Where do things stand today for using stem cells to treat COPD?
Chronic obstructive pulmonary disease (COPD) is a relatively common, often debilitating illness, which has a major impact on the people of the world. In the US alone, COPD costs the country almost $50 billion a year not to mention untold suffering. Most of us know someone who has COPD, which is an umbrella term that includes chronic bronchitis and emphysema.
Researchers are still investigating the causes, but two big ones are smoking and pollution.
There are a number of treatments for COPD, but no cure. The treatments, which can include supplemental oxygen, are largely palliative. In other words, they can temporarily help patients feel a bit better and be more functional, but they do not help the underlying cause of the disease or prevent its progression.
A number of clinics offer stem cell treatments for COPD, but these treatments are expensive and it is unclear if they work. They may also be very unsafe.
Some clinical trials are underway for stem cell treatment of COPD (note some of the trials listed below that pop up with different search terms as of 2013 are the same ones):
For “emphysema” and “stem cells” as search terms today I found 5 stem cell trials, although unfortunately none are actively recruiting patients. One of the completed studies, based on only four patients, has results that seem inconclusive to me. 2020 Update: I found 17 trials in May 2020.
For COPD and stem cells it was a bit more encouraging. I found 7 stem cell trials, including 2 actively recruiting new patients. 2020 Update: I found 47 trials in May 2020.
For Chronic Obstructive Pulmonary Disease and stem cells as a search term things are even more hopeful, I found 12 trials today including many that are recruiting, which is encouraging. 2020 Update: I found 39 trials in May 2020.
I hope these numbers continue to increase.
In principle, how could stem cells possibly work to treat COPD?
There are at least three ideas about how stem cells might benefit these airway diseases.
- The most common ideas is that stem cells could be used for immunomodulation in COPD patients. In this way of thinking, stem cells may reduce inflammation in the airway alveoli (where respiration occurs) preventing further damage and perhaps tipping the balance toward natural repair. Stem cells may do this through these so-called “immunomodulation” functions. More data is needed here to know how promising or safe this might be.
- Transplants of stem cells could be used for cell therapy. They may build healthy respiratory tissue that is diseased or has been destroyed in COPD patients. While this approach is exciting, there is not much data to support it.
- Stem cells may stimulate the formation of new capillaries (the smallest blood vessels) in the lung leading to tissue repair and better function.
There are risks associated with these kinds of treatments including autoimmune reaction (or immune reaction for an allogeneic transplant such as UBC), abnormal tissue growth, infection, pulmonary embolism, and likely other unknown risks.
Clinical trials also have risks for patients too and that is important to know. However, at least you can be more confident as a clinical trial participant that you will be treated by a trained doctor, given proper information to give informed consent, and the trial team will follow up on you to see how you are doing. The clinical trial is also not directly trying to make money off of you or use your bank account to appease investors.
More broadly, your courage to be a hero and be in a clinical trial has the potential to help other patients in the future too.
Treatments at stem cell clinics do not have these positives.
Barring action by the FDA for any given, potentially non-compliant clinic offering such treatments, patients must weigh the burden of their COPD versus the potential risks of clinic stem cell treatments.
I do have hope for the future that stem cells may be effective for COPD, but in my opinion, treatments today at dubious clinics are not worth the risk. I understand that some disagree and if you are one of them, let’s talk about it in a constructive way in the comments section.
My mom is in the same boat. The once vibrant energetic women barely walks around any more. Some days she looks so sad and depressed it breaks my heart . any hope is better then none. where could I take her for such treatments?
I really find this to be one of the absolute best stem cell blogs on the internet. It’s helped me educate myself on stem cells and the current state of the industry. When my father was diagnosed with COPD we really ran out of options. I came across this site and researched as much as possible and then searched for stem cell treatment centers that treat COPD. I immediately ruled out non-domestic treatment centers and contacted XXXXX that uses adult adipose stem cells to treat COPD. I took the plunge with my father and thank God every day that I did. After the treatment, he was completely taken off of oxygen and has no need to get back on. He’s doing great, no more oxygen tanks whatsoever. He is no longer winded from going room to room. He has tons of energy due to being able to sleep at night. He’s a new man. Again, thank you for helping to educate me on stem cells, otherwise I would not have known to seek out treatment for my father. (editors note: comment edited XXXXX)
Can you tell me how I can contact you. I am in the same boat as your dad was, and am looking to discuss my situation with someone who has the knowledge. Please contact me. Thank you in advance. Krell10@cox.net
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I am skeptical of the rationale here beyond just technical–people are doing this because they *can* do it. It seems obvious to me that there are many applications of “stem cells” which do not require stem cell activity per se, but use these cells to differentiate and produce soluble factors, cytokines. Most likely, IMHO this is the explanation for any effects e.g. on cardiac function in MI (ever pan out?), rather than having stem cells integrate functionally into the damaged tissue. One iota of sympathy for the idea that maybe later one might ID specific factors, but since clinical research is so hard and long-term, I don’t have confidence that this work will transition to the ID of such factors. I would prefer a trial of VEGF, GCSF, whatever-the-F in COPD rather than just throwing stem cells into patients blindly.
Also, this comes up against the fact that clinical research is expensive, and science may suffer in the face of the profit motive. Potential profits may or may not be prompting involvement by certain startups in these endeavors, regardless of flimsy rationale.
Michael – I certainly would not object to a trial for COPD with VEGF, GCSF, HGF however, that isn’t happening. In the meantime, most patients that I know report that they do feel less short of breath, less anxiety, increased stamina, better saturation levels, improved quality of life, etc. after stem cell treatment. There are many doctors working under IRB’s doing studies here in the U.S. and elsewhere. These doctors are getting known in the COPD community and none of them are “blindly throwing stem cells” into patients. Patients will go where other patients have had success. This will help weed out the shysters far better than warnings about risk without evidence. Patients have a great patient to patient network and word travels fast.
It might also be on interest that in 2011 United Therapeutics and Pluristem entered into a licensing agreement pursuant to which United Therapeutics will develop, market and sell Pluristem’s PLX-PAD cells for Pulmonary Arterial Hypertension.
Recently data from the Queensland Lung Transplant Service at the University of Queensland, Australia was presented at the 33rd Annual Meeting and Scientific Sessions of the International Society of Heart and Lung Transplantation (ISHLT) demonstrating that following infusion of Pluristem’s PLX (Placental eXpanded) cells in a human lung model of pulmonary arterial hypertension (PAH), blood flows were maintained and no adverse hemodynamic effects were noted.
In April it was announced that United Therapeutics Corporation received approval to perform a human Phase I study in Australia using Pluristem’s PLacental eXpanded (PLX-PAD) cells in patients diagnosed with Pulmonary Arterial Hypertension (PAH).
Pulmonary hypertension is a common complication of chronic obstructive pulmonary disease (COPD) and is characterized by abnormally high blood pressure in the arteries of the lungs and leads to an increased workload on the right side of the heart.
United Therapeutics plans to conduct a single center, open-label, dose-escalation study in patients diagnosed with PAH. The study will enroll up to nine patients in three dosing levels with PLX-PAD cells administered intravenously (IV). The primary endpoint of the study is to evaluate the safety of PLX-PAD cells in a follow-up period of one year. Secondary efficacy endpoints at six weeks post-treatment are designed to assess cardio-respiratory function and include six-minute walk distance, cardiac hemodynamic parameters via a right heart catheterization and echocardiogram and pulmonary metabolism via a positron emission tomography (PET) scan.
Paul – Looking at the clinical trials, I don’t know of any patients with COPD willing to travel to Iran. I don’t think I would feel very safe there and it isn’t because of the stem cell treatment that I say that. Many might feel confident going to Hong Kong, but if you use supplemental oxygen, that’s not really an option for U.S. patients. Another clinical trial listed is being done by RMI. This clinic was not given much credit in a previous blog of yours, so has your opinion changed in the last month or so? Did you agree to meet with Dr. Lopez and learn about his protocol? Perhaps, that is why you now mention his clinical trial in a more positive light. I surely hope so.
I don’t agree with your statement that you “hope for the future”. I hope for the present. Many patients with COPD really have no future. The quality of life is so poor that they would prefer suicide or euthanasia.
I have severe COPD. The progression of my disease has been stopped. My last stem cell treatment over a year ago has given me a greatly improved quality of life that I am very grateful for. I was thinking just the other day how horrible it was when I could barely walk 20 feet without gasping for breath. It took over an hour to dress and taking a shower was an ordeal that I can’t even describe. I had to crawl up the stairs. I could never count on going anywhere for fear I would be having a day that I could barely function. All that has changed for me and other COPD patients that I know. Some have gotten off of supplemental oxygen. Most importantly, they feel more confident and happy. The quality of life changes are remarkable for most.
I am also interested in any publications you might have to support your statement about risks. Could you please provide evidence of this? Thousands of lung disease patients are getting stem cell treatment. I am not hearing of any with the types of reactions you mention. You also should compare the risks of doing nothing, using steroids for decades, lung transplants and LVRS vs experimental autologous stem cell therapy.
Barbara, your point about the risk of doing nothing is most salient.
Risks are treatment specific so very generalized statements are not much help to us patients. I did a quick search on PubMed and found the following which may be relevant:
http://www.ncbi.nlm.nih.gov/pubmed/23172272
Best wishes.
Where did you go for treatment?
Could you please advise me on who in the Chicago area maybe able to provide me with stem cell treatment for COPD? The part about considering suicide, alluded to by Barbara, is becoming more and more attractive.
God Bless
Greg
I do not know of any stem cell treatments that are proven safe or effective for COPD. I would urge you to discuss your situation with your personal physician.
Really?