Journal Article

Mesenchymal stem cells as a potential treatment for critically ill patients with coronavirus disease 2019

Liu, Wenjia, Li, Liya, Jin, Yan, Ji, Fanpu, Li, Zongfang

2020

Overview

Similar to two other lethal coronaviruses, SARS‐CoV and MERS‐CoV, SARS‐CoV‐2 induces excessive and aberrant host immune responses that are always accompanied by cytokine storms (CS) and subsequent ALI or even ARDS, resulting in multiple organ failure and death. 2 Even in patients who were treated in intensive care units for CS, persistent inflammation led to serious sequelae of lung fibrosis, causing lung dysfunction and reduced quality of life. 3 Although corticosteroid given to reverse catabolism in critical illness decreased the mortality after SARS and MERS infection, the clinical application of corticosteroid has been restricted in COVID‐19, considering its delay in virus clearance and complications in survivors. To alleviate acute respiratory disease and reverse pulmonary fibrosis in intensive‐care SARS‐CoV‐2‐infected patients, three curative properties of MSCs have emerged (Figure 1): (a) directly inducing the apoptosis of activated T cells to relieve the aberrant and excessive immune responses, (b) homing toward specific injuries of lung to maintain homeostasis as well as promote regeneration, and (c) releasing cytokines to diminish inflammation and extracellular vesicles (EVs) to stimulate tissue reparation. 1 Notably, it has been proved that MSC‐released cytokines can potently inhibit neutrophil intravasation and enhance the differentiation of macrophages. 5,6 Moreover, these MSC‐released EVs can deliver microRNA, mRNA, DNA, proteins, and metabolites into host cells in specific injuries of the lung to promote lung repair as well as regeneration and restore lung function. 1 1 FIGURE. Potential mechanism of MSCs in the treatment of severe COVID‐19 As the continuing epidemic threat of SARS‐CoV‐2 to global health and the fast‐growing number of fatalities, advancing new therapeutic development becomes central or primary to minimize the death and sequelae from SARS‐CoV‐2 infection. [...]MSCs should be considered as a potential treatment for these critical patients.

• Publisher: John Wiley & Sons, Inc,Oxford University Press
• Subject: Apoptosis / Betacoronavirus / Clinical trials / Complications / Conflicts of interest / Coronavirus / Coronavirus Infections / Coronaviruses / Corticosteroids / COVID-19 / Critical Illness / Cytokine storm / Cytokines / Epidemics / Extracellular Vesicles / Fatalities / Fibrosis / Health aspects / Homeostasis / Humans / Immune clearance / Inflammation / Injuries / Intensive care units / Letters to the Editor / Lung diseases / Lymphocytes T / Macrophages / Mesenchymal Stem Cells / Metabolites / miRNA / mRNA / Pandemics / Patients / Pneumonia, Viral / Quality of life / Recovery of function / Respiratory diseases / Respiratory Distress Syndrome / Respiratory function / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Stem cells / Therapeutic applications