Stem cell transplantation is now used worldwide in the treatment of any malignant and non-malignant hematologic conditions like auto immune diseases and in the treatment of various solid tumors. Every year, many hundreds of patients around the world receive an autologous (from the same patient) or allogeneic (from a donor) transplant procedure, and the numbers have increased vastly.
Hematopoietic stem cell transplantation and cellular therapy (Regenerative Medicine) are rapidly developing, highly effective modalities of treatment for a broad range of hematologic, immunologic, metabolic and malignant diseases.
For many disorders, hematopoietic transplantation is potentially curative for what would otherwise be fatal diseases.
Hematopoietic transplantation is the most established form of cellular therapy and is a cornerstone of treatment for a broad range of hematologic malignancies.
This form of therapy consist in the bone marrow derived stem cells use, and it is possible obtain these cells directly from bone marrow or from peripherical blood.
Hematopoietic stem cell transplantation is still a relatively new treatment modality, having been used clinically only since the 1970s. As time has passed, many changes and refinements have been introduced to improve the therapies. The patient population to which these techniques are applicable has also changed and enlarged as treatment has become safer, with the introduction of improved blood product support, antibiotics and better immunosuppressants. It can be anticipated that stem cell transplantation procedures will continue to become safer, thereby allowing us to safely extend curative treatments to elderly patients, and many other people with different pathologies like chronic pulmonary diseases or heart diseases.
Cellular components of the transplant:
Our current knowledge of stem cell transplantation (SCT) biology derives from a vast body of experimental data extending back more than 50 years.
Transplants contain a variety of cell types but the hematopoietic stem cells (HSC), conveniently identified by the CD34 surface antigen, and CD3+ T-lymphocytes, responsible for immunologic memory, are the most important because they can self-replicate and survive a lifetime in the person. Cells within the CD34 compartment establish lifelong hematopoiesis and regenerate an entire immune system.
In recent years, there has been much interest in the fact that SCT contain precursors of cells able to develop into non-hematopoietic cells such as pulmonary cells, angiocytes, endothelial cells, fibroblasts, neurons, heart cells and muscle cells. These facts allow the treatment of many diseases in those body areas.
Four transplant stem cell sources are in current use: bone marrow (BM), mobilized peripheral blood stem cells (PBSC), grease cells and umbilical cord blood (UCB). These sources differ considerably both quantitatively and qualitatively, and our Apheresis and Regenerative Medicine Unit only use BM, PBSC and grease from the own patient body.
Stem Cells for Lung Disease.
The lung is a complex organ with limited regenerative capacity. Local stem cells, with the capacity for unlimited self renewal and the production of more committed progenitors, have long been thought of as central to the repair and regeneration processes of various organs. However, this endogenous repair in the lung is insufficient to prevent the many progressive respiratory diseases.
Many series of exciting reports over the last 5 to 10 years have demonstrated that adult bone marrow-derived stem cells may have more plasticity and are able to differentiate
into bronchial and alveolar epithelium, vascular endothelium, and interstitial cell types, making them prime candidates for lung repair.
Stem cells have a multitude of clinical implications in the lung. The realization that adult bone marrow stem cells contribute to the repair of lung injury allows this avenue to be manipulated and augmented in human diseases. Treatment by cell therapy could be envisaged for acute disorders such as Acute Respiratory Distress Syndrome, or more chronic disorders such as emphysema, chronic obstructive pulmonary disease (COPD) and lung fibrosis (CHEST 2007; 132:279–285).
What Is COPD?
COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. “Progressive” means the disease gets worse over time.
COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dust—also may contribute to COPD.
Emphysema and chronic bronchitis are the two most common conditions that make up COPD. Chronic bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. Emphysema occurs when the air sacs (alveoli) at the end of the smallest air passages (bronchioles) in the lungs are gradually destroyed.
Symptoms of COPD often don’t appear until significant lung damage has occurred, and they usually worsen over time. For chronic bronchitis, the main symptom is a cough that you have at least three months a year for two consecutive years. Other signs and symptoms of COPD include:
- Shortness of breath, especially during physical activities
- Chest tightness
- Having to clear your throat first thing in the morning, due to excess mucus in your lungs
- A chronic cough that produces sputum that may be clear, white, yellow or greenish
- Blueness of the lips or fingernail beds (cyanosis)
- Frequent respiratory infections
- Lack of energy
- Unintended weight loss (in later stages)
People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse and persist for days or longer.
COPD is a major cause of disability, and it’s the third leading cause of death in the United States. Currently, millions of people are diagnosed with COPD. Many more people may have the disease and not even know it.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
Except the stem cells therapy, the COPD has no cure, and doctors don’t know how to reverse the damage to the airways and lungs.
Pulmonary fibrosis (PF) describes a condition in which the lung tissue becomes thickened, stiff, and scarred.
The medical terminology used to describe this scar tissue is fibrosis. The alveoli (air sacs) and the blood vessels within the lungs are responsible for delivering oxygen to the body, including the brain, heart, and other organs. All of the body’s functions depend upon delivery of a steady supply of oxygen.
As lung tissue becomes scarred and thicker, it is more difficult for the lungs to transfer oxygen into the bloodstream. As a result, the brain, heart, and other organs do not get the oxygen they need to function properly.
In some cases, doctors can determine the cause of the fibrosis (scarring), but in many cases the cause remains unknown. When there is no known cause for the development of pulmonary fibrosis (and certain radiographic and/or pathologic criteria are met), the disease is called idiopathic pulmonary fibrosis or IPF.
Signs and symptoms of pulmonary fibrosis include:
- Shortness of breath (dyspnea)
- A dry cough
- Unexplained weight loss
- Aching muscles and joints
The course of pulmonary fibrosis, and the severity of symptoms, can vary considerably from person to person. Some people become ill very quickly with severe disease. Others have more-moderate symptoms that worsen over months or years.
Like COPD and except the stem cells therapy, the fibrosis has no cure at this moment.
Stem Cell Treatment for COPD and Fibrosis.
The goal of the stem cell COPD treatment is to generate new lung tissues and blood vessels through angiogenesis. In the stem cell treatment for COPD protocol, the destroyed lung tissues and cells causing the various types of complications are targeted for regeneration. Using autologous stem cells from the patient’s own blood, bone marrow or fat the doctors are able to promote rapid healing of previously damaged cells.
The therapy is safe, with small discomfort for the patient, takes only 10 days and the 85% of the people improve their disease.
If you need a medical opinion about this treatment, please send a short resume of your history disease to firstname.lastname@example.org and include a transcription of the results of your thorax TAC and spirometry.