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Autologous peripheral blood mononuclear cells as treatment in refractory acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a devastating disorder. Despite enormous efforts in clinical research, effective treatment options are lacking, and mortality rates remain unacceptably high. <b><i>Objectives:</i></b> A male patient with severe ARDS showed no clin...

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Bibliographische Detailangaben
1. Verfasser: Jungebluth, Philipp (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: November 28, 2015
In: Respiration
Year: 2015, Jahrgang: 90, Heft: 6, Pages: 481-492
ISSN:1423-0356
DOI:10.1159/000441799
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000441799
Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/441799
Volltext
Verfasserangaben:Philipp Jungebluth, Bernhard Holzgraefe, Mei Ling Lim, Adil Doganay Duru, Vanessa Lundin, Nina Heldring, Oscar P.B. Wiklander, Joel Z. Nordin, Michael Chrobok, Christoph Roderburg, Sebastian Sjöqvist, Björn Anderstam, Antonio Beltrán Rodríguez, Johannes C. Haag, Ylva Gustafsson, Katharina G. Roddewig, Petra Jones, Matthew J.A. Wood, Tom Luedde, Ana I. Teixeira, Ola Hermanson, Ola Winqvist, Håkan Kalzén, Samir El Andaloussi, Evren Alici, Paolo Macchiarini
Beschreibung
Zusammenfassung:Acute respiratory distress syndrome (ARDS) is a devastating disorder. Despite enormous efforts in clinical research, effective treatment options are lacking, and mortality rates remain unacceptably high. <b><i>Objectives:</i></b> A male patient with severe ARDS showed no clinical improvement with conventional therapies. Hence, an emergent experimental intervention was performed. <b><i>Methods:</i></b> We performed intratracheal administration of autologous peripheral blood-derived mononuclear cells (PBMCs) and erythropoietin (EPO). <b><i>Results:</i></b> We found that after 2 days of initial PBMC/EPO application, lung function improved and extracorporeal membrane oxygenation (ECMO) support was reduced. Bronchoscopy and serum inflammatory markers revealed reduced inflammation. Additionally, serum concentration of miR-449a, b, c and miR-34a, a transient upregulation of E-cadherin and associated chromatin marks in PBMCs indicated airway epithelial differentiation. Extracellular vesicles from PBMCs demonstrated anti-inflammatory capacity in a TNF-a-mediated nuclear factor-&#954;B in vitro assay. Despite improving respiratory function, the patient died of multisystem organ failure on day 38 of ECMO treatment. <b><i>Conclusions:</i></b> This case report provides initial encouraging evidence to use locally instilled PBMC/EPO for treatment of severe refractory ARDS. The observed clinical improvement may partially be due to the anti-inflammatory effects of PBMC/EPO to promote tissue regeneration. Further studies are needed for more in-depth understanding of the underlying mechanisms of in vivo regeneration.
Beschreibung:Gesehen am 17.06.2020
Beschreibung:Online Resource
ISSN:1423-0356
DOI:10.1159/000441799

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