Abstract
Nearly 500’000 fatalities due to COVID-19 have been reported globally and the death toll is still rising. Most deaths are due to acute respiratory distress syndrome (ARDS), as a result of an excessive immune response and a cytokine storm elicited by severe SARS-CoV-2 lung infection, rather than by a direct cytopathic effect of the virus. In the most severe forms of the disease therapies should aim primarily at dampening the uncontrolled inflammatory/immune response responsible for most fatalities. Pharmacological agents - antiviral and anti-inflammatory molecules - have not been able so far to achieve compelling results for the control of severe COVID-19 pneumonia. Cells derived from the placenta and/or fetal membranes, in particular amniotic epithelial cells (AEC) and decidual stromal cells (DSC), have established, well-characterized, potent anti-inflammatory and immune-modulatory properties that make them attractive candidates for a cell-based therapy of COVID19 pneumonia. Placenta-derived cells are easy to procure from a perennial source and pose minimal ethical issues for their utilization. In view of the existing clinical evidence for the innocuousness and efficiency of systemic administration of DSCs or AECs in similar conditions, we advocate for the initiation of clinical trials using this strategy in the treatment of severe COVID-19 disease.
Highlights
Since December 2019, when it was first tracked in China, the novel human coronavirus SARS-CoV-2, the agent of COVID-19 disease, has quickly spread to pandemic proportions, with rapid person-to-person transmission, and has become a global health emergency
We briefly present the pathogenesis of severe COVID-19 disease, argue that it should be treated primarily with an anti-inflammatory strategy, and propose that this can be achieved by cell therapy using placenta-derived cells known for their anti-inflammatory and immunomodulatory properties, as previously successfully attempted in similar diseases
There are currently more than 30 registered clinical trials planning to use stem cell-based therapy for COVID-19 pneumonia and Acute Respiratory Distress Syndrome (ARDS) [15]: umbilical cord blood, Wharton’s jelly, menstrual blood, dental pulp, and bone marrow and adipose tissue derived stromal cells are all in the pipeline for clinical evaluation
Summary
Since December 2019, when it was first tracked in China, the novel human coronavirus SARS-CoV-2, the agent of COVID-19 disease, has quickly spread to pandemic proportions, with rapid person-to-person transmission, and has become a global health emergency. Mesenchymal stromal cells (MSC) have been used for decades from basic research to clinical trials, more for their anti-inflammatory and immunomodulatory properties, than for stemness characteristics [16,17,18].
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