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Review
. 2023 Dec 20;14(1):8.
doi: 10.3390/biom14010008.

Mesenchymal Stem Cell-Based Therapies in the Post-Acute Neurological COVID Syndrome: Current Landscape and Opportunities

Lilia Carolina León-Moreno  1 , Edwin Estefan Reza-Zaldívar  2 , Mercedes Azucena Hernández-Sapiéns  1 , Erika Villafaña-Estarrón  1 , Marina García-Martin  3 , Doddy Denise Ojeda-Hernández  3 , Jordi A Matias-Guiu  3 , Ulises Gomez-Pinedo  3 , Jorge Matias-Guiu  4 , Alejandro Arturo Canales-Aguirre  1
Affiliations
Review

Mesenchymal Stem Cell-Based Therapies in the Post-Acute Neurological COVID Syndrome: Current Landscape and Opportunities

Lilia Carolina León-Moreno et al. Biomolecules. .

Abstract

One of the main concerns related to SARS-CoV-2 infection is the symptoms that could be developed by survivors, known as long COVID, a syndrome characterized by persistent symptoms beyond the acute phase of the infection. This syndrome has emerged as a complex and debilitating condition with a diverse range of manifestations affecting multiple organ systems. It is increasingly recognized for affecting the Central Nervous System, in which one of the most prevalent manifestations is cognitive impairment. The search for effective therapeutic interventions has led to growing interest in Mesenchymal Stem Cell (MSC)-based therapies due to their immunomodulatory, anti-inflammatory, and tissue regenerative properties. This review provides a comprehensive analysis of the current understanding and potential applications of MSC-based interventions in the context of post-acute neurological COVID-19 syndrome, exploring the underlying mechanisms by which MSCs exert their effects on neuroinflammation, neuroprotection, and neural tissue repair. Moreover, we discuss the challenges and considerations specific to employing MSC-based therapies, including optimal delivery methods, and functional treatment enhancements.

Keywords: exosomes; long COVID; mesenchymal stem cells; neurological sequelae.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the writing of the manuscript; or in the decision to publish it.

Figures

Figure 1
Figure 1
Neuroinvasiveness routes of SARS-CoV-2. Once the virus is in the respiratory system, it can reach the central nervous system by two main mechanisms.SARS-CoV-2 makes contact with the olfactory mucosa, reaching the olfactory nerves, and by transport through the nerve endings, it can travel and spread to the CNS. The other pathway is the hematogenous route, where the virus can reach the brain-blood barrier and, by transcytosis, infect the neuroepithelia and then the cells of the CNS. Viral RNA is present in neurons, astrocytes, oligodendrocytes, and endothelial cells. After the prolongated symptoms, people with long-COVID-19 develop neurologic sequalae. CNS = central nervous system, ACE2 = angiotensin-converting enzyme 2 receptor. Created with BioRender.com.
Figure 2
Figure 2
Formulation approaches for MSCs and their cell-derived exosomes using biomaterials to improve MSC-based delivery, absorption, and therapeutic potential. Created with BioRender.com.
See this image and copyright information in PMC

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