Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position

Diana Álvarez,1,2 Melanie Levine,1 Mauricio Rojas1–3 1Dorothy P and Richard P Simmons Center for Interstitial Lung Disease, 2Pulmonary, Allergy, and Critical Care Medicine, 3McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA...

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Autores principales:	Álvarez D, Levine M, Rojas M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Cytology QH573-671
Acceso en línea:	https://doaj.org/article/517cbed9b1b74d7584fd16df60f4dc27
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spelling	oai:doaj.org-article:517cbed9b1b74d7584fd16df60f4dc272021-12-02T00:49:54ZRegenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position1178-6957https://doaj.org/article/517cbed9b1b74d7584fd16df60f4dc272015-04-01T00:00:00Zhttp://www.dovepress.com/regenerative-medicine-in-the-treatment-of-idiopathic-pulmonary-fibrosi-peer-reviewed-article-SCCAAhttps://doaj.org/toc/1178-6957Diana Álvarez,1,2 Melanie Levine,1 Mauricio Rojas1–3 1Dorothy P and Richard P Simmons Center for Interstitial Lung Disease, 2Pulmonary, Allergy, and Critical Care Medicine, 3McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Abstract: Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible disease of the lung that has no lasting option for therapy other than transplantation. It is characterized by replacement of the normal lung tissue by fibrotic scarring, honeycombing, and increased levels of myofibroblasts. The underlying causes of IPF are still largely unknown. The focus of the current review is the possible use of stem cell therapy, specifically mesenchymal stem cells (MSCs), a multipotent stromal cell population, which have demonstrated promising data in multiple animal models of pulmonary fibrosis (PF). The most studied source of MSCs is the bone marrow, although they can be found also in the adipose tissue and umbilical cord, as well as in the placenta. MSCs have immunomodulatory and tissue-protective properties that allow them to manipulate the local environment of the injured tissue, ameliorating the inflammation and promoting repair. Because IPF primarily affects older patients, the issue of aging is intrinsically linked to many aspects of the disease, including the age of the stem cells. Animal models have shown the success of MSC therapy in mitigating the fibrotic effects of bleomycin-induced PF. However, bleomycin, the most commonly used model for PF, is imperfect in mimicking IPF as it presents in humans, as the duration of the illness is not parallel or reversible, and honeycombing is not produced. Furthermore, the time of MSC dosage has proven to be critical in determining whether the cells will ultimately have a positive or negative effect on disease progression, since it has been demonstrated that the maximal beneficial effect of MSCs occurs during the early inflammatory phase of the disease and that there is no or negative effect during the late fibrotic phase. Therefore, all the current clinical trials of MSCs and IPF, though promising, should proceed with caution as we move toward true stem cell therapy for this disease. Keywords: aging, cell therapy, idiopathic pulmonary fibrosis, lung disease, lung fibrosis, mesenchymal stem cellsÁlvarez DLevine MRojas MDove Medical PressarticleCytologyQH573-671ENStem Cells and Cloning: Advances and Applications, Vol 2015, Iss default, Pp 61-65 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cytology QH573-671
spellingShingle	Cytology QH573-671 Álvarez D Levine M Rojas M Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
description	Diana Álvarez,1,2 Melanie Levine,1 Mauricio Rojas1–3 1Dorothy P and Richard P Simmons Center for Interstitial Lung Disease, 2Pulmonary, Allergy, and Critical Care Medicine, 3McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Abstract: Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible disease of the lung that has no lasting option for therapy other than transplantation. It is characterized by replacement of the normal lung tissue by fibrotic scarring, honeycombing, and increased levels of myofibroblasts. The underlying causes of IPF are still largely unknown. The focus of the current review is the possible use of stem cell therapy, specifically mesenchymal stem cells (MSCs), a multipotent stromal cell population, which have demonstrated promising data in multiple animal models of pulmonary fibrosis (PF). The most studied source of MSCs is the bone marrow, although they can be found also in the adipose tissue and umbilical cord, as well as in the placenta. MSCs have immunomodulatory and tissue-protective properties that allow them to manipulate the local environment of the injured tissue, ameliorating the inflammation and promoting repair. Because IPF primarily affects older patients, the issue of aging is intrinsically linked to many aspects of the disease, including the age of the stem cells. Animal models have shown the success of MSC therapy in mitigating the fibrotic effects of bleomycin-induced PF. However, bleomycin, the most commonly used model for PF, is imperfect in mimicking IPF as it presents in humans, as the duration of the illness is not parallel or reversible, and honeycombing is not produced. Furthermore, the time of MSC dosage has proven to be critical in determining whether the cells will ultimately have a positive or negative effect on disease progression, since it has been demonstrated that the maximal beneficial effect of MSCs occurs during the early inflammatory phase of the disease and that there is no or negative effect during the late fibrotic phase. Therefore, all the current clinical trials of MSCs and IPF, though promising, should proceed with caution as we move toward true stem cell therapy for this disease. Keywords: aging, cell therapy, idiopathic pulmonary fibrosis, lung disease, lung fibrosis, mesenchymal stem cells
format	article
author	Álvarez D Levine M Rojas M
author_facet	Álvarez D Levine M Rojas M
author_sort	Álvarez D
title	Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
title_short	Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
title_full	Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
title_fullStr	Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
title_full_unstemmed	Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
title_sort	regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/517cbed9b1b74d7584fd16df60f4dc27
work_keys_str_mv	AT alvarezd regenerativemedicineinthetreatmentofidiopathicpulmonaryfibrosiscurrentposition AT levinem regenerativemedicineinthetreatmentofidiopathicpulmonaryfibrosiscurrentposition AT rojasm regenerativemedicineinthetreatmentofidiopathicpulmonaryfibrosiscurrentposition
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Regenerative medicine in the treatment of idiopathic pulmonary fibrosis: current position

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