Mesenchymal stem cells and their derived exosomes for the treatment of COVID-19

Newswise — Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infection typically presents with fever and respiratory symptoms, which can progress to severe respiratory distress syndrome and multiple organ failure. In severe cases, these complications may even lead to death. One of the causes of COVID-19 deaths is the cytokine storm caused by an overactive immune response. Therefore, suppressing the overactive immune response may be an effective strategy for treating COVID-19. Mesenchymal stem cells (MSCs) and their derived exosomes (MSCs-Exo) have potent homing abilities, immunomodulatory functions, regenerative repair, and antifibrotic effects, promising an effective tool in treating COVID-19. In this paper, we review the main mechanisms and potential roles of MSCs and MSCs-Exo in treating COVID-19. We also summarize relevant recent clinical trials, including the source of cells, the dosage and the efficacy, and the clinical value and problems in this field, providing more theoretical references for the clinical use of MSCs and MSCs-Exo in the treatment of COVID-19.

Key Words: COVID-19, Cytokine storm, Immunomodulation, Mesenchymal stem cell, Mesenchymal stem cell-derived exosomes

Core Tip: As the coronavirus disease 2019 (COVID-19) pandemic normalizes, developing efficient treatments is critical to reducing the strain on the healthcare system. We summarize the various current treatments for COVID-19 and the mechanisms of damage caused by severe acute respiratory syndrome coronavirus 2. Through the comparison to existing treatments, we find that stem cell therapy has more research value. Mesenchymal stem cells (MSC) and their derived exosomes (MSC-Exo) have homing, immunomodulatory, and tissue repair abilities. They can reduce lung injury and inhibit pulmonary fibrosis. We summarized the clinical trials in recent years, analyzed the safety and effectiveness of MSC and MSC-Exo treatment from various aspects such as mechanism of action and therapeutic effect, and provided substantial theoretical support for their clinical application.

• Citation: Hou XY, Danzeng LM, Wu YL, Ma QH, Yu Z, Li MY, Li LS. Mesenchymal stem cells and their derived exosomes for the treatment of COVID-19. World J Stem Cells 2024; 16(4): 353-374
• URL: https://www.wjgnet.com/1948-0210/full/v16/i4/353.htm
• DOI: https://dx.doi.org/10.4252/wjsc.v16.i4.353