Acute respiratory distress syndrome is a life threatening condition with few effective treatment options. Preliminary studies using mesenchymal stem cells, or stromal cells, to treat ARDS have shown promise with decreased levels of bacteria in the lungs, reduced pulmonary edema and improved oxygenation. In Part 1, Dr. Calfee begins by explaining that acute respiratory distress syndrome (ARDS) is pulmonary edema, or fluid in the lungs, not due to heart failure. It is a condition that affects 200,000 people/year in the USA with a 30-40% mortality rate. During ARDS, there are many cellular changes with complex pathophysiology making it extremely difficult to treat. Currently, patients are treated by ventilation with low tidal volume and fluid conservative therapy as many pharmacological interventions have failed. Mesenchymal stem cells (MSC), however, may hold promise as a treatment.
In Part 2, Dr. Matthay provides the rationale behind treating ARDS patients with MSC. Initial studies in a mouse model of ARDS, showed that treatment with MSCs increased levels of anti-inflammatory cytokines and antimicrobial peptides in the lung, and increased phagocytosis of bacteria by monocytes. Further studies in ex vivo perfused human lungs and in sheep with severe lung injury showed that treatment with MSCs improved oxygenation and reduced pulmonary edema. An NIH/NHLBI supported phase 1 clinical trial for safety has been completed and a randomized, blinded phase 2 trial has now been initiated to test the safety and efficacy of MSC treatment in human patients with ARDS.
Dr. Carolyn Calfee is an Associate Professor of Medicine and Anesthesia at the University of California, San Francisco and a member of the UCSF Cancer Center and the Center for Tobacco Control Research and Education at UCSF. Calfee’s clinical and research focus is the diagnosis and treatment of acute lung injury and acute respiratory distress… Continue Reading
Dr. Michael Matthay was an undergraduate student at Harvard University and a medical student at the University of Pennsylvania School of Medicine. He completed his training in Internal Medicine at the University of Colorado and in Pulmonary/Critical Care Medicine at UCSF. Currently, Matthay is a Professor of Medicine and Anesthesia at the University of California,… Continue Reading