Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study

Respiratory Research

Research

Qiang Shu¹  Yaoqin Hu¹  Baoli Cheng²  Liuya Zhang³  Guoping Zheng³  Haijiang Tong³  Keqin Deng³  Bin Zou³  Lanfang Huang³  Menghua Ge³  Jianguo Xu⁴ 

[1] Children’s Hospital, School of Medicine, Zhejiang University, Zhejiang, China;First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China;Shaoxing Second Hospital, 123 Yan An Road, 312000, Shaoxing, Zhejiang, China;Shaoxing Second Hospital, 123 Yan An Road, 312000, Shaoxing, Zhejiang, China;First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China;

关键词: Mesenchymal stem cells;    Adipose-derived;    Acute respiratory distress syndrome;    Biomarkers;   

DOI  :  10.1186/1465-9921-15-39

 received in 2013-09-29, accepted in 2014-03-26,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundRecent studies have demonstrated that mesenchymal stem cells (MSCs) modulate the immune response and reduce lung injury in animal models. Currently, no clinical studies of the effects of MSCs in acute respiratory distress syndrome (ARDS) exist. The objectives of this study were first to examine the possible adverse events after systemic administration of allogeneic adipose-derived MSCs in ARDS patients and second to determine potential efficacy of MSCs on ARDS.MethodsTwelve adult patients meeting the Berlin definition of acute respiratory distress syndrome with a PaO2/FiO2 ratio of < 200 were randomized to receive allogeneic adipose-derived MSCs or placebo in a 1:1 fashion. Patients received one intravenous dose of 1 × 106 cells/kg of body weight or saline. Possible side effects were monitored after treatment. Acute lung injury biomarkers, including IL-6, IL-8 and surfactant protein D (SP-D), were examined to determine the effects of MSCs on lung injury and inflammation.ResultsThere were no infusion toxicities or serious adverse events related to MSCs administration and there were no significant differences in the overall number of adverse events between the two groups. Length of hospital stay, ventilator-free days and ICU-free days at day 28 after treatment were similar. There were no changes in biomarkers examined in the placebo group. In the MSCs group, serum SP-D levels at day 5 were significantly lower than those at day 0 (p = 0.027) while the changes in IL-8 levels were not significant. The IL-6 levels at day 5 showed a trend towards lower levels as compared with day 0, but this trend was not statistically significant (p = 0.06).ConclusionsAdministration of allogeneic adipose-derived MSCs appears to be safe and feasible in the treatment of ARDS. However, the clinical effect with the doses of MSCs used is weak, and further optimization of this strategy will probably be required to reach the goal of reduced alveolar epithelial injury in ARDS.Trial registrationClinical trials.gov, NCT01902082

【 授权许可】

Unknown   
© Zheng et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.