Platelet Lysate Nebulization Protocol for the Treatment of COVID-19 and Its Sequels: Proof of Concept and Scientific Rationale

Abstract

One of the most severe effects of coronavirus disease 2019 (COVID-19) is lung disorders such as acute respiratory distress syndrome. In the absence of effective treatments, it is necessary to search for new therapies and therapeutic targets. Platelets play a fundamental role in respiratory disorders resulting from viral infections, being the first line of defense against viruses and essential in maintaining lung function. The direct application of platelet lysate (PL) obtained from the platelet-rich plasma of healthy donors could help in the improvement of the patient due its anti-inflammatory, immunomodulatory, antifibrotic, and repairing effects. This work evaluates PL nebulization by analyzing its levels of growth factors and its biological activity on lung fibroblast cell cultures, besides describing a scientific basis for its use in this kind of pathology. The data of the work suggest that the molecular levels and biological activity of the PL are maintained after nebulization. Airway administration would allow acting directly on the lung tissue modulating inflammation and stimulating reparative processes on key structures such as the alveolocapillary barrier, improving the disease and sequels. The protocol developed in this work is a first step for the study of nebulized PL both in animal experimentation and in clinical trials.

The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on “Profibrotic Cytokine” IL-1β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study

“…Nebulized PRP is also studied for its effects in COVID-19 in vitro . Beitia et al [ 28 ] hypothesized that the administration of PRP results in the reduction of fibrosis and the regeneration of damaged pulmonary tissue.…”

Phase I/II Clinical Trial of Autologous Activated Platelet-Rich Plasma (aaPRP) in the Treatment of Severe Coronavirus Disease 2019 (COVID-19) Patients

“…The association between dose and efficacy of aaPRP needs to be explored in further studies. Another possible PRP administration is via airway that would reach pulmonary alveoli lung directly [ 21 ]. The possibilities of PRP as a treatment against the respiratory condition were also reported by [ 21 , 22 ].…”

“…HGF, which is the main active component of the PRP, acts in intracellular pathways. It has an important role as an anti-inflammatory to suppress NF-kB and to reduce the cytokine storm in COVID-19 patients [ 21 ]. HGF also has antiapoptotic effect against proinflammatory stimuli towards epithelial cells [ 34 ], which is important as an angiogenic and a recovery agent for COVID-19 patients.…”

“…There has been a reference suggesting the use of PRP from healthy patients to be considered as an allogenic potential therapy for COVID-19 [ 21 ]. With the lack of our experiences of using allogenic PRP therapy, the comparison of autologous and allogenic PRP therapy for COVID-19 needs to be evaluated in further studies to prove the efficacy.…”

Conventional and Unconventional Approaches for Innovative Drug Treatments in COVID-19: Looking Outside of Plato’s Cave

“…Additional large numbers of drug targeting options could involve specific proteins, protein receptors, mRNA, specific biochemical pathways and cells playing a key role in the proliferation of SARS-CoV-2, as well as the outcome of the COVID-19 infection [13][14][15].…”