On stem cells for lungs the-profit clinic offerings don’t make much sense

"Mouse (left) and human (right) alveolar progenitor cells grow into large lung organoids in culture, and make multiple types of epithelial cells including gas exchange type 1 cells (red) and surfactant-producing type 2 cells (green). Credit: led by Edward E. Morrisey, PhD, Perleman School of Medicine, University of Pennsylvania."
"Mouse (left) and human (right) alveolar progenitor cells grow into large lung organoids in culture, and make multiple types of epithelial cells including gas exchange type 1 cells (red) and surfactant-producing type 2 cells (green). Credit: led by Edward E. Morrisey, PhD, Perleman School of Medicine, University of Pennsylvania."

What’s the deal with lung stem cells and stem cells for lungs?

For a long time researchers found that stem cells were elusive in adult lungs. There was debate about whether they even existed, but it now seems fairly established that there are some of the little guys in there. Just because one of the early papers on purported human lung stem cells came from Piero Anversa and has been retracted doesn’t mean these stem cell cells don’t exist at all. Other groups have reported on their existence. Also, lung organoids can be grown from stem and progenitor cells, which is a powerful relatively new tool. You can see some lung organoids at right from recent cool research done at Penn.

"Mouse (left) and human (right) alveolar progenitor cells grow into large lung organoids in culture, and make multiple types of epithelial cells including gas exchange type 1 cells (red) and surfactant-producing type 2 cells (green). Credit: led by Edward E. Morrisey, PhD, Perleman School of Medicine, University of Pennsylvania."
“Mouse (left) and human (right) large lung organoids have multiple types of cells including type 1 (red) and type 2 pneumocytes (green). Images credit: led by Edward E. Morrisey, PhD, Perleman School of Medicine, University of Pennsylvania.” Condensed material from Penn.

However, if we flip things around and instead of asking about “lung stem cells” we ask about “stem cells for lungs” (i.e. using stem cell products to treat lung or other respiratory diseases), I’m very skeptical at this time. Unfortunately, there is a variety of unproven stem cell or related “stuff” being sold for lung disease by for-profit clinics.

One of the most well known lung and stem cell-related clinic businesses has been called The Lung Institute or now The Lung Health Institute. As far as I know they are still the subject of a proposed class action lawsuit. Note that the number of lawsuits again stem cell clinics and related firms continues to grow.

If we think about the idea of stem cell treatments for lungs, two modalities are being pitched. First, some places are claiming that IV injections of stem cells or even PRP (platelet rich plasma) help respiratory problems, while others promote what generally might be referred to as inhalation (or airway infusion) of stem cells or at least materials purported to contain stem cells. In both cases, the potential for benefit from the “stem cells” seems low-to-non-existent given that there are common sense hurdles and challenges. For instance, IV infusions aren’t likely to deliver healthy, persistent populations of stem cells to lungs and even less likely to deliver them to the rest of the respiratory tract. While it is true that there have been reports of stem cells “being filtered out” in the lungs after IV injection that doesn’t mean the cells survive or do anything helpful.

They could definitely do harm too.

The lungs are literally crawling with macrophages and it’s quite possible they view foreign stem cells (e.g. why would fat stem cells be present in lungs?) as invaders that should be eaten. This same kind of fate could await cells that are inhaled. I’m not sure it is really even known if inhaled cells would make it deep enough in the respiratory tract to get into the lungs. Higher up, they would likely get trapped in mucous and/or be coughed back out.

Despite all of this, there are loads of stem cells trials for lung diseases listed on Clinicaltrials.gov right now as of late 2018. Some are sponsored by for-profit clinics, but many others are by research institutions. Notably, some years back a placebo-controlled study of prochymal for COPD did not show benefit.

Others are skeptical too as seen in this quote from a site called PulmonaryAdvisor:

“At present, there has not been any clinical trial which has demonstrated therapeutic efficacy using stem cells to treat COPD in patients,” said Darcy E. Wagner, PhD, of the Department of Experimental Medical Sciences, Wallenberg Center for Molecular Medicine and Lund Stem Cell Centre at Lund University in Sweden, in an interview with Pulmonology Advisor. “While several different stem cell therapies have been shown to be promising in animal models of COPD, they have not been successfully translated into the clinic. There is still a general lack of understanding of potential mechanisms of action and therefore it is difficult to understand how to best translate findings in the animals into the clinic.”

I have to agree with Dr. Wagner on that.

Given the sometimes incurable, progressive nature of some lung disease and the suffering of those involved, stem cells should be explored as an option. However, in terms of actual experimental interventions in patients in my view they should only be done in rigorous placebo-controlled, true clinical trials in which patients do not have to pay.

Basic and translational research into lung stem cells and their potential use or use of other cells for respiratory diseases are important for providing real hope too. See a nice overview of this kind of research here on EuroStemCell.

6 Comments

  1. “Given the sometimes incurable, progressive nature of some lung disease and the suffering of those involved, stem cells should be explored as an option. However, in terms of actual experimental interventions in patients in my view they should only be done in rigorous placebo-controlled, true clinical trials in which patients do not have to pay.” –Paul Knoepfler, in this post.

    It is rare that I agree so wholeheartly with one of your statement that I must chime in on this one, except for the last phrase about not paying. It might be fair to include some patients who have no means of paying their share of costs, but I would prefer that it would be something like one or two in ten patients, certainly not all the patients.

    But more significantly than who pays for what, in my experience over several years of having eight stem-cell treatments for my COPD emphysema, I am in better overall health and younger than most other patients that I know of. The staff at The Lung Health Institute in Tampa, where I have had all my treatments, have told me that until recently, older and sicker patients were common, but that lately, the clientel is getting younger and somewhat healthier.

    Perhaps this phenomenon is quite logical. When the newest treatments arrive on the scene, only the sickest and most desperate apply for the services. Then as the services become more widely known, more people become agreeable to a procedure that can be very expensive and sometimes pretty scary, depending on past experiences.

    I was 74 y.o. when I had my first treatment and I’m 78 now. I feel and live far better now than I did at 74. Considering that COPD emphysema is a progressive, incurable disease, I certainly claim stem-cell treatments at the Lung Health Institute in Tampa to be the reason that my health is improving, not deteriorating.

    Thanks for your Niche blog. I always enjoy it, even if we disagree occasionaly.

    • @rcart,
      Thanks for the comment.
      Can you please tell us more on the details about your treatments? What’d you pay each time? Were actual stem cells used? If so, what kind and how many? How were they given: IV injection or some other way of administration? Who was the physician who gave you the stem cells? Anything else?

      • In my opinion you looks angry for money problem ….
        I know several patient who using adipose derived SVF from fat tissue and different disease, all but all of them are better, some get much more improvement other some improve, but not one has complication, get worse…
        What you only write all the time again stem cell treatment?

        • Ignacio,
          My family understands your dismay as we were taken advantage of by a doctor and a chiropractor offering us what they called “stem-cell therapy.” As it turns out, the product used on us has been Re-Called by the FDA and it made our Senior family member life threateningly ill and needing several surgeries. Though the product that we received was not for lung issues, it was sold to our family as a purported “cure all” for everything from nerve damage, arthritis, extruded/prolapsed discs, annular tears, ulcerative colitis, diabetes and more. We selected our current civil attorney because they had been successful in helping people recover their losses where adipose tissue was used in the eyes of three people causing blindness and one woman with her lungs. We also want to help people understand what we learned on our “stem cell” journey and you are welcome to see the informational website we created that might help. http://www.avoidthestemcellscam.com. Hope this might help clarify WHY there is much conflict in this arena involving what actually does contain stem cells vs products referred to as “stem-cell therapy” that do not contain any living stem cells.

  2. My sister paid 12k for a treatment at the Lung Institute clinic in Arizona last year, and hasn’t had any significant changes to her condition. I told her to check out clinical trials, but she was desperate for any relief.

    • Any significant improvement quickly fades (three months). I’ve had stem cell from the same Lung Institute clinic (in AZ), and I’ve had stem cell through Atlas Medical Center (in CO Springs CO). The effects do not last long enough to warrant the incredibly high expense. Both facilities suggested “boosters” within a very short time after the initial treatment, which suggests a big money making gimmick. Neither facility advised me that a booster would be needed (not to be confused with wanted), until after I received the first treatment. Very disappointing.

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