Abstract

H7N9 viruses quickly spread between mammalian hosts and carry the risk of human-to-human transmission, as shown by the 2013 outbreak. Acute respiratory distress syndrome (ARDS), lung failure, and acute pneumonia are major lung diseases in H7N9 patients. Transplantation of mesenchymal stem cells (MSCs) is a promising choice for treating virus-induced pneumonia, and was used to treat H7N9-induced ARDS in 2013. The transplant of MSCs into patients with H7N9-induced ARDS was conducted at a single center through an open-label clinical trial. Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9-induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs. It was notable that MSC transplantation significantly lowered the mortality of the experimental group, compared with the control group (17.6% died in the experimental group while 54.5% died in the control group). Furthermore, MSC transplantation did not result in harmful effects in the bodies of four of the patients who were part of the five-year follow-up period. Collectively, these results suggest that MSCs significantly improve the survival rate of H7N9-induced ARDS and provide a theoretical basis for the treatment of H7N9-induced ARDS in both preclinical research and clinical studies. Because H7N9 and the coronavirus disease 2019 (COVID-19) share similar complications (e.g., ARDS and lung failure) and corresponding multi-organ dysfunction, MSC-based therapy could be a possible alternative for treating COVID-19.

Highlights

  • Influenza A viruses (IAVs) are divided into multiple subtypes according to diversified viral surface antigens and two major pathotypes, including high and low pathogenicity for chicken [1,2]

  • H7N9 viruses are able to spread between mammalian hosts without losing virulence [10], and genetic mutations of H7N9 virus confer the risk of human-to-human transmission [11,12,13], as demonstrated in a few family clusters infected by this virus [14,15]

  • All patients in the experimental group and the control group received antiviral agents according to the standard therapy

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Summary

Introduction

Influenza A viruses (IAVs) are divided into multiple subtypes according to diversified viral surface antigens and two major pathotypes, including high and low pathogenicity for chicken [1,2]. Among these IAVs, all avian viruses with high pathogenicity have belonged to the H5/H7 subtype until recently [3]. A novel avian-original influenza virus emerged in the spring of 2013 and led to severe and fatal respiratory disease in humans [4].

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