Additionally, in phase I and II clinical trials mesenchymal or stromal cells (MSCs) have been reported to exert beneficial effects on immune- mediated diseases such as graft-versus-host disease and Crohn disease. Certain types of stem cell such as hematopoietic stem cell transplants have been proven to provide effective treatment for leukemia, lymphoma, or severe combined immunodeficiency. Those physicians in turn respond hesitatingly. Prompted by optimistic messages in the media, more and more emphysema patients now approach their general practitioner or their lung physician for treatment with stem cells.

This review will provide a comprehensive overview of the (pre)clinical studies on MSC effects in emphysema and discuss the current challenges regarding the optimal use of MSCs for cell-based therapies. Possible explanations for the lack of beneficial effects on clinical outcomes could be the source (bone marrow), route, dosage, frequency of administration, and delivery (lack of a bioactive scaffold). Few human studies have investigated MSC treatment for chronic obstructive pulmonary disease, demonstrating short-term safety but no convincing benefits on clinical outcomes. Essential questions about MSC engraftment, retention, and survival have not been sufficiently addressed in a systematic manner. Moreover, the regrowth potential of differentiated tissues and organs differs between species. It is difficult to draw definitive conclusions from the available animal studies, as different models, dosage protocols, administration routes, and sources of MSCs have been used with different measures of effectiveness. Still, there are considerable challenges before effective stem cell treatment can be realized in emphysema patients. The optimism regarding this treatment strategy is supported by promising results from animal models. This review discusses the current state of the art regarding the potential of MSCs for the treatment of emphysema. MSCs do not only self-renew and differentiate into renew tissues, but also have anti-inflammatory and paracrine properties to reduce damage and to support tissue regeneration, constituting a promising cell-based treatment strategy for the repair of damaged alveolar tissue in emphysema.

Mesenchymal stem or stromal cells (MSCs) are multipotent cells that play a pivotal role in various phases of lung development and lung homeostasis, and potentially also lung regeneration.

Stem cell treatment emphysema