Cell-based Therapy in Sepsis. A Step Closer

Mesenchymal stromal cells (MSCs) can be efficiently cultured from bone marrow, umbilical cord blood, adipose tissue, and other sources and have low expression of major histocompatibility antigens, permitting allogeneic therapy without the need for immunosuppression (3). During the last decade, preclinical studies in mouse, rat, sheep, and pig models of bacterial and viral sepsis have revealed additional therapeutic properties of MSCs, including enhanced phagocytosis by host macrophages (5), the release of antimicrobial peptides (6), and the transfer of mitochondria to injured cells (7), reviewed in References 2 and 8. Infusion of bone marrow-derived MSCs at 1, 5, or 10 million cells/kg predicted body weight was well tolerated in patients with moderate to severe ARDS (several of whom also had septic shock), with no evidence of adverse hemodynamic or pulmonary effects and no increase in treatmentrelated severe adverse events (9). Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study.