Tuberc Respir Dis.  2017 Jan;80(1):1-10. 10.4046/trd.2017.80.1.1.

Lung Regeneration Therapy for Chronic Obstructive Pulmonary Disease

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Korea. ymoh55@amc.seoul.kr
  • 2Asan Institute for Life Sciences, Seoul, Korea.
  • 3University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Chronic obstructive pulmonary disease (COPD) is a critical condition with high morbidity and mortality. Although several medications are available, there are no definite treatments. However, recent advances in the understanding of stem and progenitor cells in the lung, and molecular changes during re-alveolization after pneumonectomy, have made it possible to envisage the regeneration of damaged lungs. With this background, numerous studies of stem cells and various stimulatory molecules have been undertaken, to try and regenerate destroyed lungs in animal models of COPD. Both the cell and drug therapies show promising results. However, in contrast to the successes in laboratories, no clinical trials have exhibited satisfactory efficacy, although they were generally safe and tolerable. In this article, we review the previous experimental and clinical trials, and summarize the recent advances in lung regeneration therapy for COPD. Furthermore, we discuss the current limitations and future perspectives of this emerging field.

Keyword

Pulmonary Disease, Chronic Obstructive; Cell- and Tissue-Based Therapy; Drug Therapy; Emphysema; Lung; Regeneration; Regenerative Medicine; Retinoids; Stem Cells

MeSH Terms

Cell- and Tissue-Based Therapy
Drug Therapy
Emphysema
Lung*
Models, Animal
Mortality
Pneumonectomy
Pulmonary Emphysema
Pulmonary Disease, Chronic Obstructive*
Regenerative Medicine
Retinoids
Stem Cells
Retinoids

Reference

1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease [Internet]. Global Initiative for Chronic Obstructive Lung Disease;2015. cited 2015 Dec 21. Available from: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015_Sept2.pdf.
2. Kotton DN, Morrisey EE. Lung regeneration: mechanisms, applications and emerging stem cell populations. Nat Med. 2014; 20:822–832.
3. Rock J, Konigshoff M. Endogenous lung regeneration: potential and limitations. Am J Respir Crit Care Med. 2012; 186:1213–1219.
4. Adamson IY, Bowden DH. Derivation of type 1 epithelium from type 2 cells in the developing rat lung. Lab Invest. 1975; 32:736–745.
5. Voss GJ, Kump DK, Walker JA, Voss SR. Variation in salamander tail regeneration is associated with genetic factors that determine tail morphology. PLoS One. 2013; 8:e67274.
6. Laros CD, Westermann CJ. Postpneumonectomy compensatory lung growth. Am Rev Respir Dis. 1989; 139:1569–1570.
7. Landesberg LJ, Ramalingam R, Lee K, Rosengart TK, Crystal RG. Upregulation of transcription factors in lung in the early phase of postpneumonectomy lung growth. Am J Physiol Lung Cell Mol Physiol. 2001; 281:L1138–L1149.
8. Kho AT, Liu K, Visner G, Martin T, Boudreault F. Identification of dedifferentiation and redevelopment phases during postpneumonectomy lung growth. Am J Physiol Lung Cell Mol Physiol. 2013; 305:L542–L554.
9. Wolff JC, Wilhelm J, Fink L, Seeger W, Voswinckel R. Comparative gene expression profiling of post-natal and postpneumonectomy lung growth. Eur Respir J. 2010; 35:655–666.
10. Roszell B, Mondrinos MJ, Seaton A, Simons DM, Koutzaki SH, Fong GH, et al. Efficient derivation of alveolar type II cells from embryonic stem cells for in vivo application. Tissue Eng Part A. 2009; 15:3351–3365.
11. Keating A. Mesenchymal stromal cells: new directions. Cell Stem Cell. 2012; 10:709–716.
12. Katsha AM, Ohkouchi S, Xin H, Kanehira M, Sun R, Nukiwa T, et al. Paracrine factors of multipotent stromal cells ameliorate lung injury in an elastase-induced emphysema model. Mol Ther. 2011; 19:196–203.
13. Huh JW, Kim SY, Lee JH, Lee JS, Van Ta Q, Kim M, et al. Bone marrow cells repair cigarette smoke-induced emphysema in rats. Am J Physiol Lung Cell Mol Physiol. 2011; 301:L255–L266.
14. Schweitzer KS, Johnstone BH, Garrison J, Rush NI, Cooper S, Traktuev DO, et al. Adipose stem cell treatment in mice attenuates lung and systemic injury induced by cigarette smoking. Am J Respir Crit Care Med. 2011; 183:215–225.
15. Kim YS, Kim JY, Huh JW, Lee SW, Choi SJ, Oh YM. The therapeutic effects of optimal dose of mesenchymal stem cells in a murine model of an elastase induced-emphysema. Tuberc Respir Dis. 2015; 78:239–245.
16. Kim YS, Kim JY, Shin DM, Huh JW, Lee SW, Oh YM. Tracking intravenous adipose-derived mesenchymal stem cells in a model of elastase-induced emphysema. Tuberc Respir Dis. 2014; 77:116–123.
17. Murphy MB, Moncivais K, Caplan AI. Mesenchymal stem cells: environmentally responsive therapeutics for regenerative medicine. Exp Mol Med. 2013; 45:e54.
18. Guan XJ, Song L, Han FF, Cui ZL, Chen X, Guo XJ, et al. Mesenchymal stem cells protect cigarette smoke-damaged lung and pulmonary function partly via VEGF-VEGF receptors. J Cell Biochem. 2013; 114:323–335.
19. Massaro GD, Massaro D. Retinoic acid treatment partially rescues failed septation in rats and in mice. Am J Physiol Lung Cell Mol Physiol. 2000; 278:L955–L960.
20. Massaro GD, Massaro D. Retinoic acid treatment abrogates elastase-induced pulmonary emphysema in rats. Nat Med. 1997; 3:675–677.
21. Mason RJ, Leslie CC, McCormick-Shannon K, Deterding RR, Nakamura T, Rubin JS, et al. Hepatocyte growth factor is a growth factor for rat alveolar type II cells. Am J Respir Cell Mol Biol. 1994; 11:561–567.
22. Shigemura N, Sawa Y, Mizuno S, Ono M, Ohta M, Nakamura T, et al. Amelioration of pulmonary emphysema by in vivo gene transfection with hepatocyte growth factor in rats. Circulation. 2005; 111:1407–1414.
23. Hegab AE, Kubo H, Yamaya M, Asada M, He M, Fujino N, et al. Intranasal HGF administration ameliorates the physiologic and morphologic changes in lung emphysema. Mol Ther. 2008; 16:1417–1426.
24. Morino S, Nakamura T, Toba T, Takahashi M, Kushibiki T, Tabata Y, et al. Fibroblast growth factor-2 induces recovery of pulmonary blood flow in canine emphysema models. Chest. 2005; 128:920–926.
25. Lee BJ, Moon HG, Shin TS, Jeon SG, Lee EY, Gho YS, et al. Protective effects of basic fibroblast growth factor in the development of emphysema induced by interferon-gamma. Exp Mol Med. 2011; 43:169–178.
26. Guzy RD, Stoilov I, Elton TJ, Mecham RP, Ornitz DM. Fibroblast growth factor 2 is required for epithelial recovery, but not for pulmonary fibrosis, in response to bleomycin. Am J Respir Cell Mol Biol. 2015; 52:116–128.
27. Massaro D, Massaro GD. Estrogen regulates pulmonary alveolar formation, loss, and regeneration in mice. Am J Physiol Lung Cell Mol Physiol. 2004; 287:L1154–L1159.
28. Hare JM, Traverse JH, Henry TD, Dib N, Strumpf RK, Schulman SP, et al. A randomized, double-blind, placebo-controlled, dose-escalation study of intravenous adult human mesenchymal stem cells (prochymal) after acute myocardial infarction. J Am Coll Cardiol. 2009; 54:2277–2286.
29. Weiss DJ, Casaburi R, Flannery R, LeRoux-Williams M, Tashkin DP. A placebo-controlled, randomized trial of mesenchymal stem cells in COPD. Chest. 2013; 143:1590–1598.
30. Ribeiro-Paes JT, Bilaqui A, Greco OT, Ruiz MA, Marcelino MY, Stessuk T, et al. Unicentric study of cell therapy in chronic obstructive pulmonary disease/pulmonary emphysema. Int J Chron Obstruct Pulmon Dis. 2011; 6:63–71.
31. Stessuk T, Ruiz MA, Greco OT, Bilaqui A, Ribeiro-Paes MJ, Ribeiro-Paes JT. Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years. Rev Bras Hematol Hemoter. 2013; 35:352–357.
32. Mao JT, Goldin JG, Dermand J, Ibrahim G, Brown MS, Emerick A, et al. A pilot study of all-trans-retinoic acid for the treatment of human emphysema. Am J Respir Crit Care Med. 2002; 165:718–723.
33. Roth MD, Connett JE, D'Armiento JM, Foronjy RF, Friedman PJ, Goldin JG, et al. Feasibility of retinoids for the treatment of emphysema study. Chest. 2006; 130:1334–1345.
34. Jones PW, Rames AD. TESRA (Treatment of Emphysma with a Selective Retinoid Agonist) study results. Am J Respir Crit Care Med. 2011; 183:A6418.
35. Stolk J, Stockley RA, Stoel BC, Cooper BG, Piitulainen E, Seersholm N, et al. Randomised controlled trial for emphysema with a selective agonist of the gamma-type retinoic acid receptor. Eur Respir J. 2012; 40:306–312.
36. Lippman SM, Lee JJ, Karp DD, Vokes EE, Benner SE, Goodman GE, et al. Randomized phase III intergroup trial of isotretinoin to prevent second primary tumors in stage I nonsmall-cell lung cancer. J Natl Cancer Inst. 2001; 93:605–618.
37. Warrell RP Jr, de The H, Wang ZY, Degos L. Acute promyelocytic leukemia. N Engl J Med. 1993; 329:177–189.
38. Mercado N, Ito K, Barnes PJ. Accelerated ageing of the lung in COPD: new concepts. Thorax. 2015; 70:482–489.
39. Tashiro J, Elliot SJ, Gerth DJ, Xia X, Pereira-Simon S, Choi R, et al. Therapeutic benefits of young, but not old, adiposederived mesenchymal stem cells in a chronic mouse model of bleomycin-induced pulmonary fibrosis. Transl Res. 2015; 166:554–567.
Full Text Links
  • TRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr