In a remarkable advancement towards treating Chronic Obstructive Pulmonary Disease (COPD), scientists have, for the first time, demonstrated the potential of repairing damaged lung tissue using patients’ own lung cells. The breakthrough was unveiled at this year’s European Respiratory Society International Congress in Milan, Italy, where results from a pioneering phase I clinical trial were shared.

COPD, which is common in those with chronic pulmonary aspergillosis (CPA), causes progressive damage to lung tissue, significantly impacting the quality of life for patients through the obstruction of airflow out of the lungs. The disease, claiming the lives of roughly 30,000 people in the UK each year, has been historically challenging to treat. Current treatments mainly focus on alleviating symptoms through bronchodilators such as salbutamol, which widen the airways to enhance airflow but do not repair the damaged tissue.

The search for a more definitive treatment led researchers to explore the realms of stem cell and progenitor cell-based regenerative medicine. Stem cells are known for their ability to morph into any cell type. Unlike stem cells, progenitor cells can only turn into certain types of cells related to a specific area or tissue. For example, a progenitor cell in the lung can turn into different types of lung cells but not into heart cells or liver cells. Among the researchers is Professor Wei Zuo from Tongji University, Shanghai and chief scientist at Regend Therapeutics. Professor Zuo and his team at Regend have been investigating a specific type of progenitor cell known as P63+ lung progenitor cells.

The phase I clinical trial initiated by Professor Zuo and his colleagues aimed to assess the safety and efficacy of removing P63+ progenitor cells from patients’ lungs, then multiplying them in their millions in a laboratory before transplanting them back into their lungs.

20 COPD patients were enrolled in the trial, 17 of whom received the cell treatment, while three served as the control group. The results were encouraging; the treatment was well tolerated, and patients exhibited improved lung function, could walk further, and reported a better quality of life following the treatment.

After 12 weeks of this new treatment, patients experienced a significant improvement in their lung function. Specifically, the lungs’ ability to transfer oxygen and carbon dioxide to and from the bloodstream became more efficient.  Additionally, patients could walk further during a standard six-minute walking test. The median (the middle number when all numbers are arranged from smallest to largest)  distance increased from 410 meters to 447 meters –  a good sign of improved aerobic capacity and endurance. Moreover, there was a notable decrease in the scores from the St George’s Respiratory Questionnaire (SGRQ), a tool used to measure the impact of respiratory diseases on overall quality of life. A lower score indicates that patients felt their quality of life had improved, with fewer symptoms and better daily functioning. Overall, this suggests that the treatment improved lung function and positively impacted patients’ day-to-day lives.

The groundbreaking results also highlighted the potential of this treatment in repairing lung damage in patients with mild emphysema (a type of lung damage that occurs in COPD), a condition generally considered irreversible and progressive. Two patients enrolled on the trial with the condition showed resolution of the lesions at 24 weeks by CT imaging. 

Endorsed by China’s National Medical Products Administration (NMPA), which is the equivalent of the UK Medicines and Healthcare products Regulatory Agency (MHRA), a phase II clinical trial is in the pipeline to test further the use of P63+ progenitor cell transplantation in a larger group of COPD patients. 

This innovation could significantly alter the course of treatment in COPD. Professor Omar Usmani of Imperial College London and Head of the European Respiratory Society group on airway disease, asthma, COPD and chronic cough provided his thoughts on the trial’s significance, underscoring the urgent need for more effective treatments for COPD. He noted that if these results are confirmed in subsequent trials, it would be a major breakthrough in COPD treatment.

The road ahead appears promising, with the potential to not only alleviate the debilitating symptoms of COPD but to repair the damage it inflicts on the lungs, offering hope to millions suffering from this chronic respiratory disease.

You can read in more detail about the trial here: https://www.ersnet.org/news-and-features/news/transplanting-patients-own-lung-cells-offers-hope-of-cure-for-copd/