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间充质干细胞免疫调节:探索控制 COVID-19 相关细胞因子风暴的方法。

Mesenchymal stem cell immunomodulation: In pursuit of controlling COVID-19 related cytokine storm.

机构信息

Center for Stem Cell Therapeutics and Imaging (CSTI), Harvard Medical School, Boston, Massachusetts, USA.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Stem Cells. 2021 Jun;39(6):707-722. doi: 10.1002/stem.3354. Epub 2021 Mar 7.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has grown to be a global public health crisis with no safe and effective treatments available yet. Recent findings suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus pathogen that causes COVID-19, could elicit a cytokine storm that drives edema, dysfunction of the airway exchange, and acute respiratory distress syndrome in the lung, followed by acute cardiac injury and thromboembolic events leading to multiorgan failure and death. Mesenchymal stem cells (MSCs), owing to their powerful immunomodulatory abilities, have the potential to attenuate the cytokine storm and have therefore been proposed as a potential therapeutic approach for which several clinical trials are underway. Given that intravenous infusion of MSCs results in a significant trapping in the lung, MSC therapy could directly mitigate inflammation, protect alveolar epithelial cells, and reverse lung dysfunction by normalizing the pulmonary microenvironment and preventing pulmonary fibrosis. In this review, we present an overview and perspectives of the SARS-CoV-2 induced inflammatory dysfunction and the potential of MSC immunomodulation for the prevention and treatment of COVID-19 related pulmonary disease.

摘要

新型冠状病毒病(COVID-19)大流行已成为全球公共卫生危机,目前尚无安全有效的治疗方法。最近的研究结果表明,导致 COVID-19 的冠状病毒病原体严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)可能引发细胞因子风暴,导致肺部水肿、气道交换功能障碍和急性呼吸窘迫综合征,继而导致急性心脏损伤和血栓栓塞事件,导致多器官衰竭和死亡。间充质干细胞(MSCs)由于其强大的免疫调节能力,有可能减轻细胞因子风暴,因此被提议作为一种潜在的治疗方法,目前正在进行几项临床试验。鉴于静脉输注 MSCs 会导致肺部大量滞留,MSC 治疗可能通过直接减轻炎症、保护肺泡上皮细胞以及通过正常化肺微环境和防止肺纤维化来逆转肺功能障碍,从而直接减轻炎症。在这篇综述中,我们介绍了 SARS-CoV-2 诱导的炎症功能障碍的概述和观点,以及 MSC 免疫调节在预防和治疗 COVID-19 相关肺部疾病方面的潜力。

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