Method delivers cell therapies using bronchoscopy in patients requiring ECMO

Key takeaways:

• The ECMO system can get in the way of cell therapy delivery.
• Consecutive Intrabronchial Administration may be an alternative to the current delivery method.
• Researchers behind the method are not patenting it.

There are limits to cell therapy delivery in patients requiring extracorporeal membrane oxygenation due to the machine, but Consecutive Intrabronchial Administration offers a potential new delivery route, according to a press release.

Rather than delivering mesenchymal stromal cells (MSCs) via IV infusion, the Consecutive Intrabronchial Administration, or CIBA, method uses bronchoscopy to get the therapy directly into the lungs, Bernat Soria, MD, PhD, FRCP (Hon), one of the developers of this method and emeritus professor of physiology at the Institute of Bioengineering at the Miguel Hernandez University of Elche and the Health Research Institute of the Alicante University Hospital, told Healio.

The safety and feasibility study of the CIBA method in a pediatric patient with interstitial lung disease on ECMO was published in Stem Cell Research & Therapy.

Healio spoke with Soria to learn more about how CIBA builds upon the current way to deliver cell therapies to patients on ECMO and the impact MSCs have on the lungs.

Healio: What is the current way cell therapies are delivered to patients on ECMO? What are some of the challenges with this method?

Soria: Cell therapies with MSCs are usually given through IV infusion. This is because MSCs mainly work through immune signaling; however, in some cases, they need to reach a specific tissue.

In the case of lungs, 80% of the intravenously administered cells get trapped because the lungs, liver and spleen act as filters. However, IV infusion of MSCs in ECMO patients poses significant challenges, including the risk for circuit obstruction due to cell size and aggregation, which could compromise ECMO function and patient safety.

Therefore, the intrabronchial (CIBA method) route offers the advantage of avoiding immediate systemic circulation, thereby minimizing the risks of ECMO obstruction and coagulation activation. Additionally, this technique improves local therapeutic benefits by allowing direct MSC administration to the afflicted lung tissue.

Healio: How does the CIBA method/technique build upon the current way to deliver cell therapies to patients on ECMO?

Soria: By providing direct, localized distribution of MSCs into the lungs instead of via the conventional IV route, the CIBA method improves upon existing delivery techniques. This is particularly crucial for ECMO patients, as IV MSCs frequently become stuck in the ECMO circuit or do not get to the lungs in sufficient quantities. CIBA maximizes lung exposure while minimizing systemic loss by delivering MSCs directly into each lung lobe via bronchoscopy, avoiding the ECMO circuit completely and guaranteeing that the therapeutic cells reach the site of damage. It’s a focused strategy that tackles the drawbacks of IV administration in this intricate situation.

Healio: The release said that MSCs were administered via the CIBA method in a pediatric patient. What impact do these cells have on the lung?

Soria: MSCs have powerful anti-inflammatory, immunomodulatory and regenerative effects. When delivered directly into the lungs using the CIBA method, MSCs can reduce inflammation, calm an overactive immune response and promote tissue repair in damaged lung areas. This is especially valuable in patients on ECMO, who often suffer from severe lung injury and inflammation.

Healio: You are not patenting CIBA. What impact will this decision have on patients and clinicians?

Soria: Patents protect the intellectual property and restrict the use to the owners. However, advanced therapies are very expensive, and we do not want to add more restrictions. Without patent constraints, the method may be freely used, modified and distributed throughout hospitals and health care systems around the world, accelerating access to potentially life-saving treatment, particularly in situations with limited resources or urgency.

Essentially, not patenting the CIBA method puts accessibility ahead of profit, which is in line with urgent treatment in critical care and pediatric settings.

Healio: What will be assessed in further clinical testing of CIBA? When do you expect to have additional results?

Soria: I expect that new trials will begin and allow us to reach data on the efficacy for a series of inflammatory, infectious, degenerative, autoimmune and tentatively oncologic diseases.

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For more information:

Bernat Soria, MD, PhD, FRCP (Hon), can be reached at bernat.soria@umh.es.