The development of this field has been fascinating, one of the most productive investigators has been Bernard Thébaud who has just written a very clear review article for non cell researchers in Pediatric Research with his colleague Moses Fung. (Fung ME, Thebaud B: Stem cell-based therapy for neonatal lung disease-it’s in the juice. Pediatr Res 2013.) I know I’ve mentioned this very recently, but I thought I’d go into a bit more detail because of another publication that has just appeared. (And also because Bernard is visiting us tomorrow in Sainte Justine, and we are in the planning stages for a clinical trial!)

Initially it was considered possible that stem cells could be introduced into the lung, and grow there and take over lung repair. Initial results in animals were encouraging, but very few of the cells actually stayed in the lungs and grew. Then it was realized that after growing the stem cells in the required medium you could throw away the cells, just give the medium and have some of the same effects.

The new study (Miranda LF, Rodrigues CO, Ramachandran S, Torres E, Huang J, Klim J, Hehre D, McNiece I, Hare JM, Suguihara CY et al: Stem cell factor improves lung recovery following neonatal hyperoxia-induced lung injury. Pediatric Res 2013.) treated neonatal rats with hyperoxic lung injury, and gave them exogenous Stem Cell Factor, one of the things that you find in the medium when you grow Stem Cells. Now I don’t have a clue what Stem Cell Factor is (apart from what I just said, which I believe is correct) but it is only one of the things that you find in the ‘juice’ as the review article notes 

Besides factors already known to be lung protective, including keratinocyte growth factor, vascular endothelial growth factor, or adiponectin, novel molecules secreted by MSCs have already been identified and shown therapeutic benefit in various disease models, such as stanniocalcin-1 —a potent antioxidant—or tumor necrosis factor-α–stimulated gene/protein 6 (TSG-6)—a potent anti-inflammatory protein.

It is starting to look like there is a real possibility that we will be able to promote lung repair in preterm infants with some combination of stem cells and the stuff that they release into the juice.