Are mesenchymal stem cells able to manage cytokine storm in COVID-19 patients? A review of recent studies

Abstract

The Covid-19 disease has recently become one of the biggest challenges globally, and there is still no specific medication. Findings showed the immune system in severe Covid-19 patients loses regulatory control of pro-inflammatory cytokines, especially IL-6 production, called the "Cytokine storm" process. This process can cause injury to vital organs, including lungs, kidneys, liver, and ultimately death if not inhibited. While many treatments have been proposed to reduce cytokine storm, but the safety and effectiveness of each of them are still in doubt. Mesenchymal stem cells (MSCs) are multipotent cells with self-renewal potential capable of suppressing overactive immune responses and leading to tissue restoration and repair. These immuno-modulatory properties of MSCs and their derivatives (like exosomes) can improve the condition of Covid-19 patients with serious infectious symptoms caused by adaptive immune system dysfunction. Many clinical trials have been conducted in this field using various MSCs around the world. Some of these have been published and summarized in the present article, while many have not yet been completed. Based on these available data, MSCs can reduce inflammatory cytokines, increase oxygen saturation, regenerate lung tissue and improve clinical symptoms in Covid-19 patients. The review article aims to collect available clinical data in more detail and investigate the role of MSCs in reducing cytokine storms as well as improving clinical parameters of Covid-19 patients for use in future clinical studies.

Keywords: Covid-19; Cytokine storm; Immune response; Mesenchymal stem cells.

Fig. 1

Schematic diagram of how Mesenchymal stem cells (MSCs) can manage Cytokine storm in Covid-19 patients. Abbreviations (NO: Nitric oxide/TGF-β: Transforming growth factor β/IDO: Indoleamine2,3-dioxygenase/PGE2: prostaglandin E2/TNF-α: Tumor Necrosis Factor-alpha/IFN-γ: Interferon-gamma/T-reg: T regulatory cell/Th: T helper cells/NK cell: Natural Killer cell/IL-10: Interleukin-10).