Is there a place for mesenchymal stromal cell-based therapies in the therapeutic armamentarium against COVID-19?
Kátia Nunes da Silva, André Luiz Nunes Gobatto, Zaquer Suzana Munhoz Costa‐Ferro, Bruno Raphael Ribeiro Cavalcante, Alex Cleber Improta‐Caria, Luciana Souza de Aragão França, Carolina Kymie Vasques Nonaka, Fernanda de Macêdo Lima, Miquéias Lopes‐Pacheco, Patrícia R. M. Rocco, Bruno Solano de Freitas Souza
Abstract
The COVID-19 pandemic, caused by the rapid global spread of the novel coronavirus (SARS-CoV-2), has caused healthcare systems to collapse and led to hundreds of thousands of deaths. The clinical spectrum of COVID-19 is not only limited to local pneumonia but also represents multiple organ involvement, with potential for systemic complications. One year after the pandemic, pathophysiological knowledge has evolved, and many therapeutic advances have occurred, but mortality rates are still elevated in severe/critical COVID-19 cases. Mesenchymal stromal cells (MSCs) can exert immunomodulatory, antiviral, and pro-regenerative paracrine/endocrine actions and are therefore promising candidates for MSC-based therapies. In this review, we discuss the rationale for MSC-based therapies based on currently available preclinical and clinical evidence of safety, potential efficacy, and mechanisms of action. Finally, we present a critical analysis of the risks, limitations, challenges, and opportunities that place MSC-based products as a therapeutic strategy that may complement the current arsenal against COVID-19 and reduce the pandemic's unmet medical needs.