The devastating global impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has prompted scientists to develop novel strategies to fight Coronavirus Disease of 2019 (COVID-19), including the examination of pre-existing treatments for other viral infections in COVID-19 patients. This review provides a reasoned discussion of the possible use of Mesenchymal Stromal Cells (MSC) or their products as a treatment in SARS-CoV-2-infected patients. The main benefits and concerns of using this cellular therapy, guided by preclinical and clinical data obtained from similar pathologies will be reviewed. MSC represent a highly immunomodulatory cell population and their use may be safe according to clinical studies developed in other pathologies. Notably, four clinical trials and four case reports that have already been performed in COVID-19 patients obtained promising results. The clinical application of MSC in COVID-19 is very preliminary and further investigational studies are required to determine the efficacy of the MSC therapy. Nevertheless, these preliminary studies were important to understand the therapeutic potential of MSC in COVID-19. Based on these encouraging results, the United States Food and Drug Administration (FDA) authorized the compassionate use of MSC, but only in patients with Acute Respiratory Distress Syndrome (ARDS) and a poor prognosis. In fact, patients with severe SARS-CoV-2 can present infection and tissue damage in different organs, such as lung, heart, liver, kidney, gut and brain, affecting their function. MSC may have pleiotropic activities in COVID-19, with the capacity to fight inflammation and repair lesions in several organs.
【저자키워드】 COVID-19, SARS-CoV-2, Cytokine storm, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, ACE2, angiotensin converting enzyme 2, FDA, US Food and Drug Administration, ARDS, acute respiratory distress syndrome, IL, interleukin, SARS, Severe acute respiratory syndrome, cytokines/chemokines, mesenchymal stromal/stem cells, MERS, Middle East respiratory syndrome, CNS, Central Nervous System, GI, gastrointestinal, NK, natural killer, COVID-19, Coronavirus disease of 2019, JEV, Japanese encephalitis virus, IBD, Inflammatory bowel disease, TMPRSS2, Transmembrane Protease Serine 2, DCs, dendritic cells, Th, T helper, MCP-1, monocyte chemoattractant protein 1, ALI, Acute Lung Injury, IV, Intravenous, LPS, lipopolysaccharide, GMCSF, Granulocyte-macrophage colony-stimulating factor, MSC, mesenchymal stromal cells, TNF-a, tumor necrosis factor alpha, IFN-y, interferon y, FGF7, fibroblast growth factor 7, IDO, indoleamine 2,3 dioxygenase, BM-MSC, bone marrow mesenchymal stromal cells, MB-MSC, menstrual blood mesenchymal stromal cells, EVs, extracelular vesicules, LVEF, left ventricle ejection fraction, Treg, T regulatory, CD, Crohn’s disease, CM, conditioned-medium, VEGF, vascular endotelhial growth factor, BBB, blood-brain-barrier, Pleiotropic therapy,