Novel Intrabronchial Method Delivers Cell Therapies in Critically Ill Patients on External Lung Support

The risk of clogging the ECMO system’s gas-exchange membranes with intravenous infusions has been a significant barrier. Now, a new study published in Stem Cell Research & Therapy introduces a new approach to safely deliver cell therapies to ECMO patients.

The novel method, developed by a multidisciplinary clinical team led by Miguel Hernández University of Elche (UMH, Elche, Spain), is called CIBA, which stands for Consecutive Intrabronchial Administration. This approach allows for the direct delivery of stem-cell-based treatments to the alveoli of critically ill patients who are unable to receive traditional intravenous therapy due to the limitations of the ECMO system. By employing controlled, fractionated intrabronchial delivery, the CIBA method deposits therapeutic cells precisely where they are needed in the lungs without disturbing the ECMO circuit.

Using CIBA, mesenchymal stromal cells (MSCs)—which can be sourced from the umbilical cord, bone marrow, adipose tissue, or dental pulp—are administered directly into the lungs. MSCs are unspecialized cells that have the ability to migrate to damaged tissues, modulate inflammation, and promote tissue regeneration. Once delivered into the lungs, these cells interact with immune cells, such as alveolar macrophages, and release anti-inflammatory signals that help prevent further tissue damage and support the healing process. This method eliminates the need for systemic circulation and focuses the therapeutic effect directly on the lungs, minimizing potential risks. The technique was initially applied in a compassionate use case for a 2-year-old patient suffering from end-stage interstitial lung disease who was not a candidate for lung transplantation. The research team suggests that higher doses or repeated administrations could be explored in future trials. Furthermore, they have decided not to patent the technique in order to facilitate its use in public health systems once additional clinical trials are completed.

"What we've achieved is a safe way to deliver regenerative therapies when all other options are blocked,” said Professor Bernat Soria from UMH’s Institute of Bioengineering who led the research team. “Imagine watering a fragile plant, but the watering can would flood it. CIBA allows us to drip-feed the therapy gently and exactly where it's needed—right into the lungs."