HASAN TOLGA CELIK, Ahmet Öktem, Şule Yiğit, Murat Yurdakok

Bronkopulmoner displazi tanılı ikizde mezenkimal kök hücre tedavisi ve akciğer ultrasonografisi ile tedavi izlemi

Bronkopulmoner displazi düşük doğum ağırlıklı bebeklerde erken ye nidoğan döneminde mekanik ventilasyonun etkisi ve oksijen toksititesigibi nedenlerle ortaya çıkan kronik bir akciğer hastalığıdır. Bu hastalar da ventilasyon desteği ve oksijen ihtiyacı uzun süre devam etmektedir.Bronkopulmoner displazi gelişimini engellemek amaçlı antenatal ste roid kullanımı, baro/volutravmayı azaltacak ventilasyon teknikleri, post natal steroid ve A vitamini kullanımı gibi stratejiler vardır. Son yıllarda,bronkopulmoner displazi gelişimindeki patofizyolojik mekanizmalarındurdurulması ve/veya azaltılması amaçlı tercih edilebilecek yöntemler den birtanesi de mezenkimal kök hücre kullanımıdır. Bu yazıda, gebelikhaftası 26 olan 750 g kız ve 930 g erkek doğum ağırlığına sahip ikizlere,bronkopulmoner displazi tanısıyla verilen mezenkimal kök hücre teda visi ve sonuçları sunulmuştur. Bu hastalar klinik bulgular, akciğer grafi leri yanı sıra tekrarlayan akciğer ultrasonografisi ile izlenmiştir

The clinical and radiological course of bronchopulmonarydysplasia in twins treated with mesenchymal stem cellsand followed up using lung ultrasonography

Bronchopulmonary dysplasia is a chronic lung disease that develops in low-birth-weight infants as a result of mechanical ventilation and oxygen toxicity in the early neonatal period. In these patients, mechanical ventilation and oxygen support are needed for a long time. We already use antenatal steroid, ventilation techniques with minimal baro/volutrauma, postnatal steroid, and vitamin A to prevent the development of bronchopulmonary dysplasia. Mesenchymal stem cell treatment is another way to reduce or stop the pathophysiologic pathways in the development of bronchopulmonary dysplasia. Herein, we present mesenchymal stem cell treatment and its outcomes in twins who were born with a gestational age of 26 weeks and diagnosed as having bronchopulmonary dysplasia (the female twin was born with a birth weight of 750 g and the male twin was born with a birth weight of 930 g). These patients were followed up with clinical findings, chest radiography, and lung ultrasonography.

PDF

___

1. Northway WH Jr, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967;276(7):357–368.
2. Sarıcı SÜ. partment of Pediatrics, Gülhane Military Medical Academy, Ankara, Turkey). Bronchopulmonary dysplasia: new insights about the definition, pathogenesis, epidemiology and pathology. ÇSHD 2006; 49: 60–70.
3. Mohammadipoor A, Antebi B, Batchinsky AI, Cancio LC. Therapeutic potential of products derived from mesen- chymal stem/stromal cells in pulmonary disease. Respir Res 2018; 19: 218.
4. Liu J, Chen SW, Liu F, et al. BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations. Medicine (Baltimore) 2014; 93: e133.
5. Pant S, Hilton H, Burczynski ME. The multifaceted exosome: biogenesis, role in normal and aberrant cellular function, and frontiers for pharmacological and biomarker opportunities. Biochem Pharmacol 2012; 83: 1484–94.
6. O’Reilly M, Thébaud B. Animal models of bronchopulmonary dysplasia. The term rat models. Am J Physiol Lung Cell Mol Physiol 2014; 307: L948–58.
7. Chang YS, Ahn SY, Yoo HS, et al. Mesenchymal stem cells for bronchopulmonary dysplasia: phase 1 dose-escalation clinical trial. J Pediatr 2014; 164: 966–72.e6.
8. Laube M, Stolzing A, Thome UH, Fabian C. Therapeutic potential of mesenchymal stem cells for pulmonary complications associated with preterm birth. Int J Biochem Cell Biol 2016; 74: 18–32.
9. Antunes MA, Laffey JG, Pelosi P, Rocco PR. Mesenchymal stem cell trials for pulmonary diseases. J Cell Biochem 2014; 115: 1023–32.
10. Leeman KT, Pessina P, Lee JH, Kim CF. Mesenchymal Stem Cells Increase Alveolar Differentiation in Lung Progenitor Organoid Cultures. Sci Rep 2019; 9: 6479