overcome, such as high costs, ethical issues, immunological compatibility, cell survival and homing, and long-term outcomes. Further research is needed to optimize the protocols and parameters in stem cell therapy for pulmonary fibrosis, and to evaluate the clinical benefits and risks for patients.
肺纤维化是一种影响全球数百万人的慢性致命性肺部疾病，其特征是肺组织瘢痕形成，从而损害肺与血液之间的氧气交换。肺纤维化的病因是多因素的，涉及环境暴露、合并症和基因突变。目前的药物治疗只能减缓疾病进展，而肺移植则受到供体可用性和并发症的限制。干细胞疗法已成为治疗肺纤维化的一种潜在替代疗法，其中干细胞可调节炎症反应、分化为肺上皮细胞、分泌生长因子和细胞外基质成分，并增强血管生成和组织再生。在动物模型和人体试验中，已经研究了多种干细胞来源，如内源性肺干细胞、胚胎干细胞、诱导多能干细胞和间充质干细胞。已经对静脉注射、气管内滴注和吸入等多种给药途径的安全性和有效性进行了测试。然而，仍有几个挑战和限制有待克服，如成本高昂、伦理问题、免疫相容性、细胞存活和归巢以及长期疗效。需要进一步研究以优化肺纤维化干细胞治疗的方案和参数，并评估患者的临床益处和风险。
