Can Stem Cell Therapy Help against Coronavirus?

The number of confirmed cases of the 2019 novel coronavirus (2019-nCoV) reported to WHO continues to rise worldwide. Although WHO has launched a global megatrial to test 4 most promising treatments, there is currently no specific proven anti-viral treatment exists. Although there are some published studies for various promising treatments from antivirals, anti-malarial to anti-oxidants, the studies are small and yet to be confirmed. The mainstay of clinical management is largely symptomatic treatment, with organ support in intensive care for seriously ill patients.

WHO and other global public health bodies have mainly focused on preventing transmission, infection control measures, and screening of travellers. The development of vaccines has received immediate funding; however, as with SARS-CoV and MERSCoV, support for developing treatments for 2019-nCoV that reduce mortality has not been forthcoming. All three coronaviruses induce excessive non-effective host immune responses that are associated with severe lung damage, leading to death. In most patients who are severely affected, COVID-19 infection is also associated with a 'cytokine storm' or severe inflammatory response.

The term 'cytokine storm' was popularized largely in the context of avian H5N1 influenza virus infection, bringing the term into popular media.

is stem cell therapy legal in malaysia

The human umbilical cord mesenchymal stem cells (hUCMSCs) have shown very good capability to modulate immune response and repair the injured tissue with good safety (PubMed).

new pilot study which was a small study of 7 patients who were given 50-100 million, culture-expanded MSCs. 5/7 of the patients had severe COVID-19 cases and two just had viral pneumonia (common type). The two common type patients were recovered and discharged and the other four were listed as recovered but seem to have still been in the hospital at the time the paper was submitted. Three severe cases were recruited for the placebo group and the outcomes were that one died, one still was in respiratory distress (ARDS), and one was listed as stable. The treated patients showed a decrease in the inflammatory cytokine storm so prevalent in COVID-19.

Here, we have compiled and updated a few significant studies, clinical trials and related reviews on Coronavirus treatment with stem cell therapy.

There are multiple on-going studies on COVID-19 and stem cell therapy on the US Clinical Trials Register and the Chinese Clinical Trials Register. However, most of them are small in terms of size and design. However, we have shortlisted below a few clinical trials that are reasonable in terms of design and size and will be the trials to watch out for.

This list is a work-in-progress list as new evidence might be added from time to time.

Treatment With Mesenchymal Stem Cells for Severe Corona Virus Disease 2019(COVID-19)
https://clinicaltrials.gov/ct2/show/NCT04288102

Sponsor: Beijing 302 Hospital (China)

Description:

The epidemic of 2019 novel coronavirus (causing the disease Covid-19) has expanded from Wuhan throughout China and is being exported to a growing number of countries, some of which have seen onward transmission. COVID-19 caused clusters of severe respiratory illness and was associated with 2% mortality. There is currently no vaccine and no specific antiviral treatment recommended for COVID-19. About 20% of the patients were severe and the mainstay of clinical management is largely symptomatic treatment, with organ support in intensive care for seriously ill patients. Therefore, it is urgent to find a safe and effective therapeutic approach to COVID-19. 

In the last years, the promising features of mesenchymal stem cells (MSCs), including their regenerative properties and ability to differentiate into diverse cell lineages, have generated great interest among researchers whose work has offered intriguing perspectives on cell-based therapies for various diseases. These findings seem to highlight that the beneficial effect of MSC-based treatment could be principally due by the immunomodulation and regenerative potential of these cells. MSCs could significantly reduce the pathological changes of lung and inhibit the cell-mediated immune inflammatory response induced by influenza virus in animal model . MSCs have been shown to reduce nonproductive inflammation and affect tissue regeneration and is being evaluated in patients with ARDS (acute respiratory distress syndrome). Our phase I preliminary data of parallel assignment study(NCT04252118) showed that three doses of MSCs was safe in patients with COVID-19. Randomized control trial (RCT) are needed to assess efficacy and safety.

The investigators will do a prospective, double-blind, multi-centre, randomised trial to assess treatment with three intravenous doses of MSCs compared with placebo. 90 severe COVID-19 patients will be recruited in China. 60 patients will receive i.v. transfusion 3 times of MSCs (4.0*10E7 cells per time), as the treated group, all of them receive the conventional treatment. As control, 30 patients will receive placebo and conventional treatment.


Therapy for Pneumonia Patients iInfected by 2019 Novel Coronavirus
https://clinicaltrials.gov/ct2/show/NCT04293692

Sponsor: Puren Hospital Affiliated to Wuhan University of Science and Technology (China)

Description:

Since late December 2019, human pneumonia cases infected by a novel coronavirus (2019-nCoV) were firstly identified in Wuhan, China. As the virus is contagious and of great epidemic, more and more cases have found in other areas of China and abroad. At present, there is no effective treatment for patients identified with novel coronavirus pneumonia. Therefore, it's urgent to explore more active therapeutic methods to cure the patients.

Recently, studies on the 2019 novel coronavirus pneumonia published in The Lancet and The New England Journal of Medicine suggested that massive inflammatory cell infiltration and inflammatory cytokines secretion were found in patients' lungs, alveolar epithelial cells and capillary endothelial cells were damaged, causing acute lung injury. It seems that the key to cure the pneumonia is to inhibit the inflammatory response, resulting to reduce the damage of alveolar epithelial cells and endothelial cells and repair the function of the lung.

Mesenchymal stem cells (MSCs) are widely used in basic research and clinical application. They are proved to migrate to damaged tissues, exert anti-inflammatory and immunoregulatory functions, promote the regeneration of damaged tissues and inhibit tissue fibrosis. Studies have shown that MSCs can significantly reduce acute lung injury in mice caused by H9N2 and H5N1 viruses by reducing the levels of proinflammatory cytokines and the recruitment of inflammatory cells into the lungs. Compared with MSCs from other sources, human umbilical cord-derived MSCs (UC-MSCs) have been widely applied to various diseases due to their convenient collection, no ethical controversy, low immunogenicity, and rapid proliferation rate. In our recent research, we confirmed that UC-MSCs can significantly reduce inflammatory cell infiltration and inflammatory factors expression in lung tissue, and significantly protect lung tissue from endotoxin (LPS) -induced acute lung injury in mice.

The purpose of this clinical study is to investigate safety and efficiency of UC-MSCs in treating pneumonia patients infected by 2019-nCoV. The investigators planned to recruit 48 patients aged from 18 to 75 years old and had no severe underlying diseases. In the treatment group, 24 patients received 0.5*10E6 UC-MSCs /kg body weight intravenously treatment 4 times every other day besides conventional treatment. In the control group, other 24 patients received conventional treatment plus 4 times of placebo intravenously.


Wrap-Up

My biggest concern is that some of you will get diagnosed with COVID-19 over the next few weeks and then go buy a bottle of stem cells from some clinics and ask your doctor to inject it into yourselves. Please don't do that!

Stem cell therapy is not a cure all therapy and is still under evaluation. If you have no symptom or mild symptoms, you might not need any treatment. If you have severe symptoms or have risk factors (elderly, hypertension, diabetes mellitus, asthma etc.), you should see your family doctor or hospital ER (open 24 hours a day 7 days a week) about what to do next.

Most of the treatments under evaluation are hospital based treatments and need to be prescribed by qualified doctors. Do not self-medicate. A couple in Arizona mistakenly thought that a popular fish tank additive that has chloroquine was safe to ingest. It was not and this stuff ended up killing him with his wife in the ICU. Hence, please be careful out there!

If you are worried about the latest Coronavirus or COVID-19, there are several things you can do (and not do) to improve your immune system. Check out best supplements to boost your immune system. Your immune system is your first line of defence against the coronavirus, not the treatments you would get from the hospitals. That's your last line of defence.


Read more: Coronavirus

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