Stem cell therapy for Covid-19
Dr. Hesham Farouk
Aster Discovery Gardens and Arabian Ranches
Clinical Trials.U.S.A gov. currently lists more than 50 investigations of the use of stem cells for patients with COVID-19. All are variations on the mesenchymal theme, derived from bone marrow, Wharton jelly, fat, dental pulp, placenta, and surrounding blood vessels. At least 10 companies are exploring stem cell–based treatments.
Stem cell treatments for COVID-19 began to appear in March and April under the US Food and Drug Administration’s (FDA’s) expanded access designation during the crisis that began in New York City and that is now spreading around the country.
Rationale for Use in COVID-19
MSCs are multipotent adult stem cells that are present in most human tissues, including the umbilical cord. MSCs can self-renew by dividing and can differentiate into multiple types of tissues, including osteoblasts, chondroblasts, adipocytes, hepatocytes, and others, which has led to a robust clinical research agenda in regenerative medicine. It is hypothesized that MSCs could reduce the acute lung injury and inhibit the cell-mediated inflammatory response induced by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Furthermore, MSCs lack the angiotensin-converting enzyme 2 receptor that SARS-COV-2 uses for viral entry into cells; therefore, MSCs are resistant to infection.
Data supporting the use of MSCs in patients with viral infections, including COVID-19, are limited to case reports and small, open-label studies.
Clinical Data for COVID-19
- A pilot study of intravenous MSC transplantation in China enrolled 10 patients with confirmed COVID-19 categorized according to the National Health Commission of China criteria as critical, severe, or common type. Seven patients (one with critical illness, four with severe illness, and two with common-type illness) received MSCs; three patients with severe illness received placebo. All seven patients who received MSCs recovered. Among the three severely ill control patients, one died, one developed acute respiratory distress syndrome (ARDS), and one remained stable with severe disease.
How does COVID-19 affect the immune system?
COVID-19 causes a cytokine storm in the body, that is, virus-activated immune cells secrete an excess of cellular hormones (cytokines) that have damaging effects on their own tissues, promote swelling, fibrosis (growth of connective tissue) and functional insufficiency.
How do mesenchymal stem cells help with COVID-19?
Mesenchymal stem cells are a powerful immunomodulatory and anti-inflammatory agent, they normalize the function of the immune system, altered by COVID-19. The anti-inflammatory effect of mesenchymal stem cells has been known for a long time, that is why they have been successfully used for over 10 years in the treatment of autoimmune diseases (rheumatoid arthritis, ulcerative colitis, multiple sclerosis) and for the inhibition of transplanted organs rejection.
Mesenchymal stem cells in COVID-19
- Increase the number of lymphocytes and regulatory dendritic cells, that is, increase their own antiviral protection.
- Reduce the level of C-reactive protein, which is a major marker of inflammation.
- Reduce the level of such a powerful pro-inflammatory protein as TNF-a.
- Increase the level of anti-inflammatory protein IL-10.
According to the Kyoto Encyclopedia of Genes and Genome, mesenchymal stem cells directly take part in antiviral protection.
Positive effect of mesenchymal stem cells is observed even in old age.
COVID-19 treatment developed by UAE stem cell center:
A patent has been granted by the Ministry of Economy for the development of an innovative and promising treatment for COVID-19 infections using stem cells. The treatment was developed by a team of doctors and researchers at the Abu Dhabi Stem Cell Center, ADSCC, and involves extracting stem cells from the patient’s own blood and reintroducing them after activating them.
The patent was granted for the innovative method in which the stem cells are collected.
The treatment was administered in the UAE to 73 COVID-19 patients who have all been successfully treated and cured of the virus by inhaling the treatment into their lungs after it has been nebulized into a fine mist. It is hypothesized to have its therapeutic effect by regenerating lung cells and modulating the immune response to keep it from overreacting to the COVID-19 infection and causing further damage to healthy cells.
The treatment has successfully undergone the initial phase of clinical trials, demonstrating its safety. None of the patients who have received the treatment reported immediate adverse effects and there have been no interactions found with the conventional treatment protocols for COVID-19 patients. Trials to demonstrate the efficacy of the treatment are ongoing and are expected to be completed in a couple of weeks.
It is worth noting that the treatment has been given to patients along with the conventional medical intervention and will continue to be applied as an adjunct to established treatment protocols rather than as a replacement.