title: Stem cell therapy for acute respiratory distress syndrome: a promising future?
abstract: OBJECTIVE
  Acute respiratory distress syndrome (ARDS) is a devastating disease process with a 40% mortality rate, and for which there is no therapy. Stem cells are an exciting potential therapy for ARDS, and are currently the subject of intensive ongoing research efforts. We review data concerning the therapeutic promise of cell-based therapies for ARDS.
  
  
  RESULTS
  Recent experimental studies suggest that cell-based therapies, particularly mesenchymal stem/stromal cells (MSCs), endothelial progenitor cells, and embryonic or induced pluripotent stem cells all offer considerable promise for ARDS. Of these cell types, mesenchymal stromal cells offer the greatest potential for allogeneic therapy, given the large body of preclinical data supporting their use, and the advanced state of our understanding of their diverse mechanisms of action. Although other stem cells such as EPCs also have therapeutic potential, greater barriers exist, particularly the requirement for autologous EPC therapy. Other stem cells, such as ESCs and iPSCs, are at an earlier stage in the translational process, but offer the hope of directly replacing injured lung tissue. Ultimately, lung-derived stem cells may offer the greatest hope for lung diseases, given their homeostatic role in replacing and repairing damaged native lung tissues.MSCs are currently in early phase clinical trials, the results of which will be of critical importance to subsequent translational efforts for MSCs in ARDS. A number of translational challenges exist, including minimizing variability in cell batches, developing standard tests for cell potency, and producing large amounts of clinical-grade cells for use in patients.
  
  
  CONCLUSIONS
  Cell-based therapies, particularly MSCs, offer considerable promise for the treatment of ARDS. Overcoming translational challenges will be important to fully realizing their therapeutic potential for ARDS.
authors.affiliation: aAnaesthesia, School of Medicine, Clinical Sciences Institute bRegenerative Medicine Institute, National University of Ireland, Galway, Ireland cDepartment of Anesthesia, Critical Illness and Injury Research Centre, Keenan Research Centre for Biomedical Science, St Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: Shahd
authors.initials: S
authors.lastname: Horie
authors.forename: Claire
authors.initials: C
authors.lastname: Masterson
authors.forename: James
authors.initials: J
authors.lastname: Devaney
authors.forename: John G
authors.initials: JG
authors.lastname: Laffey
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome