Editorial Views  |   May 2019
Is a Part Better than the Whole for Cell-based Therapy for Acute Respiratory Distress Syndrome?
Author Notes
  • From the Departments of Anesthesiology and Medicine and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California.
  • This editorial accompanies the article on p. 778.
    This editorial accompanies the article on p. 778.×
  • Accepted for publication January 3, 2019.
    Accepted for publication January 3, 2019.×
  • Address correspondence to Dr. Matthay: Michael.matthay@ucsf.edu
Article Information
Editorial Views / Critical Care / Respiratory System
Editorial Views   |   May 2019
Is a Part Better than the Whole for Cell-based Therapy for Acute Respiratory Distress Syndrome?
Anesthesiology 5 2019, Vol.130, 683-685. doi:10.1097/ALN.0000000000002653
Anesthesiology 5 2019, Vol.130, 683-685. doi:10.1097/ALN.0000000000002653
Acute respiratory distress syndrome (ARDS) is a devastating clinical condition common in patients with respiratory failure in the intensive care unit. It is associated with high mortality rates and long-term physical and psychologic dysfunction among survivors.1  Based on promising preclinical data, clinical trials with mesenchymal stromal cells for ARDS are underway and constitute a new therapeutic approach.2  Although no safety issues have been identified,2  there remain some concerns with giving large numbers of live mesenchymal stromal cells intravenously, up to 10 million cells per kilogram per dose, in critically ill patients with systemic inflammation and pulmonary vascular dysfunction. In the current issue of Anesthesiology, Varkouhi et al.3  tested the therapeutic use of extracellular vesicles released by human umbilical cord–derived mesenchymal stromal cells in a well-established rat model of severe Escherichia coli bacterial pneumonia as an alternative to giving live cells, bypassing these biologic concerns.