Stem cells and regenerative medicine have become an exceedingly hot topic in recent years, pushing our knowledge and capabilities of medicine further and farther. It is an exciting area of medicine due to the cells’ ability to regenerate and repair tissue. They are truly quite remarkable, and the work that is being done with them at The Ottawa Hospital is a testament to that.
Dr. Bernard Thébaud, a scientist and neonatologist from The Ottawa Hospital, is focused on understanding the mechanisms of lung development, injury and repair to design treatments for incurable lung diseases. His lab has an emphasis on the therapeutic potential of stem cells for treating lung diseases in babies.
“Our lab, in general, is focused on stem cell-based therapies for lung diseases, especially neonatal lung diseases,” says Thébaud, who also works at the Children’s Hospital of Eastern Ontario and the University of Ottawa. “We’re trying to find solutions for these diseases because there are currently no treatments. They’re all only supportive, but not specifically devoted to healing or making a still developing lung grow. There just isn’t any medication like that, and we believe that stem cells have certain healing properties that haven’t existed so far.”
The researchers in Dr. Thébaud’s lab are choosing to focus on mesenchymal stromal cells due to their powerful anti-inflammatory agents and repair factors. Their goal is to harness the repair potential of the cells to prevent or restore damage to a developing neonatal lung.
Bronchopulmonary dysplasia is a lung disease that typically happens to preterm babies that are born at least 12 weeks early. Their lungs have not fully developed so they are intubated and mechanically ventilated to stay alive, but these life-saving techniques also damage their lungs.
“We try to, of course, decrease the amount of mechanical ventilation or pressure we use, and try to decrease the amount of oxygen, but simply because these lungs are so immature – they’re basically the size of your thumbnail – there’s still some degree of damage. Because it is happening on a developing lung anything abnormal interrupts their normal development,” Thébaud explains.
These issues can extend far past childhood and have lifelong consequences. Therefore, it is an extremely critical issue to tackle. So far in Thébaud’s lab, these mesenchymal stromal cells appear to protect or prevent injury in mice and rat models and efforts to translate this therapy into patients are underway.
Induced pluripotent stem cells are relatively new discovery, and as the name partially suggests, they have potent capabilities. They can become any type of cell and have been very efficient at turning into brain or heart cells. Less has been done in the field of turning them into alveolar epithelial cells, which are the cells in the deep lung where there are gas exchanges occurring in the air sacs.
“There are two types of alveolar epithelial cells. The type 2 cells are very important because they can differentiate and contribute to lung repair,” says Thébaud. “We think that it is those cells in BPD that are not doing their job appropriately. So, we thought if we take these pluripotent stem cells and turn them into alveolar epithelial cells and inject them into a damaged lung they may be able to protect or restore it. It is a different strategy than using mesenchymal stromal cells because those are repair factor releasing cells and will not become an actual lung cell. They will do their job and then disappear.”
Around the age of 40, a person’s lung without disease begins to age, but a person with lung disease will experience an earlier onset of aging. Premature babies with interrupted lung growth may be more prone to an early onset of aging while already experiencing a higher risk of asthma. The researchers are attempting to fine tune the use of stem cells to help heal and prevent any lung injury in the short or long-term. The hope is that mainstay treatments will reach such a level that only the tiniest of babies will need to benefit from stem cell therapy.
Hopefully, this research will continue to clinical trials, but Thébaud stresses the importance of designing these with care because this is all still experimental and no one would want to injure a small child.
“It is important that we advance in a timely fashion, but with safety and rigorous evidence,” says Thébaud. “There has to always be a good biological plausibility and rationale for using stem cells for a given disease. We have to be very careful to understand the biology of these cells and understand what they are by defining them extensively, and know what they are able to do and what they are not able to do.”
Stem cells are a fascinating field, and as modern medicine continues to expand at an exponential rate they have the potential to ascertain that various diseases become a thing of the past and allow society to live longer, more fruitful lives.
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