Mesenchymal stem/stromal cell-based therapies for severe viral pneumonia: therapeutic potential and challenges

Intensive Care Medicine Experimental

C. H. Masterson¹  J. G. Laffey²  G. F. Curley³  A. Artigas⁴  K. English⁵  S. Rolandsson Enes⁶  M. A. Matthay⁷  D. J. Weiss⁸  A. Ceccato⁹  C. dos Santos^1,10  P. R. Rocco^1,11  D. McAuley^1,12 

[1] Anaesthesia, School of Medicine, National University of Ireland, Galway, Ireland;Regenerative Medicine Institute, National University of Ireland, Galway, Ireland;Anaesthesia, School of Medicine, National University of Ireland, Galway, Ireland;Regenerative Medicine Institute, National University of Ireland, Galway, Ireland;Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Saolta University Hospital Group, Galway, Ireland;Anaesthesia, School of Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland;CIBER de Enfermedades Respiratorias (CIBERES), Sabbadell, Spain;Critical Center, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain;Department of Biology, Maynooth University, Maynooth, Co. Kildare, Ireland;Kathleen Lonsdale Institute for Human Health Research, Maynooth University, Maynooth, Co. Kildare, Ireland;Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden;Department of Medicine and Anesthesia, University of California, San Francisco, CA, USA;Cardiovascular Research Institute, University of California, San Francisco, CA, USA;Department of Medicine, University of Vermont College of Medicine, 05405, Burlington, VT, USA;Intensive Care Unit, Hospital Universitari Sagrat Cor, Barcelona, Spain;CIBER de Enfermedades Respiratorias (CIBERES), Sabbadell, Spain;Keenan Center for Biomedical Research, St. Michael’s Hospital, Bond St, Toronto, Canada;Interdepartmental Division of Critical Care Medicine and Institutes of Medical Sciences, University of Toronto, Toronto, Canada;Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil;Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, UK;Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, UK;

关键词: Cell therapy;    Mesenchymal stem cells;    Pneumonia;    Coronavirus;    Influenza;    Acute respiratory distress syndrome;    Sepsis;    Critical illness;    Pandemic;    Acute hypoxic respiratory failure;   

DOI  :  10.1186/s40635-021-00424-5

来源: Springer

【 摘 要 】

Severe viral pneumonia is a significant cause of morbidity and mortality globally, whether due to outbreaks of endemic viruses, periodic viral epidemics, or the rarer but devastating global viral pandemics. While limited anti-viral therapies exist, there is a paucity of direct therapies to directly attenuate viral pneumonia-induced lung injury, and management therefore remains largely supportive. Mesenchymal stromal/stem cells (MSCs) are receiving considerable attention as a cytotherapeutic for viral pneumonia. Several properties of MSCs position them as a promising therapeutic strategy for viral pneumonia-induced lung injury as demonstrated in pre-clinical studies in relevant models. More recently, early phase clinical studies have demonstrated a reassuring safety profile of these cells. These investigations have taken on an added importance and urgency during the COVID-19 pandemic, with multiple trials in progress across the globe. In parallel with clinical translation, strategies are being investigated to enhance the therapeutic potential of these cells in vivo, with different MSC tissue sources, specific cellular products including cell-free options, and strategies to ‘licence’ or ‘pre-activate’ these cells, all being explored. This review will assess the therapeutic potential of MSC-based therapies for severe viral pneumonia. It will describe the aetiology and epidemiology of severe viral pneumonia, describe current therapeutic approaches, and examine the data suggesting therapeutic potential of MSCs for severe viral pneumonia in pre-clinical and clinical studies. The challenges and opportunities for MSC-based therapies will then be considered.

【 授权许可】

CC BY