Acute lung injury (ALI) describes one or more initiating assaults either directly to the lungs or systemically that, if not\r\ntreated in a timely manner, ultimately progresses to the development of acute respiratory distress syndrome (ARDS) a\r\ncondition which is characterized by atelectasis, pulmonary hypertension, and an intense, overwhelming inflammatory\r\nresponse that leads to obliterating pulmonary fibrosis and ultimately respiratory failure. The long-term complications\r\nassociated with ALI/ARDS can be subverted if the fibrotic phase of the disease is suppressed; therefore, it is essential\r\nto control inflammation in such a way that endogenous self-protection mechanisms are maintained while not allowing\r\nescalating inflammatory damage to occur in the local environment of the lungs. Current treatment strategies focus on\r\noptimal ventilator management and treatment of the underlying condition. Cell-based approaches are an attractive\r\noption for directed therapeutic intervention for ALI/ARDS. In particular, mesenchymal stem cells (MSCs) from bone\r\nmarrow, adipose, umbilical cord, and lung tissue as well as induced pluripotent stem (iPS) cells have been shown to\r\nfacilitate lung repair in several animal models of ALI. The exact mechanism(s) by which these cells accomplish this\r\nfeat are as yet unknown; however, mounting evidence suggests that they possess potent immunomodulatory and anti-\r\nmicrobial capabilities which diminish the injury-induced inflammatory responses and reduce infection-mediated ALI,\r\nrespectively, in these various models. Both direct delivery of stem cells to the lung and systemic administration have\r\nbeen somewhat effective, suggesting that stem cells utilize paracrine mechanisms, at least in part, to perform these\r\nfunctions. Aside from their endogenous ability to suppress inflammation and infection, gene-modified MSCs and iPS\r\ncells have recently been used as vehicles for carrying anti-inflammatory agents to the lung. Taken together, stem cell\r\ntherapy is a promising alternative to current therapeutic intervention for ALI/ARDS.
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