Pulmonary Arterial Hypertension After Hematopoeitic Stem Cell Transplant

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 118A
Author(s):  
Hala Moukhachen ◽  
Prabalini Rajendram ◽  
Sanjay Chawla ◽  
Nina Raoof ◽  
Kaye Hale ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Pulmonary Arterial

scholarly journals EXPRESS: Pulmonary Arterial Hypertension in Pediatric Patients Undergoing High Dose Carboplatin/Thiotepa and Stem Cell Transplant

2021 ◽  
pp. 204589402110504
Author(s):  
Gretchen Louise Hackett ◽  
Farrah Munir ◽  
Teresa Shapiro ◽  
Robert Greiner ◽  
Daniel J. McKeone ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Pediatric Patients ◽  
Stem Cell Transplant ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) in pediatric patients is associated with significant morbidity and mortality. Few studies exist to evaluate the incidence of PAH in pediatric oncology patients treated with carboplatin and thiotepa followed by hematopoietic stem cell transplant (HSCT). We describe two pediatric patients who developed PAH following high dose chemotherapy with carboplatin and thiotepa followed by autologous HSCT. These cases highlight the need for a surveillance protocol and reinforce the need for cardiologist-oncologists or close collaboration between providers in these sub-specialties who provide care to patients undergoing this type of chemotherapy regimen.

Treatment of pulmonary arterial hypertension with circulating angiogenic cells

2011 ◽  
Vol 301 (1) ◽  
pp. L12-L19 ◽  
Author(s):  
Rachel Mirsky ◽  
Sarah Jahn ◽  
Juha W. Koskenvuo ◽  
Richard E. Sievers ◽  
Sarah M. Yim ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Study Endpoint ◽  
Control Group ◽  
Multiple Time ◽  
Late Time ◽  
Cell Transplant ◽  
Circulating Angiogenic Cells ◽  
Time Points ◽  
Pulmonary Arterial

Despite advances in the treatment of pulmonary arterial hypertension, a truly restorative therapy has not been achieved. Attention has been given to circulating angiogenic cells (CACs, also termed early endothelial progenitor cells) because of their ability to home to sites of vascular injury and regenerate blood vessels. We studied the efficacy of human CAC therapy in the treatment of pulmonary arterial hypertension at two different stages of disease severity. Cells were isolated from peripheral blood and administered to nude rats on day 14 (“early”) or day 21 (“late”) after monocrotaline injection. The control group received monocrotaline but no cell treatment. Disease progression was assessed using right heart catheterization and echocardiography at multiple time points. Survival differences, right ventricular hypertrophy (RVH), and vascular hypertrophy were analyzed at the study endpoint. Quantitative PCR was performed to evaluate cell engraftment. Treatment with human CACs either at the early or late time points did not result in increased survival, and therapy did not prevent or reduce the severity of disease compared with control. Histological analysis of RVH and vascular muscularization showed no benefit with therapy compared with control . No detectable signal was seen of human transcript in transplanted lungs at 14 or 21 days after cell transplant. In conclusion, CAC therapy was not associated with increased survival and did not result in either clinical or histological benefits. Future studies should be geared toward either earlier therapeutic time points with varying doses of unmodified CACs or genetically modified cells as a means of delivery of factors to the pulmonary arterial circulation.

scholarly journals Macrophage Immunomodulation: The Gatekeeper for Mesenchymal Stem Cell Derived-Exosomes in Pulmonary Arterial Hypertension?

2018 ◽  
Vol 19 (9) ◽  
pp. 2534 ◽  
Author(s):  
Gareth Willis ◽  
Angeles Fernandez-Gonzalez ◽  
Monica Reis ◽  
S. Mitsialis ◽  
Stella Kourembanas
Keyword(s):  
Stem Cell ◽  
Pulmonary Arterial Hypertension ◽  
Mesenchymal Stem Cell ◽  
Arterial Hypertension ◽  
Pulmonary Inflammation ◽  
Pulmonary Arteries ◽  
Cross Sectional ◽  
Macrophage Function ◽  
Beneficial Effects ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) is a progressive disease characterized by remodeling of the pulmonary arteries, increased pulmonary infiltrates, loss of vascular cross-sectional area, and elevated pulmonary vascular resistance. Despite recent advances in the management of PAH, there is a pressing need for the development of new tools to effectively treat and reduce the risk of further complications. Dysregulated immunity underlies the development of PAH, and macrophages orchestrate both the initiation and resolution of pulmonary inflammation, thus, manipulation of lung macrophage function represents an attractive target for emerging immunomodulatory therapies, including cell-based approaches. Indeed, mesenchymal stem cell (MSC)-based therapies have shown promise, effectively modulating the macrophage fulcrum to favor an anti-inflammatory, pro-resolving phenotype, which is associated with both histological and functional benefits in preclinical models of pulmonary hypertension (PH). The complex interplay between immune system homeostasis and MSCs remains incompletely understood. Here, we highlight the importance of macrophage function in models of PH and summarize the development of MSC-based therapies, focusing on the significance of MSC exosomes (MEx) and the immunomodulatory and homeostatic mechanisms by which such therapies may afford their beneficial effects.

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