Безклітинні біологічні засоби: нові горизонти у лікуванні передчасно народжених дітей (огляд літератури)

Abstract

Preterm birth, is a complex syndrome and remains a major global health problem. Taking into account the plasticity and regenerative potential of developing organs, nowadays the most promising therapeutic strategy is the use of mesenchymal stem cells (MSCs) and their derivatives. Aim. To summarize current information about the therapeutic potential of cell-free biological agents in the treatment of diseases of premature newborns according to data from open sources of information. Publications have been selected, which covered information on the use of conditioned media and MSC exosomes in the treatment of diseases of premature newborns. In comparison to MSCs, the use of cell-free agents has advantages: the use of the secretome eliminates the risks potentially associated with the transplantation of living and proliferative cell populations, including immune compatibility, tumorigenicity, emboli formation, and transmission of infections; MSC-derived secretome can be evaluated for safety, dosage, and efficacy in a manner similar to conventional pharmaceutical agents; storage can be carried out without the use of potentially toxic cryopreservatives for a long period without losing the effectiveness of the product; the use of secretome from MSCs, such as conditioned MSC medium, is more economical and more practical for clinical use, as it avoids invasive cell collection procedures; mass production is possible using custom-made cell lines in controlled laboratory conditions, providing a convenient source of bioactive factors; the time and cost of expansion and maintenance cultured stem cells could be greatly reduced, and ready-made secretome therapies could be immediately available for the treatment of acute conditions; a biological product obtained for therapeutic use can be modified to have the desired cell-specific effects. Conclusions. The treatment of premature newborns represents a unique clinical task, since their diseases involve dynamic physiological processes in immature, developing organs. The introduction into clinical use of cell-free biological agents is one of the most promising areas in the development of neonatology and will obviously change the paradigms in the treatment of a number of diseases of newborns, in particular bronchopulmonary dysplasia, hypoxic ischemic encephalopathy and necrotizing enterocolitis. No conflict of interests was declared by the authors.