Mesenchymal stem cells and exosome therapy for COVID-19: current status and future perspective
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REVIEW ARTICLE
Mesenchymal stem cells and exosome therapy for COVID‑19: current status and future perspective Ashim Gupta1,2,3,4 · Shivaji Kashte5 · Manu Gupta1 · Hugo C. Rodriguez1,3,6 · Shraddha Singh Gautam7 · Sachin Kadam5,7 Received: 20 July 2020 / Accepted: 28 July 2020 © Japan Human Cell Society 2020
Abstract Acute respiratory distress syndrome (ARDS) is the main cause for the COVID-19 infection-related morbidity and mortality. Recent clinical evidences suggest increased level of cytokines and chemokines targeting lung tissue as a prominent etiological factor. The immunomodulatory effect of mesenchymal stem cells (MSCs) as the alternative therapy for the treatment of inflammatory and autoimmune diseases is well known. Several studies have also revealed that similar therapeutic impacts of parent MSCs are also exhibited by MSCs-derived extracellular vesicles (EVs) including exosomes. In this review, we explored the therapeutic potential of both MSCs and exosomes in mitigating the COVID-19 induced cytokine storm as well as promoting the regeneration of alveolar tissue, attributed to the intrinsic cytokines and growth factor present in the secretome. The preliminary studies have demonstrated the safety and efficacy of MSCs and exosomes in mitigating symptoms associated with COVID-19. Thus, they can be used on compassionate basis, owing to their ability to endogenously repair and decrease the inflammatory reactions involved in the morbidity and mortality of COVID-19. However, more preclinical and clinical studies are warranted to understand their mechanism of action and further establish their safety and efficacy. Keywords Mesenchymal stem cells · Exosomes · COVID-19 · Cytokine storm · Acute respiratory distress syndrome
Introduction The novel corona virus disease (COVID-19) has grown to be a global public-health emergency since the first case was detected in Wuhan, China, in December 2019. The novel corona virus or SARS-CoV-2 as named by the International Committee on Taxonomy of Viruses has over 14 million * Sachin Kadam [email protected]
confirmed cases worldwide and has claimed over 600,000 lives [1]. After 6 months from the first COVID19 diagnosis, we neither have an effective antiviral medication nor a vaccine available to deal with this emergency. Once infected, a patient mainly relies on their immunity to resist SARSCoV-2, with supportive treatment given if complications occur [2]. It has been confirmed that the first step in the 2
BioIntegrate, Lawrenceville, GA, USA
3
South Texas Orthopaedic Research Institute, Laredo, TX, USA
4
Veterans in Pain, Los Angeles, CA, USA
5
Department of Stem Cell and Regenerative Medicine, Centre for Interdisciplinary Research, D. Y. Patil Education Society (Institution Deemed To Be University), Kolhapur 416006, India
Hugo C. Rodriguez [email protected]
6
School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX, USA
Shraddha Singh Gautam [email protected]
7
Advancells Group, Noida, A‑102, S
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