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Review
Cell therapy for the preterm infant: promise and practicalities
  1. Elizabeth K Baker1,2,
  2. Susan E Jacobs1,2,
  3. Rebecca Lim3,4,
  4. Euan M Wallace3,4,
  5. Peter G Davis1,2
  1. 1 Newborn Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia
  2. 2 Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
  4. 4 The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
  1. Correspondence to Dr Elizabeth K Baker, Newborn Research Centre, Royal Women's Hospital, Parkville, VC 3052, Australia; Elizabeth.Baker2{at}thewomens.org.au

Abstract

Recent decades have seen the rapid progress of neonatal intensive care, and the survival rates of the most preterm infants are improving. This improvement is associated with changing patterns of morbidity and new phenotypes of bronchopulmonary dysplasia and preterm brain injury are recognised. Inflammation and immaturity are known contributors to their pathogenesis. However, a new phenomenon, the exhaustion of progenitor cells is emerging as an important factor. Current therapeutic approaches do not adequately address these new mechanisms of injury. Cell therapy, that is the use of stem and stem-like cells, with its potential to both repair and prevent injury, offers a new approach to these challenging conditions. This review will examine the rationale for cell therapy in the extremely preterm infant, the preclinical and early clinical evidence to support its use in bronchopulmonary dysplasia and preterm brain injury. Finally, it will address the challenges in translating cell therapy from the laboratory to early clinical trials.

  • neonatology
  • intensive care
  • respiratory
  • neurodevelopment

https://doi.org/10.1136/archdischild-2019-317896

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    Footnotes

    • Contributors PGD, EKB and EMW conceived the manuscript. EKB drafted the manuscript. All authors were involved in editing the manuscript.

    • Funding PGD receives funding from National Health and Medical Research Council, Australia Practitioner Fellowship No. 1157782. EKB receives funding from The University of Melbourne, Research Training Program Scholarship.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.