Secretome of Mesenchymal Stem Cells and its Impact on Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by irreversible loss of lung function that stem from two mechanisms, inflammation and senescence. Crosstalk between these two mechanisms accelerate the development of COPD, thus targeting these two pathways may offer benefits in the treatment of COPD. Growing amount of evidence have shown that mesenchymal stem cells as a promising candidate for the treatment of COPD.Over the years, many studies conducted to decipher the therapeutic effect of MSC in COPD and the mechanisms involve, in the hope of utilizing these cells as new therapeutic strategy for COPD. However, the cell-based therapy by using the MSC presented with many obstacles including low engraftment at the site of injury, the risk of microvascular occlusion, unwanted differentiation, and also the risk of malignant transformation. Recently, recently researchers begin to look at the possibility of using MSC derived extracellular vesicles as an alternative to MSC. Here we review the effect of MSC and MSC derived EV in modulating inflammation, and senescence in COPD. We also review current treatment and the side effect in COPD, and senolytic drugs, a new therapeutic strategy targeting the senescent cells. Chronic Obstructive Pulmonary DiseaseChronic obstructive pulmonary disease (COPD) has a tremendous economic impact on healthcare and is associated with high morbidity, and high mortality rate. Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2017 reported that more than 3 million people died in 2012 accounting for 6% of total death globally. It is estimated that the prevalence and the burden of COPD to increase in the coming decade and by 2020, COPD will become the third leading cause of death worldwide. Symptoms of COPD include chronic cough, dyspnea and excessive production of sputum, while anorexia, fatigue and weight loss may present in patient with severe COPD. The diagnosis of post-bronchodilator forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) ≤0.7 confirms the presence of airflow limitation. The body mass index (BMI) are also useful in predicting outcomes such as survival with the values <21 kg . m -2 are associated with increased mortality (Celli et al., 2004).Cigarette smoke is the main risk factor of COPD which accounts for 80-90% of all cases.However, environmental pollution, noxious gases, genetic predisposition, pulmonary infections, and aging can also increase the risk of COPD (Churg et el.,2008).