The results look promising
First studies testing the effect of mesenchymal stem cells in the treatment of COVID-19 have been published.
In this contex, Dr. Leng and colleagues found that a single injection had an effect on 7 patients with COVID-19 (1 critically severe, 4 severe and 2 normal). At the same time, a team of experts under Bing Liang’s leadership released the details of a case involving a critically ill 65-year-old Chinese woman infected with the same disease. The woman’s condition improved significantly after 3 infusions with umbilical cord stem cells (1,2).
Currently, 21 active studies with mesenchymal stem cells are underway to treat COVID-19.
To date, ongoing and completed studies have been small and with the primary purpose of investigating the safety of stem cell therapy. No undesirable effects have been seen in the administration of cells. The largest study, conducted in the United States, with 60 patients with moderate to severe respiratory problems that COVID-19 can cause, shows signs of improved oxygenation and endothelial barrier (3,4).
Our understanding of the pathology of respiratory problems due to COVID-19 is increasing on a daily basis.
It is important to note that the immunological profile of patients changes during the two stages of the disease. In incubation and non-severe stages, a specific flexible immune response is needed to eliminate the virus and prevent the disease from progressing to a more severe stage. Therefore, strategies to boost the immune system at this stage are quite important.
When the protective effect of the immune system is impaired, viruses will spread and destruction of affected tissues will occur, especially in organs such as kidneys and intestines. The damaged cells first induce pneumonia, which is largely mediated by pro-inflammatory macrophages and granulocytes.
Pneumonia is the main cause of life-threatening respiratory problems in the severe stage. When severe lung injury occurs, you should try to suppress inflammation and relieve the symptoms.
The use of mesenchymal stem cells has shown that their inherent anti-inflammatory effect could have therapeutic value in the treatment of lung tissue damage. Although we do not fully understand the mechanisms, it has been suggested that the release of anti-inflammatory factors through cell-to-cell contact with damaged alveolar epithelial cells may play a role in the clinical response seen. (5,6,7).
- Zikuan Leng RZ Wei Hou, Yingmei Feng, Yanlei Yang, Qin Han, Guangliang Shan, Fanyan Meng, Dongshu Du, Shihua Wang, Junfen Fan, Wenjing Wang, Luchan Deng, Hongbo Shi, Hongjun Li, Zhongjie Hu, Fengchun Zhang, Jinming Gao, Hongjian Liu, Xiaoxia Li, Yangyang Zhao, Kan Yin, Xijing He, Zhengchao Gao, Yibin Wang, Bo Yang, Ronghua Jin, Ilia Stambler, Lee Wei Lim, Huanxing Su, Alexey Moskalev, Antonio Cano, Sasanka Chakrabarti, Kyung-Jin Min, Georgina Ellison-Hughes, Calogero Caruso, Kunlin Jin, Robert Chunhua Zhao. Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia. Aging Dis. 9 mars 2020;11(2):216‑28.
- Liang B, Chen J, Li T, Wu H, Yang W, Li Y, et al. Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells [Internet]. Disponible sur: http://simplymimi.net/archives/1677
- According to Clinicaltrials.gov; search term COVID-19 and mesenchymal; search performed on 24th of April 2020
- Matthay MA, Calfee CS, Zhuo H, Thompson BT, Wilson JG, Levitt JE, et al. Treatment with allogeneic mesenchymal stromal cells for moderate to severe acute respiratory distress syndrome (START study): a randomised phase 2a safety trial. Lancet Respir Med. 2018/11/16. févr 2019;7(2):154‑62. Wilson JG, Liu KD, Zhuo H, Caballero L, McMillan M, Fang X, et al. Mesenchymal stem (stromal) cells for treatment of ARDS: a phase 1 clinical trial. Lancet Respir Med. 2014/12/17. janv 2015;3(1):24‑32. Zheng G, Huang L, Tong H, Shu Q, Hu Y, Ge M, et al. Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study. Respir Res. 4 avr 2014;15(1):39‑39.
- Simonson OE, Mougiakakos D, Heldring N, Bassi G, Johansson HJ, Dalén M, et al. In Vivo Effects of Mesenchymal Stromal Cells in Two Patients With Severe Acute Respiratory Distress Syndrome. Stem Cells Transl Med. 2015/08/18. oct 2015;4(10):1199‑213.
- Shi, Y., Wang, Y., Shao, C. et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ 27, 1451–1454 (2020). https://doi.org/10.1038/s41418-020-0530-3
- Lopes-Pacheco M, Robba C, Rocco PRM, Pelosi P. Current understanding of the therapeutic benefits of mesenchymal stem cells in acute respiratory distress syndrome. Cell Biol Toxicol. 1 févr 2020;36(1):83‑102.