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. 2020 Feb;36(1):83-102.
doi: 10.1007/s10565-019-09493-5. Epub 2019 Sep 4.

Current understanding of the therapeutic benefits of mesenchymal stem cells in acute respiratory distress syndrome

Miquéias Lopes-Pacheco  1   2 , Chiara Robba  3 , Patricia Rieken Macêdo Rocco  4   5 , Paolo Pelosi  6   7
Affiliations

Current understanding of the therapeutic benefits of mesenchymal stem cells in acute respiratory distress syndrome

Miquéias Lopes-Pacheco et al. Cell Biol Toxicol. 2020 Feb.

Abstract

The acute respiratory distress syndrome (ARDS) is a multifaceted lung disorder in which no specific therapeutic intervention is able to effectively improve clinical outcomes. Despite an improved understanding of molecular mechanisms and advances in supportive care strategies, ARDS remains associated with high mortality, and survivors usually face long-term morbidity. In recent years, preclinical studies have provided mounting evidence of the potential of mesenchymal stem cell (MSC)-based therapies in lung diseases and critical illnesses. In several models of ARDS, MSCs have been demonstrated to induce anti-inflammatory and anti-apoptotic effects, improve epithelial and endothelial cell recovery, and enhance microbial and alveolar fluid clearance, thus resulting in improved lung and distal organ function and survival. Early-stage clinical trials have also demonstrated the safety of MSC administration in patients with ARDS, but further, large-scale investigations are required to assess the safety and efficacy profile of these therapies. In this review, we summarize the main mechanisms whereby MSCs have been shown to exert therapeutic effects in experimental ARDS. We also highlight questions that need to be further elucidated and barriers that must be overcome in order to efficiently translate MSC research into clinical practice.

Keywords: Acute respiratory distress syndrome; Biomarkers; Cell therapy; Clinical trials; Lung; Mesenchymal stem cells; Paracrine effects.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The pathogenesis cascade of acute respiratory distress syndrome (ARDS) begins with an insult that causes disruption of alveolar-capillary integrity. The alveolar epithelium is the first structure injured in pulmonary ARDS, while endothelial cells are the first structure injured in extrapulmonary ARDS. The loss of alveolar-capillary integrity leads to increased pro-inflammatory cell infiltration, edema, and tissue remodeling, resulting in impairment of lung function
Fig. 2
Fig. 2
Summary of therapeutic benefits associated with mesenchymal stem cell therapy in experimental acute respiratory distress syndrome
See this image and copyright information in PMC

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