Stem Cell Therapy for Advanced Emphysema: Does It Work?

Here is a typical question among many that I have received about stem cell therapy to regenerate new lung tissue in emphysema. Dear Dr. Mahler: I hope that you can provide an update on stem cell therapy for emphysema. I am 53 years old and have been told that I have Stage 3 COPD /emphysema. Although I quit smoking and my lung doctor has me on the “best” medications, I find that I am slowly getting worse.  I attend pulmonary rehab 2-3 times a week, and have a normal weight. I want to be around to see my granddaughter get married. Is there hope? Sally from Boulder, CO Dear Sally, It is good to hear that you are doing all of the “right things” for your COPD. You and many others have asked about stem cell therapy. Certainly, it is an attractive option in theory – to regrow new lung tissue to replace damaged emphysema. Unfortunately, stem cell therapy remains experimental at the present time for advanced COPD. What are stem cells?  Stem cells have the potential to develop into cells that serve many different functions in the body. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a lung cell. Types of Stem Cells There are two types of stem cells. 1. Those that come from a human embryo – obtained by in-vitro fertilization in a laboratory. They cells can take on the function of any part of the body including cells in the lung. 2. Those that come from developed organs and tissues in the human. They are used by the body to repair and replace damaged areas. Current Status of Research  Here is a summary of what is happening in research laboratories. Stem cell therapy has been used successfully in the treatment of blood (hematological) and orthopedic conditions. This technology will hopefully be used to advance knowledge as a potential treatment for those with advanced emphysema. The goal would  be to regrow functional lung tissue where there is currently disease or damage. At the present time there are over 30 trials focusing on lung disease; 7 of these are in emphysema. Of the emphysema studies, only a few are taking place in academic medical centers in the US. The major challenges are: 1. finding a appropriate source of stem cells; and 2. finding the correct dose. At Brigham and Women’s Hospital in Boston, a stem cell research program is underway. Researchers are taking a biopsy of the lung in someone with emphysema, growing these cells in a tissue culture, and then at a later time placing them back into the individual. If this approach is successful, it will likely take many years before this type of stem cell treatment is ready for use. To summarize, current information does not support the benefits of stem cell therapy in treating those with advanced COPD. Hopefully, that will change in time. Keep active and stay positive. Sincerely, Donald A. Mahler, M.D.    

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.