A groundbreaking advancement in medical science has emerged from the Institute of Bioengineering at Miguel Hernández University of Elche (UMH, Spain), offering hope to critically ill patients on extracorporeal membrane oxygenation (ECMO). Led by Professor Bernat Soria, a multidisciplinary team has devised a novel technique called Consecutive Intrabronchial Administration (CIBA) that allows stem-cell-based therapies to reach the lungs directly without compromising the ECMO system. This innovation paves the way for enhanced regenerative treatments and underscores a commitment to open-access healthcare solutions.

Unlocking New Possibilities in Regenerative Medicine

In an era where advanced therapies hold immense potential, accessibility remains a critical challenge. The CIBA method addresses this issue head-on, providing a safe alternative for delivering cell therapies to ECMO-dependent patients who previously had no viable options.

Innovative Approach to Stem-Cell Delivery

The development of the CIBA method marks a significant leap forward in addressing the limitations faced by clinicians treating ECMO-supported patients. Traditionally, administering cell therapies via intravenous infusion posed substantial risks due to the possibility of clogging ECMO's delicate gas-exchange membranes. By employing controlled, fractionated intrabronchial delivery, CIBA ensures precise placement of therapeutic cells within the alveoli, bypassing systemic circulation entirely. This targeted approach not only maximizes the treatment's efficacy but also significantly reduces associated hazards.Professor Bernat Soria likened the process to nurturing a fragile plant with care. Just as overwatering could harm a delicate sapling, indiscriminate administration of cell therapies might overwhelm the body’s systems. With CIBA, however, the therapy is administered gently and precisely where it is most needed—the lungs—ensuring optimal results.Mesenchymal stromal cells (MSCs), derived from sources such as the umbilical cord, bone marrow, adipose tissue, or dental pulp, play a pivotal role in this breakthrough. These versatile cells possess the unique ability to migrate toward damaged tissues, modulate inflammatory responses, and stimulate regeneration. Upon reaching the lungs, they interact with immune cells like alveolar macrophages, releasing anti-inflammatory signals that aid in preventing further tissue damage while promoting healing.

Pioneering Application in Pediatric Care

The first application of the CIBA method occurred under compassionate use circumstances involving a 2-year-old child suffering from end-stage interstitial lung disease. Despite extensive immunosuppressive treatments and prolonged ECMO support spanning over three months, the young patient's condition remained dire, leaving lung transplantation as the sole remaining option—an unattainable one given his fragile state.With approval from Spain's Spanish Agency of Medicines and Medical Devices (AEMPS), the clinical team administered a single dose of Wharton’s jelly-derived mesenchymal stromal cells (WJ-MSCs) using the CIBA method. The procedure proved well-tolerated, leading to successful extubation within 72 hours. Although the child's condition later deteriorated, necessitating withdrawal of ECMO support after 127 days, the trial demonstrated the safety and feasibility of delivering cell therapies to ECMO patients—a monumental achievement in itself.Professor Soria emphasized that while CIBA did not eradicate the underlying disease, it successfully opened a new therapeutic avenue. "We now have a tool that can bring advanced therapies closer to those who need them most," he remarked, highlighting the transformative implications of this breakthrough.

Targeted Mechanisms Behind the Success

Understanding how the CIBA method functions provides insight into its effectiveness. Mesenchymal stromal cells exhibit remarkable properties that make them ideal candidates for regenerative medicine. Once introduced into the lungs through the CIBA technique, these cells engage with local immune cells, initiating a cascade of beneficial effects. They release anti-inflammatory mediators that mitigate excessive inflammation, fostering an environment conducive to tissue repair and recovery.Moreover, the direct targeting of the lungs minimizes collateral exposure throughout the body, reducing the likelihood of adverse reactions. This localized approach enables higher doses or repeated administrations to be explored in subsequent trials, potentially enhancing outcomes even further. Such flexibility positions CIBA as a cornerstone for future advancements in personalized medicine tailored specifically for ECMO patients.

National Collaboration Fostering Open Science

This landmark study forms part of the DECODE clinical project, generously funded by Spain's Instituto de Salud Carlos III. It represents a collaborative effort involving 28 clinicians hailing from four prominent national institutions: Hospital 12 de Octubre (Madrid), Banc de Sang i Teixits (Catalonia), the Institute of Bioengineering at UMH (Elche), and the Institute for Health and Biomedical Research of Alicante (ISABIAL).Professor Soria underscored the importance of maintaining affordability in advanced therapies. Recognizing the prohibitive costs often associated with cutting-edge treatments, the team opted against patenting the CIBA method. Instead, they chose to prioritize public health benefits, ensuring widespread accessibility without undue financial burdens. "Our goal is to contribute meaningful, impactful science that reaches patients directly," Prof. Soria affirmed, reflecting the team's unwavering dedication to advancing global healthcare standards.