The following is a summary of “Potential application of mesenchymal stromal cells as a new therapeutic approach in acute respiratory distress syndrome and pulmonary fibrosis,” published in the April 2024 issue of Pulmonology by Gazzaniga et al.
As the global investigation into the COVID-19 pandemic and its repercussions continues, the emergence of post-inflammatory pulmonary fibrosis (PF) as a lingering consequence of acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection has garnered significant attention. However, therapeutic options for individuals afflicted with ARDS and PF remain notably limited, often failing to offer substantial improvements in patient outcomes. Presently, lung transplantation stands as the sole definitive treatment for end-stage PF, underscoring the urgent need for alternative therapeutic avenues. In recent years, a burgeoning body of preclinical and clinical research has highlighted the potential of allogeneic mesenchymal stromal cells (MSCs) as a promising therapeutic modality for various lung disorders.
Against the backdrop of the COVID-19 pandemic, investigations into the utility of MSC-based interventions for ARDS treatment and PF prevention have gained momentum. Within the timeframe spanning April 2020 to April 2022, the institution administered up to two same-dose infusions of third-party allogeneic bone marrow-derived MSCs (BM-MSCs) intravenously, 15 days apart, to six adult patients presenting with moderate COVID-19-related ARDS in the late proliferative stage. Notably, no major adverse events were recorded following MSC therapy. Of the six patients, four completed the treatment regimen and subsequently achieved discharge from the intensive care unit (ICU). Conversely, two patients received only a single dose of MSCs due to the onset of multiorgan dysfunction syndrome (MODS) and subsequent mortality. Encouragingly, all four survivors exhibited enhanced gas exchange parameters, as evidenced by improvements in the PaO2/FiO2 ratio surpassing 200, a stark contrast to their counterparts.
Additionally, distinct trends in lactate dehydrogenase (LDH) levels post-MSC therapy were observed between survivors and non-survivors, further underscoring the potential therapeutic efficacy of MSCs in this context. While continued investigation and collaborative efforts are imperative, the consistent demonstration of MSC therapy’s safety profile and its potential to mitigate ARDS and forestall PF progression represent promising strides toward novel therapeutic strategies in these challenging clinical scenarios.
Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02795-1