Department of Infection, Division of Infection and Immunity, University College London, and National Institutes of Health and Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, China.
Int J Infect Dis. 2020 Jul;96:431-439. doi: 10.1016/j.ijid.2020.05.040. Epub 2020 May 17.
As of May 17th 2020, the novel coronavirus disease 2019 (COVID-19) pandemic has caused 307,395 deaths worldwide, out of 3,917,366 cases reported to the World Health Organization. No specific treatments for reducing mortality or morbidity are yet available. Deaths from COVID-19 will continue to rise globally until effective and appropriate treatments and/or vaccines are found. In search of effective treatments, the global medical, scientific, pharma and funding communities have rapidly initiated over 500 COVID-19 clinical trials on a range of antiviral drug regimens and repurposed drugs in various combinations. A paradigm shift is underway from the current focus of drug development targeting the pathogen, to advancing cellular Host-Directed Therapies (HDTs) for tackling the aberrant host immune and inflammatory responses which underlie the pathogenesis of SARS-CoV-2 and high COVID-19 mortality rates. We focus this editorial specifically on the background to, and the rationale for, the use and evaluation of mesenchymal stromal (Stem) cells (MSCs) in treatment trials of patients with severe COVID-19 disease. Currently, the ClinicalTrials.gov and the WHO Clinical Trials Registry Platform (WHO ICTRP) report a combined 28 trials exploring the potential of MSCs or their products for treatment of COVID-19. MSCs should also be trialed for treatment of other circulating WHO priority Blueprint pathogens such as MERS-CoV which causes upto 34% mortality rates. It's about time funding agencies invested more into development MSCs per se, and also for a range of other HDTs, in combination with other therapeutic interventions. MSC therapy could turn out to be an important contribution to bringing an end to the high COVID-19 death rates and preventing long-term functional disability in those who survive disease.
截至 2020 年 5 月 17 日，新型冠状病毒病 2019（COVID-19）大流行已在全球范围内造成 307395 人死亡，而向世界卫生组织报告的病例为 3917366 例。目前尚无降低死亡率或发病率的特定治疗方法。在找到有效和适当的治疗方法和/或疫苗之前，COVID-19 的死亡人数将继续在全球范围内上升。为了寻找有效的治疗方法，全球医疗、科学、制药和资助界迅速启动了 500 多项 COVID-19 临床试验，涵盖了一系列抗病毒药物方案和各种组合的重新利用药物。目前，药物开发的重点从针对病原体的靶向药物治疗，转向推进针对 SARS-CoV-2 和高 COVID-19 死亡率的异常宿主免疫和炎症反应的细胞宿主定向治疗（HDT），这一范式正在发生转变。我们在这篇社论中特别关注在严重 COVID-19 疾病患者的治疗试验中使用和评估间充质基质（Stem）细胞（MSCs）的背景和理由。目前，ClinicalTrials.gov 和世界卫生组织临床试验注册平台（WHO ICTRP）报告了 28 项联合试验，探索 MSCs 或其产品治疗 COVID-19 的潜力。MSCs 也应该在临床试验中用于治疗其他循环的世界卫生组织优先蓝皮书病原体，如引起高达 34%死亡率的中东呼吸综合征冠状病毒（MERS-CoV）。现在是时候让资助机构更多地投资于 MSCs 本身的开发，以及一系列其他 HDT，与其他治疗干预相结合。MSC 疗法可能成为结束 COVID-19 高死亡率并防止那些幸存下来的患者长期功能障碍的重要贡献。
