The Potential Use of Mesenchymal Stem Cells and Their Derived Exosomes as Immunomodulatory Agents for COVID-19 Patients.

Faisal A Alzahrani,Abdulmajeed F Alrefaei,Abdulrahim Sajini,Islam M Saadeldin,Arif Jamal Siddiqui,Bassem Kurdi,Dipak Kumar,Esam I Azhar,Sadaf Jahan,Abrar Ahmad

doi:10.1155/2020/8835986

Abstract

A novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) causing lethal acute respiratory disease emerged in December 2019. The World Health Organization named this disease “COVID-19” and declared it a pandemic on March 11, 2020. Many studies have shown that mesenchymal stem cells (MSCs) and their exosomes (MSCs-Exo), which are isolated from allogenic bone marrow stem cells, significantly lower the risk of alveolar inflammation and other pathological conditions associated with distinct lung injuries. For example, in acute respiratory distress syndrome (ARDS) and pneumonia patients, MSCs-Exo and MSCs provide similar healing properties and some clinical trials have used cell-based inhalation therapy which show great promise. MSCs and MSCs-Exo have shown potential in clinical trials as a therapeutic tool for severely affected COVID-19 patients when compared to other cell-based therapies, which may face challenges like the cells' sticking to the respiratory tract epithelia during administration. However, the use of MSCs or MSCs-Exo for treating COVID-19 should strictly adhere to the appropriate manufacturing practices, quality control measurements, preclinical safety and efficacy data, and the proper ethical regulations. This review highlights the available clinical trials that support the therapeutic potential of MSCs or MSCs-Exo in severely affected COVID-19 patients.

Highlights

A lethal acute respiratory tract disease caused by a novel severe acute respiratory syndrome (SARS) coronavirus emerged at the end of 2019 in Wuhan, China [1,2,3]
The World Health Organization (WHO) identified the virus as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and recommended that the disease resulting in the current outbreak should be explained as “2019-nCoV acute respiratory disease” (2019 novel coronavirus acute respiratory disease)
This review focuses on approaches to improve patients’ immunological response against SARS-CoV-2 infection using mesenchymal stem cells (MSCs) and/or MSCs-Exo therapy

Summary

Introduction

A lethal acute respiratory tract disease caused by a novel severe acute respiratory syndrome (SARS) coronavirus emerged at the end of 2019 in Wuhan, China [1,2,3]. The WHO identified the virus as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and recommended that the disease resulting in the current outbreak should be explained as “2019-nCoV acute respiratory disease” (2019 novel coronavirus acute respiratory disease). Rapid replication of SARS-CoV-2 is believed to occur after the onset of infection and severe inflammatory responses due to cytokine storms have been observed. This subsequent inflammatory response damages alveolar epithelia and capillary endothelial cells, resulting in interstitial and alveolar edema and impaired pulmonary functions. Previous studies have shown that stem cell therapy is a promising treatment for numerous diseases and conditions, such as neurodegeneration, diabetes, and cancer. This review focuses on approaches to improve patients’ immunological response against SARS-CoV-2 infection using MSCs and/or MSCs-Exo therapy

Covid-19 Diagnosis and Pathogenesis

Recent Studies and Clinical Trials Using Stem

Findings

Summary and Conclusions