Chronic obstructive pulmonary disease (COPD) is an incurable lung disorder which makes it difficult to breathe. It includes chronic bronchitis and emphysema and is characterized by a persistent cough and mucus production. While it is not curable, it can be managed through ongoing treatment to provide patients with effective symptom control and good quality of life. There are a few key types of lung damage that can occur in COPD:
- With emphysema, the air sacs (alveoli) in the lungs are compromised. The walls of alveoli are stretched and actually cause the lungs to expand, which makes it more difficult for air to move in and out.
- In chronic bronchitis, the bronchial tubes are constantly inflamed, which limits airflow. In specific, the cilia (hair-like structures in the airways) become damaged. The airway can also become swollen and clogged.
- Refractory asthma is also marked by swelling of the bronchial airways. Even medications cannot reverse the swelling.
Here, we examine a form of COPD treatment which has been gaining attention recently.
Blood-derived platelet-rich plasma (PRP) therapy is increasingly being used to treat a broad range of conditions, including sports injuries and arthritis. The procedure is performed via intravenous blood extraction. After the blood cells are harvested, they are processed, and the platelets are separated from other blood components. With the higher concentration of platelets, the treated blood is then reinserted into the patient with the hopes of reducing inflammation and speeding up the body’s healing process.
The problem with blood-derived PRP is that the evidence illustrating the effectiveness of this treatment for COPD is lacking. While some studies have been performed and suggest the treatment’s ability to support hair regrowth and reduce osteoarthritis pain, the lack of definitive proof supporting PRP therapy’s ability to make a noticeable impact on COPD has spurred criticism.
A Better Alternative
Stem cell PRP takes PRP injections a step further by mixing platelets with stem cells to treat the structural airway issues present in all forms of COPD. In numerous studies, this approach has shown promise. Coupling blood derivatives with stem cell therapy have proven effective in tissue regeneration in areas like the knee and gums, for instance. In one report, researchers concluded that the therapy “offers a promising therapeutic approach that has shown potential in diverse degenerative lung diseases” based on findings across 15 separate studies.
Through traditional PRP treatment, platelets become 5-10 times more concentrated, or 150,000- 450,000 platelets per microliter. When combined with stem cells, however, they become supercharged and platelet counts are much higher. Because research suggests that the therapeutic level for platelet count should be closer to 1,000,000 per cubic milliliter, PRP and stem cells are far more powerful than PRP alone. Moreover, PRP therapy is derived from whole blood alone, meaning it contains very few CD34+ cells – the cells commonly found in the umbilical cord and bone marrow which have the greatest self-renewal capacity – if any.
With stem cell therapy for COPD, it is guaranteed that these cells will be introduced into the body in a higher concentration. They can then promote the healing process, replacing countless cells throughout the entire body, including the lung tissue.
A recent review published in the International Journal of Molecular Sciences covers evidence demonstrating that Wharton’s jelly mesenchymal stem cells show promise for treating chronic obstructive pulmonary disease (COPD). After analyzing the literature on how stem cells may be applied in COPD treatment, the authors suggest that chronic immune-inflammatory processes are a critical component of COPD that these stem cells may be able to combat.
According to the authors of the study, several characteristics of Wharton’s jelly mesenchymal stem cells make them well suited to therapies against COPD and other immune-inflammatory diseases. These characteristics include their accessibility, their ability to expand and differentiate, and their tendency to avoid the immune reactions that often occur with other types of stem cells. These cells can come from several types of tissue, including adipose tissue, the umbilical cord, and bone marrow, and can differentiate into many different cell types.
Given the inflammatory nature of COPD, the ability of Wharton’s jelly mesenchymal stem cells to avoid serious immune reactions upon implantation may be one of the most important features of these cells. Youthful forms of these stem cells appear particularly promising, as they are agile and even less likely to cause problematic immune reactions. Intuitively, youthful stem cells are healthier in many ways because they have not undergone the biological damage that occurs with aging.
In addition to their relatively low likelihood of causing immune reactions, mesenchymal stem cells have also been shown to relieve inflammation in the airway in some studies. They have done so by producing mucus that can help minimize inflammation, by killing off cells involved in inflammation, by inhibiting the formation of problematic fibrous connective tissue, and by promoting the formation of new blood vessels.
As the reviewers note, the positive results of preclinical investigations justified the initiation of clinical trials using mesenchymal stem cells in COPD. As such, there are currently Phase I and Phase II trials underway and some that have already been completed. One completed study demonstrated the safety of using these stem cells, as no patients experienced serious adverse side effects after stem cell transplantation. The study also showed that the stem cells were associated with a reduction in an inflammatory marker, suggesting that the stem cells may, in fact, help to reduce inflammation in these patients.
Another study also demonstrated safety. It also showed functional improvement in COPD patients. These patients performed better on the breathing spirometry test after stem cell transplantation. This change in performance suggests that the pathological degeneration occurring in the lungs of those with COPD was slowed with the implantation of stem cells. These patients also experienced improved quality of life after the stem cell transplantation.
Chronic Obstructive Pulmonary Disease (COPD) is one of a long list of diseases that may be impacted by stem cells. A number of studies have suggested that mesenchymal stem cells may protect against the lung damage associated with COPD, but they have not been able to explain how the cells may achieve such protection.
Understanding the mechanism by which stem cells offer therapeutic value is critical for developing effective therapies that can help patients. As such, researchers from London and Hong Kong undertook a collaborative study to investigate how stem cells may protect the lungs of those with COPD. Their results were recently published in the Journal of Allergy and Clinical Immunology.
The researchers hypothesized that stem cells may work by reducing the damage that mitochondria endure in COPD. Mitochondria are the cell’s energy source and are damaged through a process known as oxidative stress, which occurs when the cells are exposed to free radicals. In COPD, when oxidative stress damages mitochondria, the lungs often become inflamed, resulting in the death of lung cells.
To test their hypothesis, the scientists looked at the effect of induced pluripotent stem cell-derived mesenchymal stem cells on airway smooth muscle cells. Consistent with their hypothesis, they found that the presence of the stem cells reduced mitochondrial damage caused by oxidative stress. The stem cells also reduced the amount of cellular death.
While more research is needed to determine how exactly stem cells can be used to treat patients with COPD, the finding that stem cells can prevent damage to lung tissue is promising. Now that researchers have also helped clarify how these cells are able to prevent such damage, they are equipped with information that could help them optimize any cell-based therapies that are developed for COPD.
Managing with a condition like COPD can be quite troublesome, but some practical steps can be taken to cope with it in a better way and even making some small changes can help a great deal.
Everyday Health offers some basic tips that you can use to make COPD management easier.
With a lung disease like COPD, quitting smoking is the best way to avoid the worsening of the symptoms. Quitting smoking may not cure the disease, but it will certainly aid in breathing easier and improve the overall health of the lungs and body.
Signing up for a pulmonary rehabilitation program can help with COPD. This program can help you catch the breath when you struggle with breathing and will help teach the most effective ways to inhale, sit and stand to get the control of your breathing at times of struggle.
Eating healthy can improve lung function. If you find yourself not sure where to start, you can talk to your doctor to recommend a well rounded and nutritious diet that can aid in managing with the growing symptoms.
An important thing that helps in COPD treatment is to remain physically active. Exercising regularly four to five days a week helps in keeping the body active and healthy. Exercise also helps strengthen muscles and improve the functioning of the lungs which then can help in breathing.
One can feel fatigued due to the lack of oxygen intake because of their struggle with breathing. Getting a good night’s sleep helps people with COPD maintain a healthy weight, better immunity against infections, avoid cardiovascular problems and improve the mood.
Look for Support from Family and Friends
Having COPD makes it difficult to carry out the daily activities so never hesitate to ask for support from your friends and family, especially if you are getting treated with oxygen therapy. Carrying a portable oxygen tank can be a little challenging in public, so having a friend or family member by your side can help.
Avoid Lung Irritation
Getting sick with a flu or cold can worsen the symptoms of COPD. Attack of common respiratory infections like coughing and congestion can become very serious when you have this condition so make sure to be very careful in avoiding contact with sick people and to stay away from germs. Also breathing in harsh chemicals and smoke can also irritate the lungs and worsen the condition.
Work with Your Doctor
Another important factor is to stay in constant contact with your doctor and keep discussing any visible changes in your health so the symptoms can be kept under control. The doctor can help prescribe the best medications, diet and exercise programs and pulmonary rehabilitation so you can easily manage the symptoms and enjoy an active and healthy life.
A recent study that followed-up on the condition of patients with advanced pulmonary emphysema three years after they had begun a Phase I clinical trial in which they were treated with a type of stem cell called bone marrow mononuclear cells demonstrated improved symptoms and improved pathology. The idea for using stem cells to treat advanced pulmonary emphysema, a form of chronic obstructive pulmonary disease (COPD) arose because of a need for a treatment that is effective in slowing the progression of the disease. Despite advances in pharmaceutical interventions for COPD, there had not yet been an intervention that was viable in the long-term.
The group who reported these new results had also led the Phase I clinical trial 3 years prior. They had chosen bone marrow mononuclear cells because of evidence that when this type of cell was introduced to the bloodstream, it could later be found in pulmonary tissue. When the researchers used these cells in patients with emphysema, they found that the procedure was safe and did not produce any significant harmful side effects. Further, immediately following the clinical procedure, the rate of degeneration of lung tissue slowed down.
The 4 patients included in the study were males between 40 and 72 years old, had stopped smoking for about 10 years before the stem cells were introduced to their bodies, and had solid family support. They had each previously smoked for more than two decades. None of the patients abused drugs or alcohol or were pregnant, and those suffering from certain infections or other health complications were excluded from the study.
While patients improved immediately following the stem cell procedure, two of the patients developed pneumonia as a result of hospital infections. The other two showed improved lung function at the 3-year follow-up. These patients experienced reduced symptoms and also performed better in the spirometry test of lung function. In addition, they both reported a higher quality of life as a result of the stem cell procedure.
Learn more about stem cell therapy for COPD.
In response to the limitation of current treatments of chronic obstructive pulmonary disease (COPD), researchers have posted that stem cells may be a good option for patients who suffer from COPD. One of the key characteristics of COPD is inflammation seen in the lungs, and this inflammation leads to tissue destruction. Thus, researchers have tried to zero in on stem cells that could help minimize inflammation. In a recent study published in Scientific Reports, researchers show that certain stem cells can reverse inflammation and also demonstrate, at a molecular level, how the stem cells achieved this challenge.
For the study, researchers chose to use bone marrow-derived mesenchymal stem cells because this type of stem cell has reliably been shown to repair tissue that has been damaged by heart attacks or strokes. Further, clinical trials have shown that these cells can be used in COPD patients safely and are associated with a reduction in C-reactive protein (CRP). CRP is a prognostic marker, with higher levels indicating a worse prognosis in COPD patients.
Given the promise of bone marrow-derived mesenchymal stem cells in the treatment of COPD, the researchers aimed to help clarify the mechanism by which these stem cells may achieve their positive impacts on COPD patients. Such information would be useful when developing specific treatment protocols for this group of patients.
The researchers found that the stem cells did, in fact, reduce inflammation of the airway by inhibiting the action of an enzyme called cyclooxygenase-2 (COX-2). The suppression of COX-2 is known to be associated with relief of both inflammation and pain. The study also suggests that this suppression may specifically occur within macrophages, which play a role in inflammation.
These results help to solidify the idea that stem cell therapy can be useful for COPD treatment and point to a mechanism by which the use of stem cells could achieve the clinical goal of improved COPD symptoms and pathology. Further research into this mechanism may help researchers optimize stem cell interventions for COPD.
To find out more about stem cell therapy for COPD treatment, click here.