The rationale of using mesenchymal stem cells in patients with COVID-19-related acute respiratory distress syndrome: What to expect.,STEM CELLS Translational Medicine

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The rationale of using mesenchymal stem cells in patients with COVID-19-related acute respiratory distress syndrome: What to expect.
STEM CELLS Translational Medicine ( IF 5.4 ) Pub Date : 2020-07-21 , DOI: 10.1002/sctm.20-0164
Alp Can ₁ , Hakan Coskun _{2,

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Affiliation

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐caused coronavirus disease 2019 (COVID‐19) pandemic has become a global health crisis with an extremely rapid progress resulting in thousands of patients who may develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) treatment. So far, no specific antiviral therapeutic agent has been demonstrated to be effective for COVID‐19; therefore, the clinical management is largely supportive and depends on the patients' immune response leading to a cytokine storm followed by lung edema, dysfunction of air exchange, and ARDS, which could lead to multiorgan failure and death. Given that human mesenchymal stem cells (MSCs) from various tissue sources have revealed successful clinical outcomes in many immunocompromised disorders by inhibiting the overactivation of the immune system and promoting endogenous repair by improving the microenvironment, there is a growing demand for MSC infusions in patients with COVID‐19‐related ARDS in the ICU. In this review, we have documented the rationale and possible outcomes of compassionate use of MSCs, particularly in patients with SARS‐CoV‐2 infections, toward proving or disproving the efficacy of this approach in the near future. Many centers have registered and approved, and some already started, single‐case or phase I/II trials primarily aiming to rescue their critical patients when no other therapeutic approach responds. On the other hand, it is also very important to mention that there is a good deal of concern about clinics offering unproven stem cell treatments for COVID‐19. The reviewers and oversight bodies will be looking for a balanced but critical appraisal of current trials.

中文翻译：

在与COVID-19相关的急性呼吸窘迫综合征患者中使用间充质干细胞的基本原理：期望值。

严重的急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的冠状病毒病2019（COVID-19）大流行已成为全球性健康危机，进展极为迅速，导致成千上万的患者可能发展为急性呼吸窘迫综合征（ARDS））需要重症监护病房（ICU）的治疗。到目前为止，还没有任何特定的抗病毒治疗剂对COVID-19有效。因此，临床管理在很大程度上是支持性的，取决于患者的免疫反应导致细胞因子风暴，随后是肺水肿，空气交换功能障碍和ARDS，这可能导致多器官衰竭和死亡。鉴于来自各种组织来源的人间充质干细胞（MSC）已通过抑制免疫系统的过度活化并通过改善微环境促进内源性修复而在许多免疫功能低下的疾病中显示出成功的临床结果，因此对患有以下疾病的患者进行MSC输注的需求不断增长ICU中与COVID-19相关的ARDS。在这篇综述中，我们记录了在不远的将来证明或同情使用这种方法的有效性的理论基础和可能的结果，尤其是在SARS-CoV-2感染患者中。许多中心已经注册并批准了，有些已经开始的单例或I / II期试验，其主要目的是在其他治疗方法没有反应时挽救其危重病人。另一方面，值得一提的是，诊所对COVID-19提供未经证实的干细胞治疗也引起了很多关注。审稿人和监督机构将寻求对当前试验进行平衡但严格的评估。

更新日期：2020-07-21

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