Extracellular vesicles in the therapy of BPD

Cell-based therapies are entering the clinical arena to curb complications of extreme preterm birth. While clinical trials are testing the feasibility and safety of first generation mesenchymal stromal cell (MSC) products, next generation cell-free therapies are already on the horizon. Fueled by the realization that MSCs exert their therapeutic benefit by releasing nanosized extracellular vesicles (EVs), a new field of cell-based therapy has blossomed. EVs, contain a rich cargo, making them ideal candidates to treat multifactorial diseases such as bronchopulmonary dysplasia (BPD). EV-based therapies may have significant advantages over the use of whole cells, including product consistency, higher repair potential and manufacturing scalability. As any disruptive technology, numerous iterations and refinements will be required over the coming decade to harness the potential of EVs. This chapter reviews current EV isolation and characterization techniques, summarizes preclinical studies suggesting their lung repair capabilities in experimental models mimicking BPD and highlights future challenges.