Stem cells for the prevention and treatment of bronchopulmonary dysplasia in preterm infants

Background

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that often complicates the course of babies who are born too early. Bronchopulmonary dysplasia can lead to serious health issues during childhood and later in life. There is currently no effective and safe treatment for BPD. Mesenchymal stem cells (MSCs), cells that can multiply and turn into a different type of cell, can protect the damage to newborn lungs in experimental models of BPD. Mesenchymal stem cells may bring new hope for untreatable health issues in babies born too early, including BPD, and thus improve their survival and quality of life.

Review question

Are MSCs, administered intravenously or endotracheally, safe and effective in preventing or treating BPD, or both, in preterm infants?

Study characteristics

We found no clinical trials that addressed the use of MSCs for prevention or treatment of BPD in premature infants. However, some studies are currently underway.

Key results

There is insufficient evidence to determine the safety and efficacy of MSCs for the treatment or prevention of BPD in premature infants. The results of the ongoing trials are expected in the near future.

Authors' conclusions: 

There is insufficient evidence to determine the safety and efficacy of MSCs in the treatment or prevention of BPD in premature infants. The results of the ongoing trials addressing this issue are expected in the near future.

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Background: 

Bronchopulmonary dysplasia (BPD) remains a major complication of prematurity and currently lacks efficient treatments. Mesenchymal stem/stromal cells (MSCs) have been extensively explored as a potential therapy in several preclinical and clinical settings. Human and animal MSCs have been shown to prevent and treat lung injury in various preclinical models of lung diseases, including experimental BPD.

Objectives: 

To determine if MSCs, administered intravenously or endotracheally, are safe and effective in preventing or treating BPD, or both, in preterm infants.

Search strategy: 

We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 10), MEDLINE via PubMed (1966 to 6 November 2016), Embase (1980 to 6 November 2016), and CINAHL (1982 to 6 November 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials (RCTs) and quasi-RCTs.

Selection criteria: 

We considered RCTs and quasi-RCTs investigating prevention or treatment of BPD, or both, in preterm infants.

Data collection and analysis: 

Two review authors independently assessed trial quality according to prespecified criteria.

Main results: 

We found no RCTs or quasi-RCTs addressing the use of MSCs for prevention or treatment of BPD in premature infants. Two RCTs are currently registered and ongoing.

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