November 3, 2017

The latest in stem-cell therapy for lung disease

Many patients and their families are aware of scientific breakthroughs in stem-cell science and are interested to learn whether these breakthroughs have led to new treatments for lung disease. So where is the stem-cell field up to?

What are stem-cells and stem-cell therapy?
Advances in stem-cell science over the past decade have been astounding and we now understand much more about how each organ, including the lung, repairs itself to ensure that it functions well throughout a lifetime. Much of this repair is dependent on stem-cell function to provide a ready source of newly minted cells to keep the organ in tip-top condition. This function is conducted by cells called ‘adult stem-cells.’ It is very likely that dysfunction of adult lung stem-cells contributes to or even causes some lung diseases. It is this idea which invites the possibility that stem-cell therapy might be effective for lung disease. This term is used very broadly to refer to a treatment involving the delivery of cells, obtained either from the person themselves or from a donor, to a diseased organ. In many cases, and especially in the lung, cells home to the organ of interest after being given through a vein, but sometimes they have been delivered directly to the diseased organ (for example heart stem-cells have been delivered via a catheter placed in the heart or surrounding coronary arteries).

Is stem-cell therapy effective?
It is too early to be able to answer this question. The work done to date has been in early phase clinical trials where the focus is on determining whether it is feasible to deliver a stem-cell treatment, and just as importantly, whether it is safe. Although later phase clinical trials are now underway, there is currently no evidence that any stem-cell treatment is effective for lung disease.

What about advertisements claiming that a ‘stem-cell therapy’ might help me?
Unfortunately the news is not all good. Due to loopholes in the way medicines and other treatments are regulated, a growing number of websites and other forums offer unsubstantiated claims of cell therapy efficacy in a range of lung and other diseases. This has become a particular problem in Australia.

Typically these clinics will take cells from a person’s blood, or from fat obtained during liposuction, and inject it back into the same person. The large majority of cells so obtained are not stem-cells. Furthermore there is no evidence for any of these treatments, and in fact there is a risk of significant harm or even death. This industry has developed because in Australia and many other countries, cells or tissues taken from a person and given back to that same person in a single course of treatment are not seen as ‘therapeutic goods’ and hence escape regulation by (in Australia) the Therapeutic Goods Administration (TGA). The Australian Government is taking steps to better regulate these practices.

Is there still hope that ‘stem-cell therapy’ will help cure lung diseases?
There is hope for the future. It is very likely that adult stem-cell dysfunction is a major cause of some lung diseases, including Idiopathic Pulmonary Fibrosis (IPF). As we gain more knowledge about which stem-cell populations are affected and how they are dysfunctional, we will be able to design treatments which correct these defects. Although future treatments may well not involve cells at all, their target will still be dysfunctional adult lung stem-cells, and therefore the future looks bright for stem-cell therapy in some form.

If you are looking for more information, contact reputable organisations such as The Thoracic Society of Australia and New Zealand, The Transplantation Society of Australia and New Zealand, or the American Thoracic Society who have joined with stem-cell societies and developed statements against unsubstantiated cell treatments on their respective websites. Find out more at lungfoundation.com.au/stem-cell-therapy.

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