Regenerative and translational medicine in COPD: hype and hope

Abstract

COPD is a common, preventable and usually progressive disease associated with an enhanced chronic inflammatory response in the airways and lung, generally caused by exposure to noxious particles and gases. It is a treatable disease characterised by persistent respiratory symptoms and airflow limitation due to abnormalities in the airways and/or alveoli. COPD is currently the third leading cause of death worldwide, representing a serious public health problem and a high social and economic burden. Despite significant advances, effective clinical treatments have not yet been achieved. In this scenario, cell-based therapies have emerged as potentially promising therapeutic approaches. However, there are only a few published studies of cell-based therapies in human patients with COPD and a small number of ongoing clinical trials registered onclinicaltrials.gov. Despite the advances and interesting results, numerous doubts and questions remain about efficacy, mechanisms of action, culture conditions, doses, timing, route of administration and conditions related to homing and engraftment of the infused cells. This article presents the state of the art of cell-based therapy in COPD. Clinical trials that have already been completed and with published results are discussed in detail. We also discuss the questions that remain unanswered about cell-based regenerative and translational medicine for COPD.

PD-1+ T lymphocyte proportions and hospitalized exacerbation of COPD: a prospective cohort study

“…Participants aged 45 to 85, were recruited at discharge following hospitalization for COPD diagnosis given by clinical physicians from the Department of Respiration and Critical Care Medicine at Fujian Provincial Hospital, from 2022 January to August. According to the "Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease (2021 Revision) [16], the criteria for discharge are as follows: (1) Clinical symptoms and ABG (Arterial Blood Gases) are stable for 24 to 48 h or more, and the primary physician deems the patient suitable for home care, with the degree of dyspnea not affecting daily activities; (2) The patient fully understands and is able to correctly use inhaled medications; (3) Must be able to walk indoors; (4) Serological tests for infection-related indicators return to normal (Procalcitonin < 0.25ng/ml or last C-reactive protein < 5 mg/ml); (6) Follow-up and home care plans are properly arranged. Only those who meet the above conditions and provide informed consent will be screened and included in the cohort study.…”

“…Chronic obstructive pulmonary disease (COPD) was a preventable and manageable respiratory condition characterized by persistent airflow limitation, impacting around 9-10% of elderly individuals [1][2][3]. Acute exacerbation of COPD (AECOPD) could occur during the natural course of COPD and is related to disease progression [4].…”

ERS International Congress 2023: highlights from the Airway Diseases Assembly

“…Cell transplantation resulted in increased D LCO % predicted. iPSCs also have the potential to act as therapeutics themselves by aiding cellular repair in the lungs of patients [ 51 , 52 ].…”