Insights into the mechanisms of alveolarization - Implications for lung regeneration and cell therapies |
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| Institution: | 1. Otolaryngology Department, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil;2. Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil;1. Interdisciplinary Center for Cleft Palate & Craniofacial Malformations and Department of Neonatology, Tübingen University Hospital, Tübingen, Germany;2. Department of General Pediatrics, Reference Center for Rare Diseases “Pierre Robin Sequences and Congenital Sucking-swallowing Troubles”, Necker University Hospital, Paris University, France;3. Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Emma Children''s Hospital - Location AMC, University of Amsterdam, the Netherlands;4. Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital, London, UK;1. Emergency Department, IRCCS Burlo Garofolo, Trieste, Italy;2. Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, F-75015, Paris, France;3. Université de Paris, VIFASOM, F-75004, Paris, France |
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| Abstract: | Although the lung has extensive regenerative capacity, some diseases affecting the distal lung result in irreversible loss of pulmonary alveoli. Hitherto, treatments are supportive and do not specifically target tissue repair. Regenerative medicine offers prospects to promote lung repair and regeneration. The neonatal lung may be particularly receptive, because of its growth potential, compared to the adult lung. Based on our current understanding of neonatal lung injury, the ideal therapeutic approach includes mitigation of inflammation and fibrosis, and induction of regenerative signals. Cell-based therapies have shown potential to prevent and reverse impaired lung development. Their mechanisms of action suggest effects on both, mitigating the pathophysiological processes and promoting lung growth. Here, we review our current understanding of normal and impaired alveolarization, provide some rationale for the use of cell-based therapies and summarize current evidence for the therapeutic potential of cell-based therapies for pulmonary regeneration in preterm infants. |
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| Keywords: | Bronchopulmonary dysplasia Lung injury Development Regenerative medicine Cell therapy Mesenchymal stem/stromal cells |
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