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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 9/2011

01.09.2011 | Review

Mechanisms of cellular therapy in respiratory diseases

verfasst von: Soraia C. Abreu, Mariana A. Antunes, Paolo Pelosi, Marcelo M. Morales, Patricia R. M. Rocco

Erschienen in: Intensive Care Medicine | Ausgabe 9/2011

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Abstract

Purpose

Stem cells present a variety of clinical implications in the lungs. According to their origin, these cells can be divided into embryonic and adult stem cells; however, due to the important ethical and safety limitations that are involved in the embryonic stem cell use, most studies have chosen to focus on adult stem cell therapy. This article aims to present and clarify the recent advances in the field of stem cell biology, as well as to highlight the effects of mesenchymal stem cell (MSC) therapy in the context of acute lung injury/acute respiratory distress syndrome and chronic disorders such as lung fibrosis and chronic obstructive pulmonary disease.

Methods

For this purpose, we performed a critical review of adult stem cell therapies, covering the main clinical and experimental studies published in Pubmed databases in the past 11 years. Different characteristics were extracted from these articles, such as: the experimental model, strain, cellular type and administration route used as well as the positive or negative effects obtained.

Results

There is evidence for beneficial effects of MSC on lung development, repair, and remodeling. The engraftment in the injured lung does not occur easily, but several studies report that paracrine factors can be effective in reducing inflammation and promoting tissue repair. MSC releases several growth factors and anti-inflammatory cytokines that regulate endothelial and epithelial permeability and reduce the severity of inflammation.

Conclusion

A better understanding of the mechanisms that control cell division and differentiation, as well as of their paracrine effects, is required to enable the optimal use of bone marrow-derived stem cell therapy to treat human respiratory diseases.
Literatur
1.
Krause DS, Theise ND, Collector MI, Henegariu O, Hwang S, Gardner R, Neutzel S, Sharkis SJ (2001) Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem cell. Cell 105:369–377PubMedCrossRef
2.
Moodley Y, Manuelpillai U, Weiss DJ (2011) Cellular therapies for lung disease: a distant horizon. Respirology 16:223–237PubMedCrossRef
3.
Matthay MA, Thompson BT, Read EJ, McKenna DH Jr, Liu KD, Calfee CS, Lee JW (2010) Therapeutic potential of mesenchymal stem cells for severe acute lung injury. Chest 138:965–972PubMedCrossRef
4.
Ortiz LA, Gambelli F, McBride C, Gaupp D, Baddoo M, Kaminski N, Phinney DG (2003) Mesenchymal stem cell engraftment in lung is enhanced in response to bleomycin exposure and ameliorates its fibrotic effects. Proc Natl Acad Sci USA 100:8407–8411PubMedCrossRef
5.
Rojas M, Xu J, Woods CR, Mora AL, Spears W, Roman J, Brigham KL (2005) Bone marrow-derived mesenchymal stem cells in repair of the injured lung. Am J Respir Cell Mol Biol 33:145–152PubMedCrossRef
6.
Segev H, Fishman B, Ziskind A, Shulman M, Itskovitz-Eldor J (2004) Differentiation of human embryonic stem cells into insulin-producing clusters. Stem Cells 22:265–274PubMedCrossRef
7.
Passier R, Denning C, Mummery C (2006) Cardiomyocytes from human embryonic stem cells. Handb Exp Pharmacol 174:101–122PubMedCrossRef
8.
Wang DHD, Burns AR, Zsigmond E, Wetsel RA (2007) A pure population of lung alveolar epithelial type II cells derived from human embryonic stem cells. Proc Natl Acad Sci USA 104:4449–4454PubMedCrossRef
9.
Rippon HJ, Polak JM, Qin M, Bishop AE (2006) Derivation of distal lung epithelial progenitors from murine embryonic stem cells using a novel three-step differentiation protocol. Stem Cells 24:1389–1398PubMedCrossRef
10.
Liras A (2010) Future research and therapeutic applications of human stem cells: general, regulatory, and bioethical aspects. J Transl Med 8:131PubMedCrossRef
11.
Reynolds SD, Malkinson AM (2010) Clara cell: progenitor for the bronchiolar epithelium. Int J Biochem Cell Biol 42:1–4PubMedCrossRef
12.
Borthwick DW, Shahbazian M, Krantz QT, Dorin JR, Randell SH (2001) Evidence for stem-cell niches in the tracheal epithelium. Am J Respir Cell Mol Biol 24:662–670PubMed
13.
Chen H, Matsumoto K, Stripp BR (2009) Bronchiolar progenitor cells. Proc Am Thorac Soc 6:602–606PubMedCrossRef
14.
Kim CF, Jackson EL, Woolfenden AE, Lawrence S, Babar I, Vogel S, Crowley D, Bronson RT, Jacks T (2005) Identification of bronchioalveolar stem cells in normal lung and lung cancer. Cell 121:823–835PubMedCrossRef
15.
Morino S, Toba T, Tao H, Araki M, Shimizu Y, Nakamura T, Nagayasu T, Tagawa T (2007) Fibroblast growth factor-2 promotes recovery of pulmonary function in a canine models of elastase-induced emphysema. Exp Lung Res 33:15–26PubMedCrossRef
16.
17.
Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, Deans R, Keating A, Prockop Dj, Horwitz E (2006) Minimal criteria for defining multipotent mesenchymal stromal cells. The International society for cellular therapy position statement. Cytotherapy 8:315–317PubMedCrossRef
18.
Chamberlain G, Fox J, Ashton B, Middleton J (2007) Concise review: mesenchymal stem cells: their phenotype, differentiation capacity, immunological features, and potential for homing. Stem Cells 25:2739–2749PubMedCrossRef
19.
Rosland GV, Svendsen A, Torsvik A, Sobala E, McCormack E, Immervoll H, Mysliwietz J, Tonn JC, Goldbrunner R, Lonning PE, Bjerkvig R, Schichor C (2009) Long-term cultures of bone marrow-derived human mesenchymal stem cells frequently undergo spontaneous malignant transformation. Cancer Res 69:5331–5339PubMedCrossRef
20.
Zvaifler NJ, Marinova-Mutafchieva L, Adams G, Edwards CJ, Moss J, Burger JA, Maini RN (2000) Mesenchymal precursor cells in the blood of normal individuals. Arthritis Res 2:477–488PubMedCrossRef
21.
Dazzi F, Horwood NJ (2007) Potential of mesenchymal stem cell therapy. Curr Opin Oncol 19:650–655PubMedCrossRef
22.
Chunmeng S, Tianmin C (2004) Effects of plastic-adherent dermal multipotent cells on peripheral blood leukocytes and CFU-GM in rats. Transplant Proc 36:1578–1581PubMedCrossRef
23.
Lama VN, Smith L, Badri L, Flint A, Andrei AC, Murray S, Wang Z, Liao H, Toews GB, Krebsbach PH, Peters-Golden M, Pinsky DJ, Martinez FJ, Thannickal VJ (2007) Evidence for tissue-resident mesenchymal stem cells in human adult lung from studies of transplanted allografts. J Clin Invest 117:989–996PubMedCrossRef
24.
Ishizawa K, Kubo H, Yamada M, Kobayashi S, Suzuki T, Mizuno S, Nakamura T, Sasaki H (2004) Hepatocyte growth factor induces angiogenesis in injured lungs through mobilizing endothelial progenitor cells. Biochem Biophys Res Commun 324:276–280PubMedCrossRef
25.
Mao M, Wang SN, Lv XJ, Wang Y, Xu JC (2010) Intravenous delivery of bone marrow-derived endothelial progenitor cells improves survival and attenuates lipopolysaccharide-induced lung injury in rats. Shock 34:196–204PubMedCrossRef
26.
Kotton DN, Ma BY, Cardoso WV, Sanderson EA, Summer RS, Williams MC, Fine A (2001) Bone marrow-derived cells as progenitors of lung alveolar epithelium. Development 128:5181–5188PubMed
27.
Hashimoto N, Jin H, Liu T, Chensue SW, Phan SH (2004) Bone marrow-derived progenitor cells in pulmonary fibrosis. J Clin Invest 113:243–252PubMed
28.
Theise ND, Henegariu O, Grove J, Jagirdar J, Kao PN, Crawford JM, Badve S, Saxena R, Krause DS (2002) Radiation pneumonitis in mice: a severe injury model for pneumocyte engraftment from bone marrow. Exp Hematol 30:1333–1338PubMedCrossRef
29.
Kotton DN, Fabian AJ, Mulligan RC (2005) Failure of bone marrow to reconstitute lung epithelium. Am J Respir Cell Mol Biol 33:328–334PubMedCrossRef
30.
Spees JL, Olson SD, Ylostalo J, Lynch PJ, Smith J, Perry A, Peister A, Wang MY, Prockop DJ (2003) Differentiation, cell fusion, and nuclear fusion during ex vivo repair of epithelium by human adult stem cells from bone marrow stroma. Proc Natl Acad Sci USA 100:2397–2402PubMedCrossRef
31.
Herzog EL, Van Arnam J, Hu B, Krause DS (2006) Threshold of lung injury required for the appearance of marrow-derived lung epithelia. Stem Cells 24:1986–1992
32.
Krause DS (2008) Bone marrow-derived cells and stem cells in lung repair. Proc Am Thorac Soc 5:323–327PubMedCrossRef
33.
Araujo IM, Abreu SC, Maron-Gutierrez T, Cruz F, Fujisaki L, Carreira H Jr, Ornellas F, Ornellas D, Vieira-de-Abreu A, Castro-Faria-Neto HC, Muxfeldt Ab’Saber A, Teodoro WR, Diaz BL, Peres Dacosta C, Capelozzi VL, Pelosi P, Morales MM, Rocco PR (2010) Bone marrow-derived mononuclear cell therapy in experimental pulmonary and extrapulmonary acute lung injury. Crit Care Med 38:1733–1741PubMedCrossRef
34.
Abreu SC, Antunes MA, Maron-Gutierrez T, Cruz FF, Carmo LG, Ornellas DS, Junior HC, Ab’Saber AM, Parra ER, Capelozzi VL, Morales MM, Rocco PR (2010) Effects of bone marrow-derived mononuclear cells on airway and lung parenchyma remodeling in a murine model of chronic allergic inflammation. Respir Physiol Neurobiol 175:153–163PubMedCrossRef
35.
Ortiz LA, Dutreil M, Fattman C, Pandey AC, Torres G, Go K, Phinney DG (2007) Interleukin 1 receptor antagonist mediates the antiinflammatory and antifibrotic effect of mesenchymal stem cells during lung injury. Proc Natl Acad Sci USA 104:11002–11007PubMedCrossRef
36.
Kinnaird T, Stabile E, Burnett MS, Lee CW, Barr S, Fuchs S, Epstein SE (2004) Marrow-derived stromal cells express genes encoding a broad spectrum of arteriogenic cytokines and promote in vitro and in vivo arteriogenesis through paracrine mechanisms. Circ Res 94:678–685PubMedCrossRef
37.
Takahashi K, Mitsui K, Yamanaka S (2006) Role of ERas in promoting tumour-like properties in mouse embryonic stem cells. Nature 423:541–545CrossRef
38.
Ohnishi S, Yasuda T, Kitamura S, Nagaya N (2007) Effect of hypoxia on gene expression of bone marrow-derived mesenchymal stem cells and mononuclear cells. Stem Cells 25:1166–1177PubMedCrossRef
39.
Abe S, Boyer C, Liu X, Wen FQ, Kobayashi T, Fang Q, Wang X, Hashimoto M, Sharp JG, Rennard SI (2004) Cells derived from the circulation contribute to the repair of lung injury. Am J Respir Crit Care Med 170:1158–1163PubMedCrossRef
40.
Zhang C, Zhang X, Chen XH (2011) Granulocyte-colony stimulating factor-mobilized mesenchymal stem cells: a new resource for rapid engraftment in hematopoietic stem cell transplantation. Med Hypotheses 76:241–243PubMedCrossRef
41.
Loebinger MR, Sage EK, Janes SM (2008) Mesenchymal stem cells as vectors for lung disease. Proc Am Thorac Soc 5:711–716PubMedCrossRef
42.
Zhao YD, Courtman DW, Ng DS, Robb MJ, Deng YP, Trogadis J, Han RN, Stewart DJ (2006) Microvascular regeneration in established pulmonary hypertension by angiogenic gene transfer. Am J Respir Cell Mol Biol 35:182–189PubMedCrossRef
43.
Mei SH, McCarter SD, Deng Y, Parker CH, Liles WC, Stewart DJ (2007) Prevention of LPS-induced acute lung injury in mice by mesenchymal stem cells overexpressing angiopoietin 1. PLoS Med 4:e269PubMedCrossRef
44.
Aguilar S, Scotton CJ, McNulty K, Nye E, Stamp G, Laurent G, Bonnet D, Janes SM (2009) Bone marrow stem cells expressing keratinocyte growth factor via an inducible lentivirus protects against bleomycin-induced pulmonary fibrosis. PLoS One 4:e8013PubMedCrossRef
45.
Krasnodembskaya A, Song Y, Fang X, Gupta N, Serikov V, Lee JW, Matthay MA (2010) Antibacterial effect of human mesenchymal stem cells is mediated in part from secretion of the antimicrobial peptide LL-37. Stem Cells 28:2229–2238PubMedCrossRef
46.
Mei SH, Haitsma J, Dos Santos CC, Deng Y, Lai PF, Slutsky AS, Liles WC, Stewart DJ (2010) Mesenchymal stem cells reduce inflammation while enhancing bacterial clearance and improving survival in sepsis. Am J Respir Crit Care Med 182:1047–1057PubMedCrossRef
47.
Goss CH, Brower R, Hudson LD, Rubenfeld GD (2003) Incidence of acute lung injury in the United States. Crit Care Med 31:1607–1611PubMedCrossRef
48.
Erickson SE, Martin GS, Davis JL, Matthay MA, Eisner MD (2009) Recent trends in acute lung injury mortality: 1996–2005. Crit Care Med 37:1574–1579PubMedCrossRef
49.
Rocco PR, Pelosi P (2008) Pulmonary and extrapulmonary acute respiratory distress syndrome: myth or reality? Curr Opin Crit Care 14:50–55PubMedCrossRef
50.
Burnham EL, Taylor WR, Quyyumi AA, Rojas M, Brigham KL, Moss M (2005) Increased circulating endothelial progenitor cells are associated with survival in acute lung injury. Am J Respir Crit Care Med 172:854–860PubMedCrossRef
51.
Burnham E, Moss M (2006) Progenitor cells in acute lung injury. Minerva Anestesiol 72:369–374PubMed
52.
Gomperts BN, Belperio JA, Rao PN, Randell SH, Fishbein MC, Burdick MD, Strieter RM (2006) Circulating progenitor epithelial cells traffic via CXCR4/CXCL12 in response to airway injury. J Immunol 176:1916–1927PubMed
53.
Lee JW, Fang X, Gupta N, Serikov V, Matthay MA (2009) Allogeneic human mesenchymal stem cells for treatment of E. coli endotoxin-induced acute lung injury in the ex vivo perfused human lung. Proc Natl Acad Sci USA 106:16357–16362PubMedCrossRef
54.
Gupta N, Su X, Popov B, Lee JW, Serikov V, Matthay MA (2007) Intrapulmonary delivery of bone marrow-derived mesenchymal stem cells improves survival and attenuates endotoxin-induced acute lung injury in mice. J Immunol 179:1855–1863PubMed
55.
Prota LF, Lassance RM, Maron-Gutierrez T, Castiglione RC, Garcia CS, Santana MC, Souza-Menezes J, Abreu SC, Samoto V, Santiago MF, Capelozzi VL, Takiya CM, Rocco PR, Morales MM (2010) Bone marrow mononuclear cell therapy led to alveolar–capillary membrane repair improving lung mechanics in endotoxin-induced acute lung injury. Cell Transplant 19:965–971PubMedCrossRef
56.
Fang X, Neyrinck AP, Matthay MA, Lee JW (2010) Allogeneic human mesenchymal stem cells restore epithelial protein permeability in cultured human alveolar type II cells by secretion of angiopoietin-1. J Biol Chem 285:26211–26222PubMedCrossRef
57.
Willis BC, duBois RM, Borok Z (2006) Epithelial origin of myofibroblasts during fibrosis in the lung. Proc Am Thorac Soc 3:377–382PubMedCrossRef
58.
Matthay MA (2008) Treatment of acute lung injury: clinical and experimental studies. Proc Am Thorac Soc 5:297–299PubMedCrossRef
59.
Maron-Gutierrez T, Castiglione RC, Xisto DG, Oliveira MG, Cruz FF, Peçanha R, Carreira-Junior H, Ornellas DS, Moraes MO, Takiya CM, Rocco PR, Morales MM (2011) Bone marrow derived mononuclear cell therapy attenuates silica-induced lung fibrosis. Eur Respir J 37(5):1217–1225
60.
Epperly MW, Guo H, Gretton JE, Greenberger JS (2003) Bone marrow origin of myofibroblasts in irradiation pulmonary fibrosis. Am J Respir Cell Mol Biol 29:213–224PubMedCrossRef
61.
Popova AP, Bozyk PD, Goldsmith AM, Linn MJ, Lei J, Bentley JK, Hershenson MB (2010) Autocrine production of TGF-beta1 promotes myofibroblastic differentiation of neonatal lung mesenchymal stem cells. Am J Physiol Lung Cell Mol Physiol 298:L735–L743PubMedCrossRef
62.
Strieter RM, Keeley EC, Burdick MD, Mehrad B (2009) The role of circulating mesenchymal progenitor cells, fibrocytes, in promoting pulmonary fibrosis. Trans Am Clin Climatol Assoc 120:49–59PubMed
63.
Lassance RM, Prota LF, Maron-Gutierrez T, Garcia CS, Abreu SC, Passaro CP, Xisto DG, Castiglione RC, Carreira H Jr, Ornellas DS, Santana MC, Souza SA, Gutfilen B, Fonseca LM, Rocco PR, Morales MM (2009) Intratracheal instillation of bone marrow-derived cell in an experimental model of silicosis. Respir Physiol Neurobiol 169:227–233PubMedCrossRef
64.
Loivos LP, Lima MA, Szklo A, Vairo L, Brunswick THK, Souza SAL, Gutfilen B, Araújo AJ, Cardoso AP, Fonseca LMB, Goldenberg RC, Rocco PRM, Silva JRL, and Morales MM (2010) Intrabronchial instillation of bone marrow derived mononuclear cells in silicotic patients. American thoracic society internacional conference 2010 May 14–19; Lousiana, New Orleans
65.
Sin DD, McAlister FA, Man SF, Anthonisen NR (2003) Contemporary management of chronic obstructive pulmonary disease: scientific review. JAMA 290:2301–2312PubMedCrossRef
66.
Palange P, Testa U, Huertas A, Calabro L, Antonucci R, Petrucci E, Pelosi E, Pasquini L, Satta A, Morici G, Vignola MA, Bonsignore MR (2006) Circulating haemopoietic and endothelial progenitor cells are decreased in COPD. Eur Respir J 27:529–541PubMedCrossRef
67.
Urbich C, Dimmeler S (2004) Endothelial progenitor cells: characterization and role in vascular biology. Circ Res 95:343–353PubMedCrossRef
68.
Kondo T, Hayashi M, Takeshita K, Numaguchi Y, Kobayashi K, Iino S, Inden Y, Murohara T (2004) Smoking cessation rapidly increases circulating progenitor cells in peripheral blood in chronic smokers. Arterioscler Thromb Vasc Biol 24:1442–1447PubMedCrossRef
69.
Fadini GP, Schiavon M, Cantini M, Baesso I, Facco M, Miorin M, Tassinato M, de Kreutzenberg SV, Avogaro A, Agostini C (2006) Circulating progenitor cells are reduced in patients with severe lung disease. Stem Cells 24:1806–1813PubMedCrossRef
70.
Peinado VI, Ramirez J, Roca J, Rodriguez-Roisin R, Barbera JA (2006) Identification of vascular progenitor cells in pulmonary arteries of patients with chronic obstructive pulmonary disease. Am J Respir Cell Mol Biol 34:257–263PubMedCrossRef
71.
Schweitzer KS, Johnstone BH, Garrison J, Rush NI, Cooper S, Traktuev DO, Feng D, Adamowicz JJ, Van Demark M, Fisher AJ, Kamocki K, Brown MB, Presson RG Jr, Broxmeyer HE, March KL, Petrache I (2011) Adipose stem cell treatment in mice attenuates lung and systemic injury induced by cigarette smoking. Am J Respir Crit Care Med 183:215–225PubMedCrossRef
72.
Fischer UM, Harting MT, Jimenez F, Monzon-Posadas WO, Xue H, Savitz SI, Laine GA, Cox CS Jr (2009) Pulmonary passage is a major obstacle for intravenous stem cell delivery: the pulmonary first-pass effect. Stem Cells Dev 18:683–692PubMedCrossRef
73.
Furlani D, Ugurlucan M, Ong L, Bieback K, Pittermann E, Westien I, Wang W, Yerebakan C, Li W, Gaebel R, Li RK, Vollmar B, Steinhoff G, Ma N (2009) Is the intravascular administration of mesenchymal stem cells safe? Mesenchymal stem cells and intravital microscopy. Microvasc Res 77:370–376PubMedCrossRef
74.
Ribeiro-Paes JT, Bilaqui A, Greco OT, Ruiz MA, Marcelino MY, Stessuk T, de Faria CA, Lago MR (2011) Unicentric study of cell therapy in chronic obstructive pulmonary disease/pulmonary emphysema. Int J Chron Obstruct Pulmon Dis 6:63–71PubMedCrossRef
Metadaten
Titel
Mechanisms of cellular therapy in respiratory diseases
verfasst von
Soraia C. Abreu
Mariana A. Antunes
Paolo Pelosi
Marcelo M. Morales
Patricia R. M. Rocco
Publikationsdatum
01.09.2011
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 9/2011
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-011-2268-3

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