Stem Cells and Their Immunomodulatory Potential for the Treatment of ARDS

Claudia C. dos Santos

Introduction

Despite significant advances in supportive ICU care, acute respiratory distress syndrome (ARDS) remains a leading cause of death and disability worldwide [1-4]. Many potential therapies have been found ineffective, including corticosteroids and immunomodulation agents. Reasons behind the failed trials in ARDS have been discussed [5-8]. From the preclinical research perspective, the largely disappointing results from clinical trials can be explained in part by our incomplete understanding of the molecular responses to injury and the mechanisms that promote repair [9-13]. Dysregulated inflammation, inappropriate accumulation and activity of leukocytes, and disruption of the alveolar-capillary barrier remain central to the pathophysiology of ARDS. A therapeutic approach that can successfully target injurious inflammation and restore alveolar-capillary barrier function, while maintaining host defense and augmenting tissue repair, would be an ideal strategy for the treatment of ARDS. Rapid and exciting progresses in the field of cell immunotherapy have recently emerged as a disruptive strategy that can modulate the immune system and overcome the immunological derailment characterizing the pathophysiology of ARDS. This chapter focuses on summarizing current knowledge on the immunomodulatory actions of mesenchymal stromal cell (MSC) as novel immuno- therapeutics for the treatment of ARDS and the translation of new knowledge to clinical trials.

C. C. dos Santos, MSc, MD, FRCPC

The Keenan Centre for Biomedical Research, The Li Ka Shing Knowledge Institute and the Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada

St. Michael’s Hospital, 30 Bond Street, Bond Wing, Room 4-008, Toronto, ON, Canada e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it ; This email address is being protected from spam bots, you need Javascript enabled to view it

D. Chiumello (ed.), Acute Respiratory Distress Syndrome (ARDS),

DOI 10.1007/978-3-319-41852-0_17