Chronic obstructive pulmonary disease (COPD) is a relatively common, often debilitating illness, which has a major impact on the people of the world. In the US alone, COPD costs the country almost $50 billion a year not to mention untold suffering. Most of us know someone who has COPD, which is an umbrella term that includes chronic bronchitis and emphysema.
Researchers are still investigating the causes, but two big ones are smoking and pollution.
There are a number of treatments for COPD, but no cure. The treatments, which can include supplemental oxygen, are largely palliative. In other words, they can temporarily help patients feel a bit better and be more functional, but they do not help the underlying cause of the disease or prevent its progression.
A number of clinics offer stem cell treatments for COPD, but these treatments are expensive and it is unclear if they work. They may also be very unsafe.
Some clinical trials are underway for stem cell treatment of COPD (note some of the trials listed below that pop up with different search terms as of 2013 are the same ones):
For “emphysema” and “stem cells” as search terms today I found 5 stem cell trials, although unfortunately none are actively recruiting patients. One of the completed studies, based on only four patients, has results that seem inconclusive to me.
For COPD and stem cells it was a bit more encouraging. I found 7 stem cell trials, including 2 actively recruiting new patients.
For Chronic Obstructive Pulmonary Disease and stem cells as a search term things are even more hopeful, I found 12 trials today including many that are recruiting, which is encouraging.
I hope these numbers continue to increase.
In principle, how could stem cells possibly work to treat COPD?
There are at least three ideas about how stem cells might benefit these airway diseases.
- The most common ideas is that stem cells could be used for immunomodulation in COPD patients. In this way of thinking, stem cells may reduce inflammation in the airway alveoli (where respiration occurs) preventing further damage and perhaps tipping the balance toward natural repair. Stem cells may do this through these so-called “immunomodulation” functions. More data is needed here to know how promising or safe this might be.
- Transplants of stem cells could be used for cell therapy. They may build healthy respiratory tissue that is diseased or has been destroyed in COPD patients. While this approach is exciting, there is not much data to support it.
- Stem cells may stimulate the formation of new capillaries (the smallest blood vessels) in the lung leading to tissue repair and better function.
There are risks associated with these kinds of treatments including autoimmune reaction (or immune reaction for an allogeneic transplant such as UBC), abnormal tissue growth, infection, pulmonary embolism, and likely other unknown risks.
Clinical trials also have risks for patients too and that is important to know. However, at least you can be more confident as a clinical trial participant that you will be treated by a trained doctor, given proper information to give informed consent, and the trial team will follow up on you to see how you are doing. The clinical trial is also not directly trying to make money off of you or use your bank account to appease investors.
More broadly, your courage to be a hero and be in a clinical trial has the potential to help other patients in the future too.
Treatments at stem cell clinics do not have these positives.
Barring action by the FDA for any given, potentially non-compliant clinic offering such treatments, patients must weigh the burden of their COPD versus the potential risks of clinic stem cell treatments.
I do have hope for the future that stem cells may be effective for COPD, but in my opinion, treatments today at dubious clinics are not worth the risk. I understand that some disagree and if you are one of them, let’s talk about it in a constructive way in the comments section.