CHEST Guidelines-Allogeneic-Human-Mesenchymal-Stem-Cells-in-Patient

Allogeneic-Human-Mesenchymal-Stem-Cells-in-Patient

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A recent correspondence in "Chest" discussed the promising findings of the AETHER trial, which examined the safety of using allogeneic mesenchymal stem cells (MSCs) in patients with idiopathic pulmonary fibrosis (IPF). While the trial marked a significant step, highlighting the potential of MSC therapy for IPF, concerns were raised regarding the necessity of further research into the administration process, especially with multiple doses.<br /><br />Drs. Thangakunam and Christopher, who contributed to this correspondence, referenced their past experience with a patient who suffered anaphylactic shock after receiving a second infusion of MSCs. This incident underscores the potential risk of adverse reactions associated with repeated MSC dosing, possibly due to sensitization from foreign proteins or preservatives like dimethyl sulfoxide (DMSO) used in the cell preparation process.<br /><br />The authors highlighted that the AETHER trial only involved a single infusion of MSCs and emphasized the importance of conducting further studies in intensive care settings if subsequent infusions are planned. They suggested the exclusion of patients with very severe disease from the AETHER trial precluded exploring the full scope of MSC therapy's potential benefits.<br /><br />In response to these comments, the authors of the original AETHER trial maintained that allogeneic MSCs have been generally well-tolerated in patients, thanks to current production techniques that minimize potential adverse components. They also screened trial subjects for DMSO sensitivity as a precautionary measure. Moving forward, the researchers agreed that comprehensive evaluations are vital to ensure safety, particularly with more severe cases where patients might seek experimental treatments.<br /><br />Overall, the correspondence advocates for cautious optimism and encourages robust clinical trials to validate the effectiveness and safety of MSC therapy, especially for those with advanced fibrotic lung conditions.

Keywords

AETHER trial

allogeneic mesenchymal stem cells

idiopathic pulmonary fibrosis

MSC therapy

anaphylactic shock

dimethyl sulfoxide

adverse reactions

clinical trials

advanced fibrotic lung conditions

safety evaluations