Adult Stem Cells for Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Lung Disease (COPD) is a debilitating lung condition that leaves patients unable to breathe or enjoy life. It is also known as emphysema, chronic bronchitis and chronic obstructive asthma. COPD is rated as the third leading killer in the United States, killing approximately 120,000 individuals a year. Persons suffering from COPD also experience chronic disability and often a low quality of life. Sufferers also require a large amount of medical care with its expense and the need to stay near medical facilities and personnel. COPD is a very limiting and deadly disease.

This paper is designed to help readers gain a greater understanding of the use of adult stem cells for COPD and offer a framework for evaluating if stem cell treatment is a potential step for you or your loved one. We will cover the following:

  1. What are the current medical treatment options for COPD?
  2. Who should consider adult stem cell therapy for COPD?
  3. What are adult stem cells?
  4. How adult stem cells harvested from fat?
  5. How are adult stem cells deployed for COPD?
  6. What results can I expect from adult stem cells for COPD?
  7. What to expect after your deployment?

Feel free to skip to sections that provide information that is helpful to you.

For more information including definitions and descriptions of COPD visit:
http://www.lung.org/lung-disease/copd/
http://www.mayoclinic.com/health/copd/DS00916

What are the current medical treatment options for COPD?

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COPD is a chronic condition and therefore typically requires long term medications. The commonly used treatment options are:

  1. Inhaled medications:
    1. Short acting bronco dilating inhalers which include:
    2. Long acting bronco dilating inhalers which include:
    3. Inhaled steroids (glucocorticoids) like fluticasone. Most experts recommend that inhaled steroids only be used with bronco dilators.
    4. Combinations of the above inhalers
  2. Oral medications such as theophylline and roflumilast
  3. Glucocorticoids (steroids) orally, intramuscularly and/or intravenously.
  4. Pulmonary rehabilitation – exercise, physical therapy and occupational therapy
  5. Smoking cessation
  6. Oxygen therapy
  7. Non-invasive positive pressure ventilation
  8. Hospitalization is frequently required for exacerbations (worsenings)
  9. Lung reduction or transplant surgery

With the exception of surgery, these treatment options are all considered supportive. They help the symptoms but do not change the underlying disease. A simplified diagram of these treatments is:

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A COPD patient may be prescribed one, several or all of these at one time or another during the course of their illness. Some patients suffer without using any treatments. The effectiveness of treatment varies greatly both between patients and over the course of the illness. Many patients with COPD do very well for many years with exercise with or without medications.

For more information on the treatment of COPD see:
http://www.lung.org/lung-disease/copd/living-with-copd/copd-management-tools.html
or
http://www.guideline.gov/content.aspx?id=23801

If you are a person doing well using these options, this might not be the right time to consider adult stem cell treatment.

Who should consider adult stem cell therapy for COPD?

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If you are doing well with your current medical therapy, you may not be an ideal candidate for adult stem cell therapy. Persons should consider adult stem cell therapy for COPD include:

  1. Persons who have not responded very well to their medical treatment
  2. Persons who responded earlier to treatment but are no longer responding
  3. Persons who cannot tolerate the recommended treatment
  4. Persons wishing to avoid the recommended treatment such as surgery
  5. Persons for whom nothing has been effective.

treatment for chronic obstructive pulmonary disease dallas

Lung changes in COPD

Adult stem cell therapy DOES NOT assure a response in these patients. However, it does offer an alternative that they may wish to consider. We will discuss results below.

What is an adult stem cell?

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All stem cells, no matter their source, share two important characteristics:

  1. The ability to multiply and make new copies of themselves. In theory an infinite number of cells can be grown from a single stem cell.
  2. The ability to become any type of cells present in the individual the stem cells are taken from. The DNA for any type of cell is present in every cell with a nucleus in our bodies. That means that the information needed to become any cell is present in every cell. For example, stem cells from fat have been shown to become skin, muscle, or bone stem cells. Transformed stem cells can then make an infinite number of copies of the new cell type.

When we obtain stem cells from mature adult tissues they are referred to as adult stem cells. As with all stem cells, the potential exists for adult stem cells to become any type of cell and then make new copies of the new cell type. This ability to become any type of cell and then make as many cells as needed is the reason for so much interest in adult stem cells. We refer to the process of obtaining adult stem cells as harvesting. To be a good tissue for harvesting, a tissue should be easy to harvest and have an abundant number of stem cells. The two tissues that most readily meet these requirements are bone marrow and fat.

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Adult stem cells taken from fat are also known as adipose derived adult stem cells. Stem cells from fat have become increasingly attractive because stem cells from fat are easier to obtain and exist in larger numbers than bone marrow adult stem cells.

For more information on stem cells visit:

What are stem cells
or
California Stem Cell Center

How are adult stem cells harvested from fat?

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It is a simple process to harvest adult stem cells from fat. First we select an area to take the fat like the stomach or leg. The area is marked and sterilized. Next a local anesthetic solution is injected into the area through a small incision. Suction is applied using a syringe with a special tool called a cannula attached. Typically 50 ml (about 1 1.2 oz.) of fat is suctioned for processing.

treatment for chronic obstructive pulmonary disease dallas

There can be some swelling and /or bruising after the harvesting procedure. Swelling and bruising typically resolve in about 2-3 weeks. Patients are given a prescription for pain medications in case they need them. An antibiotic is given before the procedure. Since the procedure is done sterilely, no further antibiotics are needed. Applying ice to the harvest area for a few days after the procedure reduces the swelling and bruising.

After harvesting we take the fat and do some simple processing to isolate the adult stem cells. When finished, the final product is called Stromal Vascular Fraction (SVF). SVF is a very powerful mixture of adult stem cells and growth factors. Growth factors are the chemical messengers our bodies use to promote healing and cell growth. Growth factors have sometimes been referred to as text messages between cells. A typical batch of SVF contains up to about 25 million adult stem cells. Each SVF batch also contains a large amount of growth factors. The growth factors harvested in SVF tend to be highly anti-inflammatory. After harvesting and processing the SVF is now ready to be deployed for your COPD. It can also be used for many other disorders. A number of deployment protocols under investigation for a large number of disorders.

For more about the harvesting process please visit:
Harvesting adult stem cells

How are adult stem cells deployed for COPD?

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We refer to the process of actually using the adult stem cells/SVF ( Stromal Vascular Fraction ) as deployment. The typical deployment for COPD is intravenous. We also nebulize a small amount of the stme cells/SVF and have the patient inhale it.

treatment for chronic obstructive pulmonary disease dallas

The IV is started in the office and the stem cells/SVF is injected into a small IV bag. This is then given to the patient over 20-30 minutes. The nebulizer is given during the time the IV is running. When the nebulizer and IV are finished, the IV is discontinued and the patient is discharged.

What results can I expect from adult stem cells for COPD?

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Although research is in progress, there are currently no treatment groups large enough to answer this question conclusively. It is important to be aware that the Food and Drug Administration (FDA) has NOT approved the use of adult stem cells/SVF ( Stromal Vascular Fraction ) for any disorder including COPD. Understanding these issues, we do have enough experience to talk about early trends in therapy.

treatment for chronic obstructive pulmonary disease dallas

Around 90% of patients respond to deployment with adult stem cells/SVF. The most common response is an increase in exercise ability. Patients feel they can walk further without becoming winded. Patients also note an increase in their oxygen saturation levels (O2 sat). Most patients respond to only one deployment. Some require a repeat deployment in 3-6 months.

What should I expect after my deployment?

This is one of the most common questions asked by our adult stem cell/SVF ( Stromal Vascular Fraction ) patients. Response to deployment for COPD varies from a few days to about 3 months. If a patient has not seen a significant improvement after about 3 months, we recommend a repeat deployment. Many patients continue to see improvement for several months. When they plateau or regress, we then consider a repeat deployment for them as well.

treatment for chronic obstructive pulmonary disease dallas

Most of the time repeat deployment is done after the patient has seen some improvement and more improvement is sought. Occasionally, repeat deployment is done because the patient has lost some improvement previously seen. The question of how many deployments are best and how often they are needed is an area of intense interest and study at this time. It is too early to say conclusively that adult stem cells treatment promotes the growth of new lung cells.

We hope we have answered the majority of your questions. If you have others or wish to schedule a consultation please call: 214-420-7970.