Institute of Microcirculation, Hebei North University, 11 Diamond South-road, Keji Building, Room 213, Zhangjiakou, 075000, Hebei, China.
Department of Pathophysiology of Basic Medical College, Hebei North University, Zhangjiakou, 075000, Hebei, China.
J Transl Med. 2021 May 10;19(1):198. doi: 10.1186/s12967-021-02862-x.
The mortality rate of critically ill patients with acute respiratory distress syndrome (ARDS) is 30.9% to 46.1%. The emergence of the coronavirus disease 2019 (Covid-19) has become a global issue with raising dire concerns. Patients with severe Covid-19 may progress toward ARDS. Mesenchymal stem cells (MSCs) can be derived from bone marrow, umbilical cord, adipose tissue and so on. The easy accessibility and low immunogenicity enable MSCs for allogeneic administration, and thus they were widely used in animal and clinical studies. Accumulating evidence suggests that mesenchymal stem cell infusion can ameliorate ARDS. However, the underlying mechanisms of MSCs need to be discussed. Recent studies showed MSCs can modulate immune/inflammatory cells, attenuate endoplasmic reticulum stress, and inhibit pulmonary fibrosis. The paracrine cytokines and exosomes may account for these beneficial effects. In this review, we summarize the therapeutic mechanisms of MSCs in ARDS, analyzed the most recent animal experiments and Covid-19 clinical trial results, discussed the adverse effects and prospects in the recent studies, and highlight the potential roles of MSC therapy for Covid-19 patients with ARDS.
急性呼吸窘迫综合征（ARDS）危重症患者的死亡率为 30.9%至 46.1%。2019 年冠状病毒病（Covid-19）的出现已成为全球关注的焦点。严重的 Covid-19 患者可能会发展为 ARDS。间充质干细胞（MSCs）可来源于骨髓、脐带、脂肪组织等。其易于获取和低免疫原性使其可用于同种异体移植，因此在动物和临床研究中得到了广泛应用。越来越多的证据表明，间充质干细胞输注可以改善 ARDS。然而，MSCs 的潜在机制仍需要进一步探讨。最近的研究表明，MSCs 可以调节免疫/炎症细胞，减轻内质网应激，并抑制肺纤维化。旁分泌细胞因子和外泌体可能是其发挥有益作用的原因。本综述总结了 MSCs 在 ARDS 中的治疗机制，分析了最近的动物实验和 Covid-19 临床试验结果，讨论了目前研究中的不良反应和前景，并强调了 MSCs 治疗对 ARDS 的 Covid-19 患者的潜在作用。
