Mesenchymal stem/stromal cell therapy for COVID-19 pneumonia: potential mechanisms, current clinical evidence, and future perspectives

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread into more than 200 countries and infected approximately 203 million people globally. COVID-19 is associated with high mortality and morbidity in some patients, and this disease still does not have effective treatments with reproducibly appreciable outcomes. One of the leading complications associated with COVID-19 is acute respiratory distress syndrome (ARDS); this is an anti-viral host inflammatory response, and it is usually caused by a cytokine storm syndrome which may lead to multi-organ failure and death. Currently, COVID-19 patients are treated with approaches that mostly fall into two major categories: immunomodulators, which promote the body’s fight against viruses efficiently, and antivirals, which slow or stop viruses from multiplying. These treatments include a variety of novel therapies that are currently being tested in clinical trials, including serum, IL-6 antibody, and remdesivir; however, the outcomes of these therapies are not consistently appreciable and remain a subject of debate. Mesenchymal stem/stromal cells (MSCs), the multipotent stem cells that have previously been used to treat viral infections and various respiratory diseases such as ARDS exhibit immunomodulatory properties and can ameliorate tissue damage. Given that SARS-CoV-2 targets the immune system and causes tissue damage, it is presumable that MSCs are being explored to treat COVID-19 patients. This review summarizes the potential mechanisms of action of MSC therapy, progress of MSC, and its related products in clinical trials for COVID-19 therapy based on the outcomes of these clinical studies.

Elsholtzia bodinieri Vaniot Ameliorated Acute Lung Injury by NQO1, BCL2 and PTGS2 In Silico and In Vitro Analyses

“…Failure to resolve the ALI worsening will increase the poor prognosis and mortality of patients [ 35 ]. Although a large number of ALI research has been conducted, no effective drug treatments that significantly decrease the mortality have been reported [ 36 ].…”

Allogeneic Mesenchymal Stem Cells and Its Conditioned Medium as a Potential Adjuvant Therapy for COVID-19

“…In addition, MSCs promote the proliferation of regulatory T cells and inhibit the proliferation of effectors T cells, thereby reducing the immune response and repairing lung damage. 69 The allogeneic MSC transplantation for ARDS has been conducted previously, in which patients transplanted with MSCs were reported to have a lower mortality rate in H7N9-induced ARDS (17.6% vs 54.5%). Since patients with severe COVID-19 develop profound local or systemic inflammation and subsequently progresses into ARDS and the related multi-organ dysfunction, MSCs-based therapy could become a considerable option for those patients.…”

Post-Covid-19 Arthritis

“…Additionally, it improves tissue healing and lessens lung fibrosis. In critically sick patients, MSCs may treat cytokine storm syndromes in addition to standard antiviral therapy, therefore halting the course of COVID-19 and decreasing death [28].…”