Current status and prospects of basic research and clinical application of mesenchymal stem cells in acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a common and clinically devastating disease that causes respiratory failure. Morbidity and mortality of patients in intensive care units are stubbornly high, and various complications severely affect the quality of life of survivors. The pathophysiology of ARDS includes increased alveolar–capillary membrane permeability, an influx of protein-rich pulmonary edema fluid, and surfactant dysfunction leading to severe hypoxemia. At present, the main treatment for ARDS is mechanical treatment combined with diuretics to reduce pulmonary edema, which primarily improves symptoms, but the prognosis of patients with ARDS is still very poor. Mesenchymal stem cells (MSCs) are stromal cells that possess the capacity to self-renew and also exhibit multilineage differentiation. MSCs can be isolated from a variety of tissues, such as the umbilical cord, endometrial polyps, menstrual blood, bone marrow, and adipose tissues. Studies have confirmed the critical healing and immunomodulatory properties of MSCs in the treatment of a variety of diseases. Recently, the potential of stem cells in treating ARDS has been explored via basic research and clinical trials. The efficacy of MSCs has been shown in a variety of in vivo models of ARDS, reducing bacterial pneumonia and ischemia-reperfusion injury while promoting the repair of ventilator-induced lung injury. This article reviews the current basic research findings and clinical applications of MSCs in the treatment of ARDS in order to emphasize the clinical prospects of MSCs.

Key Words: Acute respiratory distress syndrome, Mesenchymal stem cells, Pulmonary edema, Inflammatory response, Tissue repair, Pulmonary fibrosis

Core Tip: Acute respiratory disease syndrome (ARDS) is a common disease with high morbidity and mortality. ARDS is characterized by increased alveolar-capillary membrane permeability, influx of protein-rich pulmonary edema fluid, and surfactant dysfunction, resulting in severe hypoxemia. Mesenchymal stem cells (MSCs) have the self-renewal and multilineage differentiation properties, and their immunomodulatory abilities have been implicated in the treatment of disease. Herein, we discuss the pathophysiology of ARDS and recent research surrounding the clinical application of MSCs in the treatment of ARDS.

• Citation: Liang TY, Lu LH, Tang SY, Zheng ZH, Shi K, Liu JQ. Current status and prospects of basic research and clinical application of mesenchymal stem cells in acute respiratory distress syndrome. World J Stem Cells 2023; 15(4): 150-164
• URL: https://www.wjgnet.com/1948-0210/full/v15/i4/150.htm
• DOI: https://dx.doi.org/10.4252/wjsc.v15.i4.150