Stem cell therapy in COVID-19: Pooled evidence from SARS-CoV-2, SARS-CoV, MERS-CoV and ARDS: A systematic review - 19/03/21
, Seema Bansal b, 1 , Phulen Sarma a , Harish Kumar a , Gajendra Choudhary a , Subodh Kumar c , Ajay Prakash a , Rakesh Sehgal d , Bikash Medhi a, ⁎
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Graphical abstract |
Highlights |
• | SARS-CoV-2, SARS-CoV and MERS-CoV shows high homology with each other and the pathophysiology of disease caused by these three coronaviruses are also similar with occurence of Acute respiratory distress syndrome (ARDS) in all the three cases. Stems cells are found to be efficacious against different viral infections and Inteferon stimulating genes (ISGs) are indicated in this protection owing to its capability of reducing the inflammation, decreasing the cell death, secreting cell protective substances, anti-oxidative effects and improving the overall immune function. |
• | In in-vitro studies, stem cells showed protective action against ARDS and no in-vitro data have been documented so far for SARS-CoV-2, SARS-CoV and MERS-CoV infection. |
• | In preclinical studies protective action was seen in various models of ARDS [lipopolysaccharide, endotoxin, E. coli, Bleomycin induced acute respiratory distress syndrome], including only one study for SARS-CoV-2. But no relevant studies were found for SARS-CoV and MERS CoV. |
• | In clinical studies mesenchymal stem cells (MSCs) derived from various sources (bone marrow, umbilical cord, exosomes and even cardiosphere derived cells) showed efficacy in patients with severe COVID-19 infection and it is already under clinical trial in overall severe COVID-19 disease population. |
• | Immunomodulating properties, tissue protection and healing properties of stem cells in combination with other anti-viral agents may prove to be a potential therapeuitc strategy for treating severe COVID-19 patients. |
Abstract |
Background |
SARS-CoV-2, which majorly affects the lungs and respiratory tract is thought due to dysregulation of the immune system which causes an immense imbalance of the cytokines. However, till now no standard treatment has been developed in treating the disease. On the other hand, it becomes important to prevent the acute respiratory tract infection due to COVID-19 which is the most dangerous phase leading to increased mortality. Hence this systematic review has been framed by pooling the available data of the use of stem cells in SARS-CoV-2, SARS-CoV, MERS-CoV and ARDS.
Methods |
6 literature databases (PubMed, EMBASE, Scopus, Google Scholar, Clinicaltrials.gov, and Clinical trial registry of India) were searched for relevant studies till 10th August 2020 using keywords stem cells, mesenchymal stem cells, cell therapy, SARS CoV-2, SARS Coronavirus, Coronavirus 2, COVID-19, nCoV-19, Novel Coronavirus, MERS CoV, ARDS, acute respiratory distress syndrome.
Results |
The observations of this systematic review suggest capability of MSCs in reducing the systemic inflammation and protecting against SARS-CoV-2 as evidenced by the available clinical data.
Conclusion |
MSCs can overcome the clinical challenges currently faced by SARS-CoV-2 infected patients, specifically who are seriously ill and not responding to conventional therapies. Though the available clinical data is motivating, still predicting the therapeutic potential of MSCs will be too early in COVID-19. Hence, further studies in a larger cohort of patients becomes a prerequisite to validate their potential efficacy.
Il testo completo di questo articolo è disponibile in PDF.Keywords : SARS-CoV-2, Stem cell therapy, ARDS, Immunomodulatory, Coronavirus
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Vol 137
Articolo 111300- Maggio 2021 Ritorno al numero
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