Abstract
Respiratory disease is the leading cause of death in children under the age of 5 years old. Currently available treatments for paediatric respiratory diseases including bronchopulmonary dysplasia, asthma, cystic fibrosis and interstitial lung disease may ameliorate symptoms but do not offer a cure. Cellular therapy may offer a potential cure for these diseases, preventing disease progression into adulthood. Induced pluripotent stem cells, mesenchymal stromal cells and their secretome have shown great potential in preclinical models of lung disease, targeting the major pathological features of the disease. Current research and clinical trials are focused on the adult population. For cellular therapies to progress from preclinical studies to use in the clinic, optimal cell type dosage and delivery methods need to be established and confirmed. Direct delivery of these therapies to the lung as aerosols would allow for lower doses with a higher target efficiency whilst avoiding potential effect of systemic delivery. There is a clear need for research to progress into the clinic for the treatment of paediatric respiratory disease. Whilst research in the adult population forms a basis for the paediatric population, varying disease pathology and anatomical differences in paediatric patients means a paediatric-centric approach must be taken.
Highlights
Respiratory disease is a leading cause of mortality worldwide and is estimated to account for 4 million deaths globally each year, with children being considered extremely susceptible [1]
bronchopulmonary dysplasia (BPD) is a chronic respiratory disease of preterm infants resulting from lung immaturity as a consequence of interruption of lung development occurring in the final weeks of gestation [4]
Childhood interstitial lung disease is a heterogenous group of over 200 chronic lung diseases characterised by abnormal pathology of the lung interstitium and distal air spaces, resulting in abnormal gas exchange [72,73]. chILD is quite a rare disease; its global incidence is not clearly identified, with the incidence in the UK and Ireland estimated at 3.6 per 1 million [74]; in Australia, estimates are 1·5–3·8 per 1 million [75], and in Germany, it is estimated at 0·13 per 100,000 children per year [76]
Summary
Respiratory disease is a leading cause of mortality worldwide and is estimated to account for 4 million deaths globally each year, with children being considered extremely susceptible [1]. Asthma is the most common chronic respiratory disease of childhood, currently estimated to affect 14% of children globally, with its prevalence increasing [2]. Many paediatric respiratory diseases remain incurable, contributing to the increasing burden of noncommunicable respiratory disease in adults globally [1]. The most recent focus of clinical studies for the treatment of respiratory disease with cellular therapies is on the adult population, with paediatric patients excluded. Cellular therapies offer a potential cure for respiratory disease that could prevent their progression into adult respiratory disease, reducing the economic burden of treatment throughout a patient’s lifetime
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