Table of Contents Author Guidelines Submit a Manuscript
Stem Cells International
Volume 2018, Article ID 9652897, 15 pages
https://doi.org/10.1155/2018/9652897
Review Article

The Potentials and Caveats of Mesenchymal Stromal Cell-Based Therapies in the Preterm Infant

1Department of General Pediatrics and Neonatology, Justus-Liebig-University, Feulgenstrasse 12, 35392 Gießen, Germany
2German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Feulgenstrasse 12, 35392 Gießen, Germany
3Excellence Cluster Cardio-Pulmonary System (ECCPS), German Center for Lung Research (DZL), Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center (UGMLC), Aulweg 130, 35392 Giessen, Germany
4Department of Lung Development and Remodeling, Max Planck Institute for Heart and Lung Research, German Center Lung Research (DZL), 61231 Bad Nauheim, Germany
5Division of Neonatology, Perinatal Center, University Children’s Hospital, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, 81377 Munich, Germany

Correspondence should be addressed to Harald Ehrhardt; ed.nesseig-inu.dem.taideap@tdrahrhe.dlarah

Received 9 August 2017; Accepted 4 March 2018; Published 8 April 2018

Academic Editor: Suk Ying TSANG

Copyright © 2018 Judith Gronbach et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The publication of this article was funded by Max Planck.

Abstract

Preponderance of proinflammatory signals is a characteristic feature of all acute and resulting long-term morbidities of the preterm infant. The proinflammatory actions are best characterized for bronchopulmonary dysplasia (BPD) which is the chronic lung disease of the preterm infant with lifelong restrictions of pulmonary function and severe consequences for psychomotor development and quality of life. Besides BPD, the immature brain, eye, and gut are also exposed to inflammatory injuries provoked by infection, mechanical ventilation, and oxygen toxicity. Despite the tremendous progress in the understanding of disease pathologies, therapeutic interventions with proven efficiency remain restricted to a few drug therapies with restricted therapeutic benefit, partially considerable side effects, and missing option of applicability to the inflamed brain. The therapeutic potential of mesenchymal stromal cells (MSCs)—also known as mesenchymal stem cells—has attracted much attention during the recent years due to their anti-inflammatory activities and their secretion of growth and development-promoting factors. Based on a molecular understanding, this review summarizes the positive actions of exogenous umbilical cord-derived MSCs on the immature lung and brain and the therapeutic potential of reprogramming resident MSCs. The pathomechanistic understanding of MSC actions from the animal model is complemented by the promising results from the first phase I clinical trials testing allogenic MSC transplantation from umbilical cord blood. Despite all the enthusiasm towards this new therapeutic option, the caveats and outstanding issues have to be critically evaluated before a broad introduction of MSC-based therapies.