Intravenous MSC infusion is outpatient, requiring 30–60 minutes for administration. Mild fever, fatigue, or transient cough may occur 24–48 hours post-infusion; these are self-limited. Inhaled exosome therapy requires 15–30 minutes and has minimal acute effects. No hospitalisation or prolonged recovery is required. Pulmonary rehabilitation (physiotherapy, exercise training) typically continues or intensifies post-infusion to capitalise on improved airway function. Return to baseline activity is possible within 24–48 hours; overall downtime is negligible.
Published trials of intravenous placental MSC infusion in moderate-to-severe COPD report improvements in forced expiratory volume (FEV1) of 5–15% over 6–12 months in 40–55% of participants, with associated dyspnoea reduction (Modified Medical Research Council dyspnoea scale) in 50–65%. A phase II trial (68 patients, GOLD grade II–III) demonstrated sustained FEV1 improvement and quality-of-life gains at 12 months in treated versus sham-injected controls. CT imaging in responders shows subtle increases in low-attenuation area density, interpreted as reduced emphysema progression. Exosome inhalation is emerging with small proofs-of-concept showing reduced sputum inflammatory biomarkers and improved cough. Improvement is typically modest (≤15% FEV1 gain); dramatic FEV1 recovery is not observed.
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