Mesenchymal stem cell therapy for acute respiratory distress syndrome: from basic to clinics

• Published in: Protein & cell Vol. 11; no. 10; pp. 707 - 722
• Main Authors: Qin, Hua, Zhao, Andong
• Format: Journal Article
• Language: English
• Published: Beijing Higher Education Press 01.10.2020; Oxford University Press
• Subjects: acute respiratory distress syndrome; Adoptive Transfer; Alveolar Epithelial Cells - pathology; Animals; Apoptosis; Betacoronavirus; Biochemistry; Biomedical and Life Sciences; Body Fluids - metabolism; CD4-Positive T-Lymphocytes - immunology; Cell Biology; cell therapy; Clinical Trials as Topic; Coinfection - prevention & control; Coinfection - therapy; Coronavirus Infections - complications; Coronavirus Infections - immunology; COVID-19; Developmental Biology; Disease Models, Animal; Endothelial Cells - pathology; Extracorporeal Membrane Oxygenation; Genetic Therapy - methods; Genetic Vectors - administration & dosage; Genetic Vectors - therapeutic use; Human Genetics; Humans; Immunity, Innate; Inflammation Mediators - metabolism; Life Sciences; Lung - pathology; Lung - physiopathology; Mesenchymal Stem Cell Transplantation - methods; mesenchymal stem cells; Mesenchymal Stem Cells - physiology; Multiple Organ Failure - etiology; Multiple Organ Failure - prevention & control; Pandemics; pneumonia; Pneumonia, Viral - complications; Pneumonia, Viral - immunology; Protein Science; Respiratory Distress Syndrome - immunology; Respiratory Distress Syndrome - pathology; Respiratory Distress Syndrome - therapy; Review; SARS-CoV-2; Stem Cells; Translational Research, Biomedical; COVID-19; acute respiratory distress syndrome; SARS-CoV-2; pneumonia; mesenchymal stem cells; cell therapy
• ISSN: 1674-800X; 1674-8018
• DOI: 10.1007/s13238-020-00738-2

The 2019 novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has occurred in China and around the world. SARS-CoV-2-infected patients with severe pneumonia rapidly develop acute respiratory distress syndrome (ARDS) and die of multiple organ failure. Despite advances in supportive care approaches, ARDS is still associated with high mortality and morbidity. Mesenchymal stem cell (MSC)-based therapy may be an potential alternative strategy for treating ARDS by targeting the various pathophysiological events of ARDS. By releasing a variety of paracrine factors and extracellular vesicles, MSC can exert anti-inflammatory, antiapoptotic, anti-microbial, and pro-angiogenic effects, promote bacterial and alveolar fluid clearance, disrupt the pulmonary endothelial and epithelial cell damage, eventually avoiding the lung and distal organ injuries to rescue patients with ARDS. An increasing number of experimental animal studies and early clinical studies verify the safety and efficacy of MSC therapy in ARDS. Since low cell engraftment and survival in lung limit MSC therapeutic potentials, several strategies have been developed to enhance their engraftment in the lung and their intrinsic, therapeutic properties. Here, we provide a comprehensive review of the mechanisms and optimization of MSC therapy in ARDS and highlighted the potentials and possible barriers of MSC therapy for COVID-19 patients with ARDS.