Despite the advancement in medicine, management of heart failure (HF), which usually presents as a disease syndrome, has been a challenge to healthcare providers. This is reflected by the relatively higher rate of readmissions along with increased mortality and morbidity associated with HF. In this review article, we first provide a general overview of types of HF pathogenesis and diagnostic features of HF including the crucial role of exercise in determining the severity of heart failure, the efficacy of therapeutic strategies and the morbidity/mortality of HF. We then discuss the quality control measures to prevent the growing readmission rates for HF. We also attempt to elucidate published and ongoing clinical trials for HF in an effort to evaluate the standard and novel therapeutic approaches, including stem cell and gene therapies, to reduce the morbidity and mortality. Finally, we discuss the appropriate utilization/documentation and medical coding based on the severity of the HF alone and with minor and major co-morbidities. We consider that this review provides an extensive overview of the HF in terms of disease pathophysiology, management and documentation for the general readers, as well as for the clinicians/physicians/hospitalists.

Lung disorders such as asthma, acute respiratory distress syndrome (ARDS), chronic obstructive lung disease (COPD), and interstitial lung disease (ILD) show a few common threads of pathogenic mechanisms: inflammation, aberrant immune activity, infection, and fibrosis. Currently no modes of effective treatment are available for ILD or emphysema. Being anti-inflammatory, immunomodulatory, and regenerative in nature, the administration of mesenchymal stem cells (MSCs) has shown the capacity to control immune dysfunction and inflammation in the lung. The intravenous infusion of MSCs, the common mode of delivery, is followed by their entrapment in lung vasculature before MSCs reach to other organ systems thus indicating the feasible and promising approach of MSCs therapy for lung diseases. In this review, we discuss the mechanistic basis for MSCs therapy for asthma, ARDS, COPD, and ILD.

Background: Large scale high quality and low cost production of clinical grade mesenchymal stem cells (MSCs) is critical for facilitating clinical research and potential stem cell therapies. Use of Fetal Bovine/Calf serum (FBS/FCS) for the clinical application carries a risk for transmission of zoonosis, therefore alternative xeno-free cell culture techniques have been evaluated. The commercial products for the culture of MSCs in xeno-free and/or serum free media such as STEMPRO® MSC SFM and MesenGro® are available but possibly not cost effective for large scale production of MSCs. The usage of human serum and pooled human platelet lysate (pHPL) present xeno-free alternatives as growth supplements. Methods: In this report, we analyzed the growth potentials of human tissue derived MSCs from bone marrow (BM), umbilical cord tissue (UCT) and umbilical cord blood (UCB) in presence of xeno-free, serum free commercial culture media (STEMPRO® MSC SFM and MesenGro®) and serum containing media supplemented with pHPL, FBS and human serum. We also evaluated the role of surface of culture flasks for the optimal production of MSCs from these tissues by comparing the expansion potential of MSCs in culture flasks from Costar®, CellBIND®, Greiner® and Tarsons® brands. Results: We compared the growth potentials of these MSCs derived from these human tissues and found that pHPL supplemented culture media serves as an efficient, cost effective xeno-free media to produce clinical grade human MSCs for clinical applications. Interestingly, out of two commercial media, MesenGro® demonstrated better isolation and expansion potential than STEMPRO® MSC SFM indicating that composition of commercial media affected the MSCs isolation and expansion although MSCs showed similar phenotypic characteristics and post cryopreservation viability. The MSCs production was at best in culture flasks with CellBIND® surface treatment. Conclusion:We conclude that pHPL supplemented media provide cost effective and efficacious way to produce clinical grade MSCs from various human tissues as opposed to commercial media. We showed that UCT can be an alternative option for large number of MSCs and unique surface treatment of cell culture flasks such as CellBIND® facilitates large scale production of MSCs from various human tissues.