Mesenchymal Stem/Stromal Cell Therapy for Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit

Abstract

Clinical trials of mesenchymal stem/stromal cell (MSC) therapy for bronchopulmonary dysplasia (BPD) are already underway. A thorough understanding of the preclinical work that underpins these trials is critical for neonatal practitioners to properly evaluate them. The more significant advances have been in investigating the mechanisms of action by which MSCs are thought to ameliorate BPD, and the recognition that this therapeutic effect is largely contained within the non-cellular exosome fraction of MSCs. In rodent hyperoxia models of BPD, MSCs have a pro-angiogenic effect mediated largely by vascular endothelial growth factor (VEGF) and shift the balance of endogenous lung cells from a pro-inflammatory to a pro-healing phenotype. MSC-derived exosomes can recapitulate these effects.