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. 2020 Sep 30:8:587866.
doi: 10.3389/fcell.2020.587866. eCollection 2020.

Mesenchymal Stem Cells and Their Extracellular Vesicles: A Potential Game Changer for the COVID-19 Crisis

Dina H Kassem  1 , Mohamed M Kamal  1   2   3
Affiliations

Mesenchymal Stem Cells and Their Extracellular Vesicles: A Potential Game Changer for the COVID-19 Crisis

Dina H Kassem et al. Front Cell Dev Biol. .

Abstract

Corona virus disease 2019 (COVID-19) is a global public health crisis. The high infectivity of the disease even from non-symptomatic infected patients, together with the lack of a definitive cure or preventive measures are all responsible for disease outbreak. The severity of COVID-19 seems to be mostly dependent on the patients' own immune response. The over-activation of the immune system in an attempt to kill the virus, can cause a "cytokine storm" which in turn can induce acute respiratory distress syndrome (ARDS), as well as multi-organ damage, and ultimately may lead to death. Thus, harnessing the immunomodulatory properties of mesenchymal stem cells (MSCs) to ameliorate that cytokine-storm can indeed provide a golden key for the treatment of COVID-19 patients, especially severe cases. In fact, MSCs transplantation can improve the overall outcome of COVID-19 patients via multiple mechanisms; first through their immunomodulatory effects which will help to regulate the infected patient inflammatory response, second via promoting tissue-repair and regeneration, and third through their antifibrotic effects. All these mechanisms will interplay and intervene together to enhance lung-repair and protect various organs from any damage resulting from exaggerated immune-response. A therapeutic modality which provides all these mechanisms undoubtedly hold a strong potential to help COVID-19 patients even those with the worst condition to hopefully survive and recover.

Keywords: COVID-19; SARS-CoV-2; corona virus; cytokine storm; exosomes; extracellular vesicles; immunomodulation; mesenchymal stem cells.

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Figures

FIGURE 1
FIGURE 1
A schematic presentation for the different types of mesenchymal stem cells and their various therapeutic strategies implicated in COVID-19 treatment. MSCs and their derived EVs can efficiently intervene via several mechanisms to improve the overall outcome of COVID-19 especially in critically-ill patients with severe symptoms. These mechanisms include their immunomodulatory activities, tissue regenerative effects, anti-microbial effects, as well as their antifibrotic and angiogenic effects. AD, Adipose tissue; BM, Bone marrow; COVID-19, Corona Virus Disease-2019; EVs, Extra-Cellular vesicles; MSCs, Mesenchymal Stem Cells; and WJ, Wharton’s Jelly. Created by Biorender.com.
FIGURE 2
FIGURE 2
A summary for the critical issues that should be carefully considered when selecting a certain type of mesenchymal stem cells for COVID-19 treatment. AD, Adipose tissue; ACE2, Angiotensin converting enzyme; BM, Bone marrow; COVID-19, Corona Virus Disease-2019; MSCs, Mesenchymal Stem Cells; TF/CD142, Tissue factor; SARS-CoV-2, Severe acute respiratory syndrome corona virus-2; TMPRSS2, Transmembrane protease serine 2 and WJ, Wharton’s Jelly. Created by Biorender.com.
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