Journal
INTENSIVE CARE MEDICINE EXPERIMENTAL
Volume 9, Issue 1, Pages -Publisher
SPRINGER
DOI: 10.1186/s40635-021-00424-5
Keywords
Cell therapy; Mesenchymal stem cells; Pneumonia; Coronavirus; Influenza; Acute respiratory distress syndrome; Sepsis; Critical illness; Pandemic; Acute hypoxic respiratory failure
Categories
Funding
- Science Foundation Ireland Future Research Leaders Award [16/FRL-3845]
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Severe viral pneumonia causes significant morbidity and mortality globally, with limited direct therapies available, mesenchymal stromal/stem cell therapy is considered a promising approach. Clinical trials have demonstrated safety of these cells, and strategies are being explored to enhance their therapeutic potential.
Severe viral pneumonia is a significant cause of morbidity and mortality globally, whether due to outbreaks of endemic viruses, periodic viral epidemics, or the rarer but devastating global viral pandemics. While limited anti-viral therapies exist, there is a paucity of direct therapies to directly attenuate viral pneumonia-induced lung injury, and management therefore remains largely supportive. Mesenchymal stromal/stem cells (MSCs) are receiving considerable attention as a cytotherapeutic for viral pneumonia. Several properties of MSCs position them as a promising therapeutic strategy for viral pneumonia-induced lung injury as demonstrated in pre-clinical studies in relevant models. More recently, early phase clinical studies have demonstrated a reassuring safety profile of these cells. These investigations have taken on an added importance and urgency during the COVID-19 pandemic, with multiple trials in progress across the globe. In parallel with clinical translation, strategies are being investigated to enhance the therapeutic potential of these cells in vivo, with different MSC tissue sources, specific cellular products including cell-free options, and strategies to'licence' or'preactivate' these cells, all being explored. This review will assess the therapeutic potential of MSC-based therapies for severe viral pneumonia. It will describe the aetiology and epidemiology of severe viral pneumonia, describe current therapeutic approaches, and examine the data suggesting therapeutic potential of MSCs for severe viral pneumonia in pre-clinical and clinical studies. The challenges and opportunities for MSC-based therapies will then be considered.
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