Abstract

During acute or chronic lung injury, inappropriate immune response and/or aberrant repair process causes irreversible damage in lung tissue and most usually results in the development of fibrosis followed by decline in lung function. Inhaled corticosteroids and other anti-inflammatory drugs are very effective in patients with inflammatory lung disorders, but their long-term use is associated with severe side effects. Accordingly, new therapeutic agents that will attenuate ongoing inflammation and, at the same time, promote regeneration of injured alveolar epithelial cells are urgently needed. Mesenchymal stem cells (MSCs) are able to modulate proliferation, activation, and effector function of all immune cells that play an important role in the pathogenesis of acute and chronic inflammatory lung diseases. In addition to the suppression of lung-infiltrated immune cells, MSCs have potential to differentiate into alveolar epithelial cells in vitro and, accordingly, represent new players in cell-based therapy of inflammatory lung disorders. In this review article, we described molecular mechanisms involved in MSC-based therapy of acute and chronic pulmonary diseases and emphasized current knowledge and future perspectives related to the therapeutic application of MSCs in patients suffering from acute respiratory distress syndrome, pneumonia, asthma, chronic obstructive pulmonary diseases, and idiopathic pulmonary fibrosis.

Highlights

  • The respiratory system is continuously exposed to various irritants such as inhaled toxins, carbon granules, pathogens, and their products

  • Acute lung injury and inflammation is seen in pneumonia and acute respiratory distress syndrome (ARDS), whereas chronic inflammation is represented by asthma and chronic obstructive pulmonary diseases (COPD) [2]

  • In line with these results are our findings related to the therapeutic potential of “Exosomes d-MAPPS,” whose activity was based on PL-Mesenchymal stem cells (MSCs)-derived exosomes containing interleukin 1 receptor antagonist (IL-1Ra) and several other imunomodulatory cytokines and chemokines (IL-27, CXCL14, and CXCL16) which are involved in immunomodulation of the immune response in the injured lungs [102]

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Summary

Introduction

The respiratory system is continuously exposed to various irritants such as inhaled toxins, carbon granules, pathogens, and their products. New therapeutic agents that will attenuate ongoing inflammation and prevent accumulation of fibrous connective tissue on one side and, at the same time, promote regeneration of injured alveolar epithelial cells are urgently needed. Due to their capacity to suppress detrimental immune response and ability to differentiate into type II alveolar epithelial (ATII) cells in vitro, mesenchymal stem cells (MSCs) represent new players in cell-based therapy of acute and chronic inflammatory lung disorders [5, 6]. Keywords used in the selection were “mesenchymal stem cells,” “inflammatory lung disease,” “ARDS,” “lung injury,” “COPD,” “asthma,” and “idiopathic pulmonary fibrosis (IPF).” Eligible studies had to delineate molecular and cellular mechanisms involved in the MSC-based therapy of acute and chronic inflammatory lung diseases, and their findings were analyzed in this review

Main Text
MSC-Mediated Attenuation of ARDS and Pneumonia
MSC-Based Therapy of Asthma
Usage of MSCs in Cell-Based Therapy of COPD
MSC-Based Therapy of IPF
Strategies to Enhance the Survival of Transplanted MSCs in the Injured Lungs
10. Conclusions

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