Preface

In recent years, progress in cell biology has uncovered complex molecular networks that have elucidated the underpinning defects and therapeutic targets in biological systems. Advances in molecular biology and the pathology of disease have provided the foundation for the advent of therapeutic interventions and innovations designed to prevent or modify disease. Today, personalized medicine is delivering targeted therapies that are optimized for the patient's phenotype and genotype.

As our understanding of the broad field of "omics" manifested by genomics, transcriptomics, proteomics, and metabolomics has contributed significantly to twenty-first century therapeutics, so too has our understanding of fundamental cell biology. To that end, it became apparent that a need exists for capturing advances in cell structure, function, and therapy.

The dawn of cell therapies and medicines is captured in this new and exciting book entitled *Innovation in Cell Research and Therapy*. This book provides an in-depth description of some of the key issues and advancements in cell biology and its application to novel therapeutic approaches. Six chapters authored by experts in the field address the components of cells, cell structure, and the emergence of stem cells and their applications. The chapters provide state-of-the-art descriptions and summaries and identify the future needs in this continuously evolving field. This book is meant to raise awareness of the complexity associated with defining and characterizing the biological and pharmacological properties of cell therapy modalities.

Hardly a day passes without hearing of a biomedical advance. Innovation in the biosciences has progressed at a rapid speed. Given that, why should you read this book? What do we bring to the table? Our answer is that we are a unique team of global experts that come from diverse backgrounds. In this engaging book we deliver a comprehensive compendium of some of the most fundamental, important, and enabling advances in cell biology. As you read the book you will personally engage with leaders in the cell biology field. I am confident that your knowledge and insight into cell biology will be significantly impacted. Indeed, the dawn of cell therapies and medicines is captured in this new and exciting book.

I am humbled and most gratified to IntechOpen for inviting me to serve as editor of this work. My sincere thanks go to Josip Knapic, Author Service Manager, and Martina Usljebrka, Commissioning Editor, for all of their help and assistance throughout the entire process. I thank my colleagues at the Touro College of Pharmacy and New York Medical College for fostering an inspiring environment with a shared quest for biomedical advancements. Words cannot express my gratitude to my wife Brenda and our children and grandchildren for their constant support and encouragement. This book is dedicated to the memory of my wonderful

**II**

**Chapter 6 129**

Stem Cells and Extracellular Vesicles: Biological Regulators of Physiology

*by Theo Borgovan, Lorin Crawford, Chibuikem Nwizu and Peter Quesenberry*

and Disease

parents Harry and Cecile Loewy. It is their value of education, and contribution to the field of education, that set me on my own personal path in academics.

> **Dr. Zvi Loewy** Professor of Pharmaceutical and Biomedical Sciences, Associate Dean of Research, Immediate Past Dean, Touro College of Pharmacy, New York, USA

> > Professor of Microbiology and Immunology, New York Medical College, New York, USA

> > > **1**

Section 1

Cell Therapy

Section 1 Cell Therapy

**3**

**Chapter 1**

**Abstract**

ARDS and sepsis.

**1. Introduction**

Current Status of Stem Cell

*Raquel Guillamat-Prats and Antonio Artigas*

**Keywords:** sepsis, ARDS, acute lung injury, cell therapy, critical care

than 5 million deaths per year worldwide [5–8].

Sepsis and acute respiratory distress syndrome (ARDS) are life-threatening diseases with high mortality and morbidity in all the critical care units around the world [1–4]. Severe sepsis is a complex syndrome produced by the response to a systemic infection. The infection produces a general inflammatory response, such as tachycardia, elevated white cell count and systemic release of pro-inflammatory cytokines, and this can lead to an acute organ dysfunction. Sepsis is producing more

The lung is one of the most affected organs during sepsis, and for that reason, one of the main indirect causes of ARDS is sepsis. ARDS can also be produced by a direct injury as a pulmonary infection or a trauma. ARDS is a multifactorial

Therapy for Sepsis and Acute

Respiratory Distress Syndrome

Sepsis and acute respiratory distress syndrome (ARDS) are life-threatening diseases with high mortality, around 40%, and morbidity in all the critical care units around the world. After decades of research, and numerous pre-clinical and clinical trials, sepsis and ARDS remain without a specific and effective pharmacotherapy and essentially the management remains supportive. Over the last years, cell therapies gained potential as a therapeutic treatment for ARDS and sepsis. Based on numerous pre-clinical studies, there is a growing evidence of the potential benefits of cell-based therapies for the treatment of sepsis and ARDS. Different cell subtypes have been used for the treatment of both syndromes; however, the major part of the studies is using mesenchymal stem/stromal cells (MSC). Also, other relevant groups performed some pre-clinical studies using induced pluripotent stem cells (iPSC) for the treatment of both syndromes and alveolar type II cells for ARDS treatment. Numerous questions need further study, including determining the best source for the progenitor cells isolation, their large-scale production, and cryopreservation. Also, the heterogeneity of patients with sepsis and ARDS is massive, and the stratification of the patients will help us to determine better the therapeutic effect of these cell therapies. In this review, we are going to describe briefly the different cell types, their potential sources, and characteristics and mechanism of action. We will review several pre-clinical and clinical studies in
