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间充质干细胞疗法在治疗肺纤维化中的应用:一项范围综述

The Application of Mesenchymal Stem Cell Therapy in Treating Pulmonary Fibrosis: A Scoping Review.

作者信息

Silverstein Elena, Richmann Michael, Tyl Delaney, Fiaoni Ashley, Pfeifer Kylie, Moussa Hadi, Treacy Alysia, Vigliotta Mathew, Schepps Michael, Sheth Reena, Barry Patrick

机构信息

Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

出版信息

Cureus. 2024 Nov 27;16(11):e74611. doi: 10.7759/cureus.74611. eCollection 2024 Nov.

Abstract

Pulmonary fibrosis (PF) is a medical condition that affects the lungs and causes scarring due to the deposition of excess fibrotic tissue. This is often preceded by various causes and can lead to long-term health consequences. The treatment of PF using mesenchymal stem cells (MSCs) to correct lung damage and decrease inflammation is a current focus of research. MSCs are beneficial in inhibiting the immune response and inducing more efficient repair processes, therefore having the potential to be useful in various settings. This review aims to identify the current utilization of MSCs in treating PF in adults. A systematic search was conducted according to the Joanna Briggs Institute Reviewers Manual using Ovid Medline, Embase, and Web of Science to identify studies. Following PRISMA guidelines, eligible peer-reviewed studies that used MSCs to treat adults with PF were identified. The initial search produced 1,836 articles after removing duplicates. Twenty-nine articles met the inclusion criteria. A final analysis of the articles further narrowed the number to eight articles that met all criteria and were relevant to the scoping review's objective. Four studies utilized bone marrow-derived MSCs, two utilized umbilical-derived MSCs, one utilized placenta-derived MSCs, and one utilized adipose-derived MSCs. Of these studies, five administered treatments via an intravenous infusion, two used an endobronchial infusion, and the last utilized an intratracheal approach. The use of MSCs in the treatment of PF in adults was found to be safe with the most common adverse effect reported being fever and chills which resolved a few hours after administration. Although the research regarding MSC use in the treatment of idiopathic PF is relatively new, our results summarize the current sources, route of administration, and current adverse effects. We have shown that future studies with larger sample sizes should be performed to determine long-term outcomes and overall efficacy before clinical practice guidelines become implemented.

摘要

肺纤维化(PF)是一种影响肺部的病症,由于过量纤维化组织的沉积而导致瘢痕形成。这通常由多种原因引发,并可能导致长期健康问题。利用间充质干细胞(MSC)治疗PF以修复肺损伤和减轻炎症是当前的研究重点。MSC有助于抑制免疫反应并诱导更有效的修复过程,因此在多种情况下都具有潜在的应用价值。本综述旨在确定目前MSC在治疗成人PF中的应用情况。根据乔安娜·布里格斯研究所评审手册,使用Ovid Medline、Embase和Web of Science进行系统检索以识别相关研究。遵循PRISMA指南,确定了使用MSC治疗成人PF的符合条件的同行评审研究。初步检索在去除重复项后产生了1836篇文章。29篇文章符合纳入标准。对这些文章的最终分析进一步将数量缩小至8篇符合所有标准且与范围综述目标相关的文章。4项研究使用了骨髓来源的MSC,2项使用了脐带来源的MSC,1项使用了胎盘来源的MSC,1项使用了脂肪来源的MSC。在这些研究中,5项通过静脉输注进行治疗,2项使用支气管内输注,最后1项采用气管内给药方法。发现使用MSC治疗成人PF是安全的,报告的最常见不良反应是发热和寒战,在给药后数小时内消退。尽管关于MSC用于治疗特发性PF的研究相对较新,但我们的结果总结了目前的来源、给药途径和当前的不良反应。我们已经表明,在实施临床实践指南之前,应进行更大样本量的未来研究以确定长期结果和总体疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9a5/11678155/7eb3c956f6e3/cureus-0016-00000074611-i01.jpg

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