Mesenchymal stem cells derived from perinatal tissues for treatment of critically ill COVID-19-induced ARDS patients: a case series

Autor: Ladan Kashani, Mina Soufizomorrod, Rasoul Aliannejad, Ensiyeh Hajizadeh-Saffar, Seyed-Mohammad Reza Hashemian, Aliasghar Karimi, Hamidreza Jamaati, Hamed Hossieni, Nasser Aghdami, Negin Hossieni Rouzbahani, Hoda Madani, Massoud Vosough, Seyedeh-Esmat Hosseini, Hediyeh Alemi, Neda Pak, Mohammad Vasei, Masoud Soleimani, Hossein Baharvand, Morteza Zarrabi, Masoumeh Nouri, Zeinab Naderpour, Elham Shajareh, Majid Sorouri, Naghmeh Khavandgar, Saeid Heidari Keshel
Rok vydání: 2021
Předmět:
Male
ARDS
Placenta
Mesenchymal stromal cells
Medicine (miscellaneous)
Comorbidity
Umbilical cord
Cell therapy
Umbilical Cord
Pregnancy
lcsh:QD415-436
Leukocytosis
Hypoxia
Lung
lcsh:R5-920
Respiratory Distress Syndrome
Acute respiratory distress syndrome
Respiratory distress
Middle Aged
Intensive Care Units
Treatment Outcome
medicine.anatomical_structure
Tolerability
Molecular Medicine
Female
Patient Safety
medicine.symptom
lcsh:Medicine (General)
Adult
medicine.medical_specialty
Critical Care
Critical Illness
Mesenchymal Stem Cell Transplantation
Biochemistry
Genetics and Molecular Biology (miscellaneous)
lcsh:Biochemistry
Sepsis
Internal medicine
Intensive care
medicine
Humans
Transplantation
Homologous
Aged
Inflammation
SARS-CoV-2
business.industry
Research
COVID-19
Mesenchymal Stem Cells
Pneumonia
Cell Biology
medicine.disease
Respiration
Artificial
Tomography
X-Ray Computed
Complication
business
Biomarkers
Zdroj: Stem Cell Research & Therapy
Stem Cell Research & Therapy, Vol 12, Iss 1, Pp 1-12 (2021)
ISSN: 1757-6512
Popis: Background Acute respiratory distress syndrome (ARDS) is a fatal complication of coronavirus disease 2019 (COVID-19). There are a few reports of allogeneic human mesenchymal stem cells (MSCs) as a potential treatment for ARDS. In this phase 1 clinical trial, we present the safety, feasibility, and tolerability of the multiple infusions of high dose MSCs, which originated from the placenta and umbilical cord, in critically ill COVID-19-induced ARDS patients. Methods A total of 11 patients diagnosed with COVID-19-induced ARDS who were admitted to the intensive care units (ICUs) of two hospitals enrolled in this study. The patients were critically ill with severe hypoxemia and required mechanical ventilation. The patients received three intravenous infusions (200 × 106 cells) every other day for a total of 600 × 106 human umbilical cord MSCs (UC-MSCs; 6 cases) or placental MSCs (PL-MSCs; 5 cases). Findings There were eight men and three women who were 42 to 66 years of age. Of these, six (55%) patients had comorbidities of diabetes, hypertension, chronic lymphocytic leukemia (CLL), and cardiomyopathy (CMP). There were no serious adverse events reported 24–48 h after the cell infusions. We observed reduced dyspnea and increased SpO2 within 48–96 h after the first infusion in seven patients. Of these seven patients, five were discharged from the ICU within 2–7 days (average: 4 days), one patient who had signs of acute renal and hepatic failure was discharged from the ICU on day 18, and the last patient suddenly developed cardiac arrest on day 7 of the cell infusion. Significant reductions in serum levels of tumor necrosis factor-alpha (TNF-α; P P P P = 0.06) patients and interferon gamma (IFN-γ) levels decreased in four (P = 0.14) patients. Four patients who had signs of multi-organ failure or sepsis died in 5–19 days (average: 10 days) after the first MSC infusion. A low percentage of lymphocytes (P = 0.02). All six survivors were well with no complaints of dyspnea on day 60 post-infusion. Radiological parameters of the lung computed tomography (CT) scans showed remarkable signs of recovery. Interpretation We suggest that multiple infusions of high dose allogeneic prenatal MSCs are safe and can rapidly improve respiratory distress and reduce inflammatory biomarkers in some critically ill COVID-19-induced ARDS cases. Patients that develop sepsis or multi-organ failure may not be good candidates for stem cell therapy. Large randomized multicenter clinical trials are needed to discern the exact therapeutic potentials of MSC in COVID-19-induced ARDS.
Databáze: OpenAIRE
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