COPD: cure could come from transplanting patient's own lung cells into damaged parts
There are more than three million people estimated to be living with the disease in the UK
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A patient's own cells could be transplanted into damaged parts of their lung in an experimental treatments for sufferers of chronic obstructive pulmonary disease (COPD), researchers have said.
A new preliminary study has shown it is possible to repair damaged lung tissue among certain COPD patients using their own lung cells.
Delegates at the European Respiratory Society’s International Congress were told that cell-based regenerative medicine could offer “hope to cure COPD”.
COPD is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.
It causes progressive damage to lung tissue – which cannot be repaired with current treatments.
People with COPD have difficulties breathing. According to the NHS website, symptoms include:
- shortness of breath
- a persistent chesty cough with phlegm
- frequent chest infections
- persistent wheezing
According to NHS Inform, the Scottish NHS website, there are more than three million people estimated to be living with the disease in the UK, of whom only about 900,000 have been diagnosed.
Just 20 patients took part in the preliminary trial, delegates at the conference in Milan were told.
Patients reported being able to breathe better, walk further and said they had a better quality of life after the treatment.
The research, led by scientists from Tongji University in China, saw experts examine whether a type of cell called P63 positive lung progenitor cells might be able to regenerate lung tissue damaged by COPD.
These cells have previously been shown to successfully repair damaged tissue in the tiny air sacs in the lung known as alveoli in animal studies.
The new research saw scientists take these cells from the lungs of patients, then using these cells to grow millions more in a laboratory before transplanting them back into the patients’ lungs.
Of the 20 patients, 17 received this treatment.
They were assessed after treatment to assess the safety and efficacy of the treatment.
The academics reported that the cell treatment was well tolerated by all patients.
Average breathing levels improved significantly by 12 weeks and even more benefits were seen six months after treatment.
In a six-minute walk test patients managed an average of 410 metres before treatment and this increased to an average of 447 metres six months after treatment.
Patients also reported that they had a better quality of life after the cell transplant.
And importantly, scientists reported that in two patients with mild emphysema, a type of lung damage that is normally permanent and progressive, the treatment repaired the lung damage.
CT scans of their lungs showed “resolution of the lesions at 24 weeks”, the authors wrote.
Scientists are now planning to confirm their findings by testing a larger group of patients in another clinical trial.
Professor Wei Zuo, of the School of Medicine at Tongji University in Shanghai and chief scientist at Regend Therapeutics, said: “Stem cell and progenitor cell-based regenerative medicine may be the biggest, if not the only, hope to cure COPD.
“In our trial, 35% of the patients had severe COPD and 53% had extremely severe COPD. Usually, many patients with such severe COPD will die quite quickly if their disease progresses.
“We used a tiny catheter that contains a brush to collect the progenitor cells from the patients’ own airways.
“We cloned the cells to create up to a thousand million more, and then we transplanted them back into the patients’ lungs via bronchoscopy in order to repair the damaged lung tissue.”
Professor Zuo added: “We found that P63 positive progenitor cell transplantation, not only improved the lung function of patients with COPD, but also relieved their symptoms, such as shortness of breath, loss of exercise ability and persistent coughing.
“This means that the patients could live a better life, and usually with longer life expectancy.
“If emphysema progresses, it increases the risk of death. In this trial, we found that P63 positive progenitor cell transplantation could repair mild emphysema, making the lung damage disappear. However, we cannot repair severe emphysema yet.”
Commenting on the study, Professor Omar Usmani, of Imperial College London, who is head of the European Respiratory Society group on airways disease, asthma, COPD and chronic cough, said: “The results from this Phase I clinical trial are encouraging. COPD is in desperate need of new and more effective treatments, so if these results can be confirmed in subsequent clinical trials it will be very exciting.
“It is also very encouraging that two patients with emphysema responded so well.
“A limitation of this study is that the uptake of the progenitor cells when they were transplanted back into the patients is uncontrolled. So we do not know whether the lungs of some patients responded better to the transplantation than others. We hope this information may become apparent in future studies.”
Dr Erika Kennington, head of research and innovation at the charity Asthma and Lung UK, said: “This research, which is reporting on the first in human trial of 17 people with chronic obstructive pulmonary disease demonstrating the safety and the proof of concept of this treatment could be a game changer for people with COPD.
“Transplanting someone’s own cells that have come from their stem cells, and which have the ability to repair and replace damaged tissue in their lungs, enables the lungs to regenerate the damaged airways and improves lung function, unlike other existing COPD treatments that simply dilate the airways to allow more air in.
“Cell transplantation could offer a damage reversing treatment for people with COPD, offering them a hope of a cure and we look forward to seeing what happens in the next phase of the trial.”