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Harnessing CD146-positive mesenchymal stromal cells for precision therapy in acute respiratory distress syndrome
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DOI：10.4252/wjsc.v18.i1.114825.png)
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Abstract
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Acute respiratory distress syndrome (ARDS) is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options. Notably, Zhang et al demonstrated that CD146+ mesenchymal stromal cells (MSCs) exhibited greater therapeutic efficacy than CD146- MSCs. These cells enhance epithelial repair through nuclear factor kappa B/cyclooxygenase-2-associated paracrine signaling and secretion of pro-angiogenic factors. We concur that MSCs hold significant promise for ARDS treatment; however, the heterogeneity of cell products is a translational barrier. Phenotype-aware strategies, such as CD146 enrichment, standardized potency assays, and extracellular vesicle profiling, are essential for improving the consistency of these studies. Furthermore, advanced preclinical models, such as lung-on-a-chip systems, may provide more predictive insights into the therapeutic mechanisms. This article underscores the importance of CD146+ MSCs in ARDS, emphasizes the need for precision in defining cell products, and discusses how integrating subset selection into translational pipelines could enhance the clinical impact of MSC-based therapies.
Keywords:
Acute respiratory distress syndrome
Mesenchymal stromal cells
CD146
Nuclear factor kappa B/cyclooxygenase-2 signaling pathway
Extracellular vesicles
Endothelial barrier repair
Precision medicine
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