First case of low-dose umbilical cord blood therapy for pediatric acute respiratory distress syndrome induced by Pneumocystis carinii pneumonia

Eur J Med Res. 2021 Aug 28;26(1):100. doi: 10.1186/s40001-021-00548-0.

Abstract

Objective: This study aimed to present the case of a boy with acute distress syndrome (ARDS) treated with low-dose umbilical cord blood (UCB) therapy and explore the underlying possible mechanism.

Methods: A 7-year-old boy with severe Pneumocystis carinii pneumonia and severe ARDS was treated with allogeneic UCB as salvage therapy.

Results: The patient did not improve after being treated with lung protective ventilation, pulmonary surfactant replacement, and extracorporeal membrane oxygenation (ECMO) for 30 days. However, his disease reversed 5 days after allogeneic UCB infusion, and he weaned from ECMO after 7 days of infusion. Bioinformatics confirmed that his Toll-like receptor (TLR) was abnormal before UCB infusion. However, after the infusion, his immune system was activated and repaired, and the TLR4/MyD88/NF-κB signaling pathway was recovered.

Conclusion: Allogenic UCB could treat ARDS by repairing the TLR4/MyD88/NF-κB signaling pathway, thereby achieving stability of the immune system.

Keywords: Acute respiratory distress syndrome; Pneumocystis carinii pneumonia; Umbilical cord blood.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Cord Blood Stem Cell Transplantation / methods*
  • Extracorporeal Membrane Oxygenation / methods*
  • Fetal Blood / cytology*
  • Humans
  • Male
  • Pneumocystis carinii / isolation & purification*
  • Pneumonia, Pneumocystis / complications*
  • Pneumonia, Pneumocystis / microbiology
  • Prognosis
  • Respiration, Artificial
  • Respiratory Distress Syndrome / microbiology
  • Respiratory Distress Syndrome / therapy*
  • Transplantation, Homologous