Mesenchymal stem cells for therapy of pulmonary fibrosis …

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease of unknown etiology, characterized by excessive scarring (fibrosis) of the lung due to an increase in number and uncontrolled activity of cells called fibroblasts. Destruction of normal lung structure usually leads to death from lung failure within five years of diagnosis. Currently available therapeutic approaches offer little clinical benefit. It has recently been suggested that injury to the lining cells of the lung (epithelial cells) may contribute by releasing substances (mediators) that stimulate fibroblasts to increase in number leading to scarring. In turn, fibroblasts may release mediators that can lead to epithelial cell death preventing normal repair.

Studies in animals have demonstrated that administration of a particular type of stem cell derived from adult bone marrow known as a mesenchymal stem cell (MSC) can improve outcome from a number of types of lung injury and prevent subsequent scarring. The mechanisms responsible for the helpful effects of MSC are not well understood and may include changes in the immune system and secretion of mediators that prevent epithelial cells from dying. This may tip the balance in favor of repair of lung damage and resolution of the injury. Experimental studies as well as clinical trials of MSC in several non-pulmonary diseases have already shown beneficial effects. Given that MSC appear to be the most immediate available opportunity for stem cell-based therapy of lung disease, the overall goal of this proposal is to assemble a Disease Team to plan a proposal for use of MSC as a therapeutic tool for IPF.

A team will be assembled with expertise in several areas including expertise in growing MSC and animal models of lung injury, preparation of products of sufficiently good quality for administration to humans, obtaining approval of new products through the Food and Drug Administration and clinical trials in patients. In initial meetings, members of the team will assess whether any other specific expertise is required. Once assembled, team members will participate in regular meetings and conference calls to plan and prepare the research proposal for development of the research proposal. The PI will actively manage the team, using deadlines for specific objectives, including development of protocols, assignment of writing tasks and coordination of written materials.

Development of MSC for treatment of IPF is ideally suited to a team approach. The varying types of expertise required for this project are usually not found at a single institution and few investigators have both knowledge of basic stem cell biology and the ability to translate findings into clinical trials. The Disease Team approach will bring together individuals of varying expertise who might not otherwise have interacted to develop a proposal for translation of MSC to the clinic for lung disease, which responds directly to the objectives of this award.

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Mesenchymal stem cells for therapy of pulmonary fibrosis ...