Stem Cell Therapy for COPD

A: 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:

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:
https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd
https://www.ahrq.gov/gam/index.html

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

A: 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.

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. See our blog: Understanding Adipose-Derived Stem Cells. We will discuss the results below.

A: We refer to the process of actually using adult stem cells. For more information see our blogs What are Stem Cells? and Understanding Adipose-Derived Stem Cells. The typical deployment for COPD is intravenous. We also nebulize a small amount of the same cells and have the patient inhale it.

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

A: 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 for any disorder including COPD. Patients can see some improvement in a few days, but for others, nothing is seen for a few months. Those who have a cough as a prominent symptom often see improvement in their cough early on. For others, the improvement is more gradual. An early review of data has shown a slow change in the course of COPD. The primary measurement used for the severity is how much air the patient can exhale in 1 second. This measurement is called FEV1. The average COPD patient loses 1% of his/her FEV1 per month from the time of diagnosis until death. After stem cells, patients, on average, gain about ½% per month. This is a slow improvement, but over time becomes significant. The number of patients remains small but the trend is encouraging. In addition, the Cell Surgical Network has collected data from a larger number of patients. In the Cell Surgical database, over two-thirds of 668 patients reported improvement in their COPD after stem cell therapy.

So there is increasing scientific evidence that stem cells from fat can give improvement to patients suffering from COPD.

A: 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 previously seen improvement. 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 cell treatment promotes the growth of new lung cells.