FEV1 and dyspnoea improvements typically initiate 4–8 weeks post-infusion and stabilise by 3–6 months. Duration is variable: 50% of responders sustain ≥50% of initial benefit beyond 12 months; others show gradual decline by 12–18 months, possibly reflecting disease progression. Re-treatment at 12–18 month intervals may sustain gains, but protocols are not standardised. Long-term follow-up (≥3 years) is limited; expectation is stabilisation of lung function decline rather than progressive improvement.
Chronic obstructive pulmonary disease (COPD) involves irreversible loss of lung parenchyma (emphysema) and small-airway inflammation, progressively restricting airflow and oxygen exchange. Conventional therapy (bronchodilators, corticosteroids) suppresses inflammation but does not repair alveolar damage. Stem cell strategies target structural restoration: placental mesenchymal stem cells (MSCs) secrete hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) that stimulate alveolar regeneration and angiogenesis, partially reconstituting gas-exchange surface. Exosomes from MSCs reduce alveolar inflammation and oxidative stress. The therapeutic hypothesis challenges the dogma of irreversibility; evidence suggests modest alveolar regeneration is possible, particularly in early-to-moderate disease. Thirty-four registered trials investigate COPD cell therapy; ten actively recruit, indicating expanding clinical interest.
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