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.

 

 

Stem Cell Therapy

Dear Dr. Mahler:

I have been reading that stem cell treatment can repair the damage in my lungs caused by emphysema. What are your thoughts on this? I am 69 year old, and have been told that my COPD is stage 4. I use three different inhalers and oxygen at a setting of 2 when I do things, but not at rest.  I am starting to feel desperate about my breathing. Thanks. 

Catherine from Reno, NV

Dear Catherine:

Your question is quite interesting, and a few patients in my practice have asked me the same thing. I will try to explain what are stem cells without being too technical.

Stem cells are unique because they can develop into any type of tissue in the human body.

 

Stems cells can be used for stem cell therapy

Stem cells can become any tissue in the body

As they have regenerative properties, stem cells offer hope for curing a variety of diseases including emphysema and scarring in the lung (fibrosis). There are two types of stem cells – one is called embryonic because they are found in embryos and the other is called adult because they are found in the umbilical cord, placenta, blood, bone marrow, skin, and other tissues. Large numbers of stem cells are needed to repair damaged tissue.

Embryonic stem cells used for stem cell therapy

At top, embryonic stem cell colonies. At bottom, nerve cells.
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Embryonic stem cells are grown in a culture medium where they divide and multiply. However, adult stem cells have difficulty dividing once they are removed from the human body.  Currently, scientists are trying to find better ways to grow adult stem cells in cell culture and to manipulate them into specific types of cells that have the ability to treat injury and disease.

For stem cell therapy to be useful to treat COPD, millions of stem cells are needed to be implanted into a specific part of the body, such as the lungs. To make millions of cells, a process called manipulation is required. However, the Food and Drug Administration considers that manipulation of these cells is equivalent to a prescription medication, and therefore the process must be carefully regulated.

Without going into detail, there are potential risks of stem cell therapy that need further study.

In summary, the use of stem cells for treating COPD has great appeal. However, there is very little known about short and long term effects. At the present, there are a few approved clinical trials (studies) in the United States and Canada evaluating stem cell therapy. They can be found on the website of the National Institutes of Health at www.clinicaltrials.gov.

Because of potential for harm, the lack of any proven benefits so far, and the high fees that are typically charged, I advise caution before further consideration of stem cell therapy for your COPD. Hopefully, the medical profession will learn more about this unique treatment.

Regarding your breathing, are you under the care of a pulmonary specialist? If not, I encourage to ask your doctor to refer you a pulmonologist to make sure that you are receiving optimal medical care for your COPD.

Sincerely,

Donald A. Mahler, M.D.