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Updated: May 8, 2026

Isolation and Characterization of Human Umbilical Cord-derived Mesenchymal Stem Cells from Preterm and Term Infants
Published on: January 26, 2019
Stem cell therapy for neonatal diseases associated with preterm birth
Alessandro Borghesi1, Claudia Cova, Diego Gazzolo
1Neonatal Intensive Care Unit and Laboratory of Neonatal Immunology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Insights
Stem cell therapies show promise for treating extremely preterm infants, potentially preventing lung and brain diseases like bronchopulmonary dysplasia and periventricular leukomalacia by addressing tissue simplification.
Area of Science:
- Neonatal Medicine
- Regenerative Medicine
- Developmental Biology
Background:
- Antenatal steroids and surfactant improve survival for extremely preterm infants.
- These infants face high risks of oxidative stress, infection, and subsequent lung/brain diseases.
- Newer sequelae include bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL), characterized by tissue simplification.
Purpose of the Study:
- To explore the potential of stem cell-based therapies for extremely preterm infants.
- To investigate stem/progenitor cell loss as a cause of tissue simplification in BPD and PVL.
- To evaluate the efficacy of cell transplantation for preventing/treating BPD, PVL, and other prematurity complications.
Main Methods:
- Review of recent data on stem/progenitor cell populations in developing lungs and brains.
- Analysis of pathogenesis in new BPD and PVL, focusing on tissue simplification.
- Consideration of preclinical models for stem cell transplantation protocols.
Main Results:
- Tissue simplification and developmental arrest are hallmarks of new BPD and PVL.
- Loss of stem/progenitor cells is implicated in the pathogenesis of tissue simplification.
- Various cell types (e.g., MSCs, EPCs, HAECs) are candidates for therapeutic transplantation.
Conclusions:
- Stem cell transplantation holds potential for preventing and treating BPD, PVL, and other sequelae in preterm infants.
- Further preclinical research is necessary to address issues before clinical translation.
- Targeting stem/progenitor cell populations may offer a novel therapeutic strategy.
Abstract:
In the last decades, the prevention and treatment of neonatal respiratory distress syndrome with antenatal steroids and surfactant replacement allowed the survival of infants born at extremely low gestational ages. These extremely preterm infants are highly vulnerable to the detrimental effects of oxidative stress and infection, and are prone to develop lung and brain diseases that eventually evolve in severe sequelae: The so-called new bronchopulmonary dysplasia (BPD) and the noncystic, diffuse form of periventricular leukomalacia (PVL). Tissue simplification and developmental arrest (larger and fewer alveoli and hypomyelination in the lungs and brain, respectively) appears to be the hallmark of these emerging sequelae, while fibrosis is usually mild and contributes to a lesser extent to their pathogenesis. New data suggest that loss of stem/progenitor cell populations in the developing brain and lungs may underlie tissue simplification. These observations constitute the basis for the application of stem cell-based protocols following extremely preterm birth. Transplantation of different cell types (including, but not limited to, mesenchymal stromal cells, endothelial progenitor cells, human amnion epithelial cells) could be beneficial in preterm infants for the prevention and/or treatment of BPD, PVL and other major sequelae of prematurity. However, before this new knowledge can be translated into clinical practice, several issues still need to be addressed in preclinical in vitro and in vivo models.
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