Cell therapy shows promise for improving gas exchange in COPD, may offer potential cure
Click Here to Manage Email Alerts
Key takeaways:
- Transplanting a patients’ own lung cells back into their lungs resulted in improved breathing.
- Lung damage was fixed in two patients with mild emphysema using this method.
Patients with COPD who underwent autologous transplantation of lung progenitor cells had improved gas exchange capacity, quality of life and walking distance, according to study results.
Further, these results, presented at European Respiratory Society International Congress, showed that transplant of these P63+ progenitor cells repaired lung damage in those with mild emphysema.
“Stem cell and progenitor cell-based regenerative medicine may be the biggest, if not the only, hope to cure COPD,” Wei Zuo, PhD, professor in the school of medicine at Tongji University in Shanghai and chief scientist at Regend Therapeutics Ltd., said in a press release. “P63+ progenitor cells are known for their ability to regenerate the tissues of the airways, and previously we and other scientists have shown in animal experiments that they can repair the damaged epithelial tissue in the alveoli — the tiny air sacs in the lungs that play a crucial role in the exchange of gases between air breathed in and the blood supply to the lungs.”
In a phase 1 clinical trial, Zuo and colleagues evaluated 20 patients with COPD (35% severe COPD; 53% extremely severe COPD) to determine the safety and efficacy of autologous P63+ lung progenitor cell transplantation 24 weeks after receiving the treatment.
In order to put a patients’ own lung cells back into their lungs, researchers had to first obtain their progenitor cells using a small catheter. Following this procedure, they cloned the cells and used bronchoscopy to transplant all the cells back into the patients’ lungs, according to the press release.
From the total cohort, 17 patients received the cell treatment, whereas three patients did not (control group).
Every patient receiving the treatment tolerated it well, according to researchers.
Among those treated, median baseline diffusing capacity of the lungs for carbon monoxide (DLCO) was 30% (interquartile range [IQR], 25-41.65), and this improved to 39.7% (IQR, 31.6-48.3) 12 weeks after treatment. By week 24, median DLCO went up to 40.3% (IQR, 27.3-48.89).
Researchers further noted improvements in quality of life and walking distance. At 24 weeks, treated patients demonstrated lower St. George’s Respiratory Questionnaire scores (baseline, 51.3 vs. 24 weeks, 44.2), signaling better health, and greater 6-minute walk distance (baseline, 410 m vs. 24 weeks, 447 m).
By the end of the study period, researchers also observed resolution of lesions for two patients with mild emphysema, demonstrating the possibility of lung damage repair for this specific patient population with this cell treatment.
According to the press release, a phase 2 trial with a bigger study population is being planned.
“With more doctors and patients participating in our clinical trial, we may develop the treatment more quickly so that it can benefit patients sooner," Zuo said in the release. “A similar therapeutic strategy is also being tested in patients with lethal lung fibrotic diseases, including idiopathic pulmonary fibrosis. We are going to test the treatment’s efficacy in larger groups of people with more lung diseases. We hope to develop the treatment for clinical use within about 2 to 3 years.”
Reference:
- Transplanting patients’ own lung cells offers hope of ‘cure’ for COPD. https://www.ersnet.org/news-and-features/news/transplanting-patients-own-lung-cells-offers-hope-of-cure-for-copd/. Published Sept. 12, 2023. Accessed Sept. 12, 2023.
Perspective
Back to Top
Gerard J. Criner, MD, FACP, FACCP
In general, optimal medical treatment of patients with COPD includes pharmacological treatment with inhaled respiratory drugs that dilate the airways (bronchodilators) and decrease airways inflammation (inhaled steroids) and nonpharmacological treatments (oxygen and pulmonary rehabilitation). Many patients remain symptomatic despite optimal medical therapy, primarily those with an emphysema-predominant phenotype, and more invasive therapies such as lung volume reduction or lung transplantation may be considered. However, these later therapies are not readily available or appropriate options for patients who are older or have significant comorbid conditions. Prior attempts with stem cell transplantation in patients with COPD have not been shown to be successful. Regenerative therapy with stem cell transplantation as described by Zuo and colleagues that has an acceptable safety profile and provides significant physiologic and quality-of-life improvements are desperately needed to improve the outcomes of patients with COPD who remain symptomatic despite optimal medical treatment. The preliminary findings reported by the investigators are encouraging, but much more work needs to be done to establish optimal patient selection criteria, the magnitude and durability of the treatment effect, the technical approach and dosing that delivers the optimal treatment response, and the safety profile of this therapeutic approach.
Collapse
Zuo W, et al. Abstract OA4297. Presented at: European Respiratory Society International Congress; Sept. 9-13, 2023; Milan.
Click Here to Manage Email Alerts