First case of low-dose umbilical cord blood therapy for pediatric acute respiratory distress syndrome induced by Pneumocystis carinii pneumonia

Shuang Liu,Rong Liu,Siyuan Huang,Huili Shen,Dong Qu

doi:10.1186/s40001-021-00548-0

Shuang Liu, Rong Liu + Show 3 more

Open Access

https://doi.org/10.1186/s40001-021-00548-0

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Abstract

ObjectiveThis study aimed to present the case of a boy with acute distress syndrome (ARDS) treated with low-dose umbilical cord blood (UCB) therapy and explore the underlying possible mechanism.MethodsA 7-year-old boy with severe Pneumocystis carinii pneumonia and severe ARDS was treated with allogeneic UCB as salvage therapy.ResultsThe patient did not improve after being treated with lung protective ventilation, pulmonary surfactant replacement, and extracorporeal membrane oxygenation (ECMO) for 30 days. However, his disease reversed 5 days after allogeneic UCB infusion, and he weaned from ECMO after 7 days of infusion. Bioinformatics confirmed that his Toll-like receptor (TLR) was abnormal before UCB infusion. However, after the infusion, his immune system was activated and repaired, and the TLR4/MyD88/NF-κB signaling pathway was recovered.ConclusionAllogenic UCB could treat ARDS by repairing the TLR4/MyD88/NF-κB signaling pathway, thereby achieving stability of the immune system.

Highlights

Acute respiratory distress syndrome [1] (ARDS) refers to acute progressive respiratory distress and hypoxemia caused by various intrapulmonary and/or extrapulmonary factors
The pathogenesis of ARDS is mainly related to uncontrolled inflammatory response, dysfunction of the alveolar capillary
Studies reported that 67%–85% of patient infected with SARS-CoV-2 had ARDS with a mortality rate of 61.5% [3, 4]

Summary

Introduction

Acute respiratory distress syndrome [1] (ARDS) refers to acute progressive respiratory distress and hypoxemia caused by various intrapulmonary and/or extrapulmonary factors. Studies reported that 67%–85% of patient infected with SARS-CoV-2 had ARDS with a mortality rate of 61.5% [3, 4]. During the epidemic of COVID-19, our center treated a patient with severe ARDS and Pneumocystis Liu et al Eur J Med Res (2021) 26:100 carinii pneumonia (PCP) with lung protective ventilation, PS replacement, ECMO therapy and allogeneic UCB infusion.

Results

Conclusion