Stem cell-derived biofactors fight against coronavirus infection

Despite various treatment protocols and newly recognized therapeutics, there are no effective treatment approaches against coronavirus disease. New therapeutic strategies including the use of stem cells-derived secretome as a cell-free therapy have been recommended for patients with critical illness. The pro-regenerative, pro-angiogenic, anti-inflammatory, anti-apoptotic, immunomodulatory, and trophic properties of stem cells-derived secretome, extracellular vesicles (EVs), and bioactive factors have made them suitable candidates for respiratory tract regeneration in coronavirus disease 2019 (COVID-19) patients. EVs including microvesicles and exosomes can be applied for communication at the intercellular level due to their abilities in the long-distance transfer of biological messages such as mRNAs, growth factors, transcription factors, microRNAs, and cytokines, and therefore, simulate the specifications of the parent cell, influencing target cells upon internalization and/or binding. EVs exhibit both anti-inflammatory and tolerogenic immune responses by regulation of proliferation, polarization, activation, and migration of different immune cells. Due to effective immunomodulatory and high safety including a minimum risk of immunogenicity and tumorigenicity, mesenchymal stem cell (MSC)-EVs are more preferable to MSC-based therapies. Thus, as an endogenous repair and inflammation-reducing agent, MSC-EVs could be used against COVID-19 induced morbidity and mortality after further mechanistic and preclinical/clinical investigations. This review is focused on the therapeutic perspective of the secretome of stem cells in alleviating the cytokine storm and organ injury in COVID-19 patients.

Core Tip: The world has witnessed unbelievable damage due to the coronavirus disease 2019 (COVID-19) pandemic. The rapid propagation of the disease requires emerging therapeutic strategies. The central role of the immune system during COVID-19 highlights the importance of a balanced immune response in order to prohibit overexaggerated responses and further multiorgan dysfunction. Stem cell and stem cell-derived secretome-related therapies have gained increasing momentum in the treatment of a broad range of diseases in the past decade. In particular, the immunomodulatory properties of stem cell-derived biofactors could be a new avenue in the treatment of COVID-19 patients.

• Citation: Ardalan M, Chodari L, Zununi Vahed S, Hosseiniyan Khatibi SM, Eftekhari A, Davaran S, Cucchiarini M, Roshangar L, Ahmadian E. Stem cell-derived biofactors fight against coronavirus infection. World J Stem Cells 2021; 13(12): 1813-1825
• URL: https://www.wjgnet.com/1948-0210/full/v13/i12/1813.htm
• DOI: https://dx.doi.org/10.4252/wjsc.v13.i12.1813