Scientists from China have proposed treating severe coronavirus pneumonia using cellular technologies. They plan to use exosomes stem cell secretion products as an active component. Experimental studies have shown that their use significantly reduces pneumonia. This technique is safer than injecting the stem cells themselves into the patient, since there is no risk of mutations and cancer development. Another advantage of such therapy is the ability to store drugs for several weeks or even months, which ensures their safe transportation and delayed use. Russian experts believe that the technique looks promising.
Despite the fact that effective methods of treating patients with severe coronavirus infection have already been worked out, many people, especially the elderly and those with poor health, are still at high risk of dying from pneumonia. Therefore, it is imperative to find a safe and effective therapeutic approach for patients with COVID-19 complicated by acute respiratory distress. In this regard, many research teams are turning their attention to the prospect of using human stem cells.
Scientists at the Shanghai Public Health Clinical Center and Jinyintan Hospital in Wuhan plan to launch a pilot study inhalations with stem cell waste products. We are talking about exosomes bubble-like small particles that release all types of cells into the surrounding fluids. They are needed for the intercellular transfer of various proteins or microRNAs. Such exosomes are also secreted by mesenchymal stem cells, which are proposed to be used in the treatment of severe coronavirus pneumonia.
Photo: REUTERS / Richard Chung
Experimental studies have shown that their use significantly reduces lung inflammation and pathological disorders resulting from various types of lung damage, said in the text of the description of the clinical study. At the same time, scientists note that the intravenous administration of living stem cells (not exosomes), which is also now being studied by various scientific teams, can carry the risks of mutations and the development of cancer. What is not observed in the treatment of cells sprayed in an aerosol.
Another advantage of the proposed technique is the possibility of storing such drugs for several weeks and months, which ensures their safe transportation and delayed therapeutic use. As stated in the document, it is planned to recruit 30 participants for the first stage. It is assumed that each will undergo five inhalation procedures.
Mesenchymal stem cells (MSCs) interact with the innate immune system and can have both anti-inflammatory and pro-inflammatory activity. The type of activity is determined by the source of MSC production, surface markers, the profile of secreted cytokines (proteins secreted by immune cells. Izvestia) and other factors, the acting newspaper told the newspaper. Andrei Vasin, director of the Institute of Biomedical Systems and Biotechnology, Peter the Great St. Petersburg Polytechnic University (the university is a participant of the 5-100 education competitiveness project).
Since the acute respiratory distress syndrome (ARDS) in COVID-19 is believed to be the result of an imbalance of cytokines and other molecules involved in inflammatory responses, it seems reasonable to use approaches to mitigate these responses. A number of studies have been carried out, which suggested the effectiveness of MSCs for the treatment of ARDS, explained Andrei Vasin. Since some of the functions are realized due to the molecules secreted by these cells, it was proposed to use not them, but exosomes containing these molecules.
Scientists have shown that in some cases the use of exosomes gave the same results as the use of MSCs. Therefore, the stem cells themselves do not need to be injected into the patient. This is the approach that the Chinese researchers decided to use in this clinical study, noted Andrey Vasin. And the very possibility of aerosol administration of the drug potentially has a number of advantages from the point of view of the safety profile and the direction of delivery to the pathology site.
Photo: TASS / Zuma / Xinhua
In general, since the beginning of this year, about two dozen studies have been organized around the world using cellular products, Alexey Lyundup, Executive Director of the Association of BMCP (Biomedical Cell Products) Manufacturers, told Izvestia. Moreover, the sources of cells can be different.
The method proposed by Chinese experts is supposed to use exosomes of adipose tissue MSCs, the expert emphasized. Research continues, the idea itself is promising.
According to the specialist, such exosomes from MSCs contain cytokines and growth factors (natural compounds that can stimulate the production of living cells), signal lipids (substances that transmit signals inside the cell) and other substances necessary to relieve inflammation. However, it is worth waiting for evidence of the safety and effectiveness of their use in preclinical studies. And only then begin clinical trials declared by Chinese scientists.
We have sufficient grounds to believe that mesenchymal stem cells (as well as exosomes with similar properties. Izvestia) extinguish the cytokine storm, said Stanislav Otstavnov, deputy head of the laboratory for analysis of population health indicators and digitalization of healthcare at MIPT. I assess the proposed methodology in China as promising, but clinical trials will tell about the effectiveness and safety. In theory, cell therapy should also help in the regeneration of damaged lung areas, but there is little specific information in official sources on this matter. But the decrease in the immune response has been confirmed.
The experts emphasize that, in general, the available data on the use of exosomes in patients with COVID-19 looks interesting and this approach may be promising. However, so far unanswered questions remain related to the dose of such drugs, the route and frequency of administration, recipient groups, interaction with other treatment methods, and so on. Therefore, research in this direction must be continued.