Msc therapy, a new attitude in covid-19 treatment

Msc therapy, a new attitude in covid-19 treatment
Ali salimi asl,¹ seyyed mohammad hashemi,² Fatemeh karami ,³ Fateme Shojaeian,⁴ Shaghayegh KermaniNezhad,^5,*
1. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3. Student Research committee , Faculty of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4. Student Research committee , Faculty of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Introduction: In 1991, Arnold L. Kaplan named mesenchymal cells which are produced during embryonic development as mesenchymal stem cells (MSCs). These cells, which originate from the bone marrow, fat, umbilical cord, placenta, etc., are feed from many sources. They are multipotent and can differentiate into a variety of cell types. MSC therapy has been used effectively to treat acute respiratory distress syndrome (ARDS) caused by the H7N9 influenza. Given the similarity of H7N9-induced ARDS to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-induced ARDS, it is the most promising treatment option.
Methods: Article selection were conducted through advanced search in science direct, Pubmed database and without time limit, using two keywords derived from MeSH (Covid-19 and Cell therapy) and limiting the search to keywords in the abstract. From the 68 available articles (25 original articles and 43 existing non-original articles), based on the content of the abstracts, 10 original articles and 26 non-original articles related to MSC therapy were selected. The articles were studied and key points of each were identified.
Results: MSCs do not have Angiotensin-Converting Enzyme 2 (ACE2) receptors, which makes them safe against Corona Virus disease 2019 )Covid-19(. Because the key to treating Covid-19 infection lies in the management of the cytokine storm in the lungs, they secrete leukemia inhibitory factor (LIF), which is a factor in fighting the Covid-19 cytokine storm. Due to their main mechanism, MSCs work well through their immunomodulatory and anti-inflammatory properties. MSCs isolated from most tissues typically express CD105, CD73, and CD90 and lack the expression of bleeding markers such as CD45, CD34, CD14 or CD11b, CD79a or CD19, and HLA-DR. Their interventions include improving lung function and pulmonary fibrosis, rearranging the functions of immune cell subsets, regulating inflammatory cytokines, inhibiting the abnormal activation of T lymphocytes and macrophages, and differentiating into T-regulatory subsets (Treg) and anti-inflammatory macrophages. Their low immunity due to the lack of HLA-Class II antigen makes them an ideal candidate for allogeneic transplantation. Another advantage is that they have a high reproduction rate. They are easier to manipulate and store and cost less than monoclonal antibody therapy. The cells are safe and intravenous injection is less likely to cause embolism. However, aspects of MSCs production that can affect cell function, such as place of production, donor age, cell source (umbilical cord, bone marrow, adipose tissue, etc.) and in-vitro expansion rate, may be sources of heterogeneity. Extensive research over the past decade has shown that MSCs exert most of their function through soluble mediators and extracellular vesicles (EVs). EVs have several advantages over cell therapy, including lower risk of tumorigenic effects, lower susceptibility to damage with hostile disease microenvironment, and the possibility of long-term storage. MSC-derived exosomes (MSCs-Ex) are also key therapeutic effects of these cells, which regenerate tissue and can be a viable alternative to cell therapy. MSCs-Exs can secrete a wide range of cellular proteins that support immune responses and neutralization of antibody titers. These exosomes are considered important because of their multifaceted role, from therapies to drug delivery and diagnosis. However, despite these benefits, only a handful of clinical trials are available to use these nano cells. One of the most important challenges that needs to be addressed is maintaining their stability and performance over a period of time.
Conclusion: In some stages of Covid-19, where cytokine storm is responsible for pathogenicity and inflammation, MSCs are more effective and less harmful candidates than other treatments and can be used as an effective treatment strategy to combat inflammation and destruction of lung tissue. However, more randomized clinical trials are needed for widespread use.
Keywords: COVID-19, Cytokine storm, Mesenchymal stem cells