Mesenchymal Stromal Cell Secretome for Post-COVID-19 Pulmonary Fibrosis: A New Therapy to Treat the Long-Term Lung Sequelae?

Elia Bari,Sara Perteghella,Luca Richeldi,Angelo Guido Corsico,Laura Saracino,Maria Luisa Torre,Ilaria Ferrarotti

doi:10.3390/cells10051203

Abstract

To date, more than 100 million people worldwide have recovered from COVID-19. Unfortunately, although the virus is eradicated in such patients, fibrotic irreversible interstitial lung disease (pulmonary fibrosis, PF) is clinically evident. Given the vast numbers of individuals affected, it is urgent to design a strategy to prevent a second wave of late mortality associated with COVID-19 PF as a long-term consequence of such a devastating pandemic. Available antifibrotic therapies, namely nintedanib and pirfenidone, might have a role in attenuating profibrotic pathways in SARS-CoV-2 infection but are not economically sustainable by national health systems and have critical adverse effects. It is our opinion that the mesenchymal stem cell secretome could offer a new therapeutic approach in treating COVID-19 fibrotic lungs through its anti-inflammatory and antifibrotic factors.

Highlights

Fibrosis: A New Therapy to Treat the Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy; Center for Diagnosis of Inherited Alpha1-Antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumology Unit IRCCS San Matteo Hospital Foundation, University of Pavia, PharmaExceed S.r.l., 27100 Pavia, Italy
An array of drugs are being studied for COVID-19 treatment in hundreds of clinical trials worldwide, as recently reviewed [3]
The virus is eradicated in such patients, fibrotic interstitial lung disease may become clinically evident in a large percentage of patients

Summary

Introduction

An array of drugs are being studied for COVID-19 treatment in hundreds of clinical trials worldwide, as recently reviewed [3]. A substantial proportion of patients who develop ARDS will experience residual long-term impairment of lung function and computed tomography (CT) evidence of pulmonary fibrosis, with anterior reticulation the dominant abnormality in as many as 85% of survivors [6,7,8]. Only one phase III clinical trial is recruiting patients to assess the effectiveness of nintedanib for COVID-19 PF (compared to placebo) on 250 patients (NCT04541680, http://www.clinicaltrials.gov (accessed on 9 March 2021)).

Results

Conclusion