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September 1, 2021

A summary of COVID-19 Mesenchymal stem cell therapy to date

Dr. Lana du Plessis

The COVID-19 pandemic is affecting everyone, some more than others. For many families, it means making changes to daily routines because of financial hardships. For others, it means raised anxiety in children and tension in parenting relationships. It can be difficult to cope with the “new normal”, since everything we are used to has changed, and there seems to be no end in sight to the pandemic.

A wide variety of medications are currently under investigation for the treatment of COVID-19. These medications include anti-viral, anti-malarial, and anti-inflammatory medications.

Almost all of these medications improve the recovery process and the life expectancy of patients but do not lead to definite repair of the lung damage caused by this disease. One of the most promising therapies to date is stem cell therapy, which could reduce inflammation but also restore the lung damage caused by COVID-19.

Mesenchymal stem cells (MSCs) are the stem cells that might be the most encouraging treatment for SARS-CoV-2 infections. The main factor in treating SARS-CoV-2 infection lies in the management of the cytokine storm in the lungs, therefore MSCs are suitable for this since their main mode of action is through their immunomodulatory, anti-inflammatory properties, as well as their ability to restore and remodel the lungs.

Since the start of the pandemic, more than 17 clinical trials evaluating the benefits of MSCs for the treatment of COVID-19 are underway. In previous years before the pandemic, the safety and efficacy of MSCs have been well established based on the completion of other clinical trials in lung diseases such as acute respiratory distress syndrome (ARDS) (Chen J, et al. 2020), bronchopulmonary dysplasia (Namba 2020), cardiovascular diseases (Kim et al. 2015), diabetes (Thakkar et al. 20150, and spinal cord injury (Xu and yang, 2019).

MSCs have been investigated as early as 2013 and 2015 for the treatment of ARDS and have shown the capacity to stimulate repair in the distal ends of the lungs.

In a comprehensive study of the clinical trials using MSCs for the treatment of ARDS, 2691 studies were reviewed. The MSCs were from various sources but were all allogeneic from either bone marrow, umbilical cord, menstrual blood, adipose tissue, or unreported sources. Overall, the patients showed better survival, no severe side effects. The patients also showed improved lung scans, lung functionality, and improved inflammatory marker levels.

All these studies concluded that ARDS patients showed low risk, reduced risk of death, and improvement in lung functionality using MSC treatment. The MSC treatment also eased the clinical symptoms leading to ARDS.

It is therefore believed that evidence suggests a favourable benefit of using MSC therapy for COVID‐19 patients. However, it is suggested that larger clinical trials that follow the same protocol should be used to standardise the treatment of ARDS.

    References

    • Mahendiratta S, et al., Stem cell therapy in COVID-19: Pooled evidence from SARS-CoV-2, SARS-CoV, MERS-CoV, and ARDS: A systematic review. Biomed Pharmacother. 2021 May; 137: 111300.

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