Mesenchymal stem cell therapy for acute respiratory distress syndrome: from basic to clinics
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Protein & Cell
REVIEW Mesenchymal stem cell therapy for acute respiratory distress syndrome: from basic to clinics Hua Qin1&
, Andong Zhao
1,2
Research Center for Tissue Repair and Regeneration Affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College, Beijing 100853, China 2 Tianjin Medical University, Tianjin 300070, China & Correspondence: [email protected] (H. Qin) Received March 27, 2020 Accepted May 12, 2020
ABSTRACT 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.
© The Author(s) 2020
KEYWORDS mesenchymal stem cells, cell therapy, acute respiratory distress syndrome, SARS-CoV-2, COVID19, pneumonia THE EPIDEMIOLOGY OF NOVEL CORONAVIRUS DISEASE 2019 (COVID-19) AND THE MANAGEMENT OF ARDS Since December 2019, an increasing number of patients have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes pneumonia in China (Chan et al., 2020; Chen et al., 2020a; Chinazzi et al., 2020; Ghinai et al., 2020; Guan et al., 2020; Kucharski et al., 2020; Le et al., 2020). The SARS-CoV-2 pneumonia is defined as a novel coronavirus disease 2019 (COVID-19) by World Health Organization (WHO). Human-to-human transmission has been occurring, and infections have been rapidly spreading in China and around the world (Chen et al., 2020a; Chinazzi et al., 2020; Kucharski et al., 2020). Some patients with severe pneumonia rapidly develop acute respiratory distress syndrome (ARDS) and require intensive care unit (ICU) admission (Guan et al., 2020; Holshue et al., 2020; Sun et al., 2020; Xu et al., 2020a). At this stage, patients worsen in a short peri
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