Cell therapy for the preterm infant: promise and practicalities
Elizabeth K Baker1,2, Susan E Jacobs3,2, Rebecca Lim4,5
1Newborn Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia Elizabeth.Baker2@thewomens.org.au.
Insights
Cell therapy offers a promising new treatment for extremely preterm infants, addressing progenitor cell exhaustion and improving outcomes for bronchopulmonary dysplasia and brain injury. This approach aims to repair and prevent injury, overcoming limitations of current therapies.
Area of Science:
- Neonatal Medicine
- Regenerative Medicine
- Developmental Neuroscience
Background:
- Neonatal intensive care advances improve survival rates for extremely preterm infants.
- Improved survival reveals new morbidities like bronchopulmonary dysplasia and preterm brain injury.
- Inflammation, immaturity, and progenitor cell exhaustion contribute to these injuries.
Purpose of the Study:
- To review the rationale for using cell therapy in extremely preterm infants.
- To examine preclinical and early clinical evidence for cell therapy in bronchopulmonary dysplasia and preterm brain injury.
- To discuss challenges in translating cell therapy to clinical practice.
Main Methods:
- Literature review of preclinical studies.
- Analysis of early-phase clinical trial data.
- Discussion of translational challenges.
Main Results:
- Cell therapy, utilizing stem and stem-like cells, shows potential for injury repair and prevention.
- Preclinical and early clinical data support cell therapy for bronchopulmonary dysplasia and preterm brain injury.
- Existing therapies do not fully address novel injury mechanisms like cell exhaustion.
Conclusions:
- Cell therapy presents a novel therapeutic strategy for extremely preterm infants.
- Further research and clinical trials are needed to overcome translational hurdles.
- Addressing progenitor cell exhaustion is crucial for improving long-term outcomes.
Abstract:
Recent decades have seen the rapid progress of neonatal intensive care, and the survival rates of the most preterm infants are improving. This improvement is associated with changing patterns of morbidity and new phenotypes of bronchopulmonary dysplasia and preterm brain injury are recognised. Inflammation and immaturity are known contributors to their pathogenesis. However, a new phenomenon, the exhaustion of progenitor cells is emerging as an important factor. Current therapeutic approaches do not adequately address these new mechanisms of injury. Cell therapy, that is the use of stem and stem-like cells, with its potential to both repair and prevent injury, offers a new approach to these challenging conditions. This review will examine the rationale for cell therapy in the extremely preterm infant, the preclinical and early clinical evidence to support its use in bronchopulmonary dysplasia and preterm brain injury. Finally, it will address the challenges in translating cell therapy from the laboratory to early clinical trials.
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