Stem Cell Treatment for COPD: A New Frontier in Respiratory Medicine

COPD, or chronic obstructive pulmonary disease, is a lung condition that occurs due to airway blockage or alveolar damage. The burden of the condition has been growing over time due to rising air pollution. The current therapies merely manage the symptoms and slow the progression, but cannot eliminate the underlying disease. Therefore, scientists have been exploring alternative treatments. Amidst the development of new therapies, Stem Cell Treatment for Lung Disease or COPD has shown the most potential.

COPD Symptoms

COPD is an inflammatory condition that spreads not just to the airways but also to the lung cells and vessels. COPD occurs due to bronchitis or emphysema. Bronchitis is characterized by mucus formation in the airways that blocks the airflow. On the other hand, inflammation eventually deteriorates the structure of alveoli (air sacs that enable gas exchange with blood) in emphysema. Therefore, COPD manifests as the following symptoms-

• Difficulty in breathing

• Sputum Production

• Coughing

• Wheezing

• Prolonged expiration

• Pursed-lip breathing

• Tightness in the chest

• Bluish discoloration in the skin

• Fatigue

• Muscle Wasting

As the condition worsens, breathlessness present during average to extreme physical activity begins to impede the daily functioning of patients, such as bathing, dressing, walking, etc. Patients might also experience sleep disturbances, anxiety, and depression as the disease worsens, impacting their quality of life.

COPD Treatment Options

The primary aim of COPD treatment is to minimize symptoms and delay the disorder progression in order to improve the quality of life and decrease the risk of mortality. The medications for COPD are inhalable to avoid their distribution to other organs and minimize any adverse effects. Some of them are also available as pills, syrups, injections, and nebulizers. The following medications are typically employed for COPD.

β2-agonists: They relax smooth muscle cells of the airway, dilating them and increasing the passage of air. The short-acting β2-agonists (SABA) offer immediate relief such as levalbuterol, salbutamol, and fenoterol. On the other hand, long-acting forms (LABA) are included in maintenance therapy. For example, formoterol, salmeterol, olodaterol, etc.

Antimuscarinics: They prevent airway constriction by blocking smooth muscle muscarinic receptors. They are also available in short-acting (SAMA) and long-acting (LAMA) forms like aclidinium bromide, ipratropium bromide, revefenacin, glycopyrrolate, etc.

Methyxanthines: They dilate the airways probably by inhibiting phophodiesterase. For example, aminophylline and theophylline. Their combination with salmeterol substantially improves the breathing capacity. They provide additional relief after using LAMA or LABA.

Corticosteroids: They mitigate inflammation for COPD Symptom management. E.g., beclomethasone, budenoside, fluticasone. Their combination with LABA or LAMA is more common. However, their use also increases the risk of pneumonia. Oral glucocorticoids can have adverse effects, which have limited their use to acute flare-ups of the condition.

Phosphodiesterase Inhibitors: They alleviate inflammation by degrading cAMP. E.g., roflumilast.

Antibiotics: Antibiotics, particularly azithromycin, can decrease the number of flare-ups and are essential in bacterial infections. However, their dosage requires adjustment to prevent antibiotic resistance.

Mucolytic Agents: They break down the mucus and enable its clearance to allow proper air flow. Examples include carbocysteine, N-acetylcysteine, and erdosteine.

In most cases, more than one medication is recommended. For example, a combination of LAMA and LABA for maintenance therapy or an inhaler with both SAMA and SABA for immediate relief.

Surgical Interventions: Lung surgery or transplant is recommended in severe cases where medications fail to manage symptoms.

Stem Cell Treatment for COPD

Stem cell therapy has shifted the treatment goal of COPD from symptom management to tissue repair and functional recovery. Mesenchymal stem cells (MSCs) have been at the forefront of this treatment strategy due to their multitude of benefits, easy availability, and low risk. They work as follows-

Repair: MSCs repair the alveoli by transforming into alveolar cells and elevating the survival of alveolar cells by declining apoptotic genes and increasing anti-apoptotic genes.

Anti-inflammation: Stem cell treatment for lung disease diminishes the inflammatory cytokines like IL6, IL1β, and TNFα, while augmenting anti-inflammatory cytokines like IL10 and TGFβ.

Prevent Lung Damage: Stem cells balance the ratio of matrix-degrading proteases to their inhibitors in order to maintain the lung architecture.

These mechanisms target the disorder in a multifaceted manner, resulting in improved breathing capacity.

Future Perspectives

COPD, a lung disease, gradually impairs the ability to perform daily functions. The focus of current COPD treatment is symptom management, which has fueled research into treatments that can enhance lung structure and function. Research studies have implied that stem cell treatment for COPD may be an effective therapy. In addition to treating symptoms, it also restores lung shape and function, improving patients' quality of life.. The ongoing research is rapidly evolving the COPD treatment options. One of the achievements is stem cell-derived exosomes that offer the effects of stem cells but in a cell-free manner. They are already under evaluation in clinical trials. A combination of stem cells and exosomes can considerably enhance the overall outcomes of the therapy. Advancells is moving the gears of the stem cell treatment for lung disease by delivering quality-assured stem cells and exosomes.

We are pioneers in stem cell manufacturing, empowering hope and healing for thousands worldwide seeking regenerative medicine.