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1.
Front Cell Dev Biol ; 11: 1146835, 2023.
Article in English | MEDLINE | ID: covidwho-20243127

ABSTRACT

This century's first major epidemic of a new coronavirus illness (2019-nCoV) was a tremendous shock to the healthcare system. The onset of the pandemic has caused severe economic and health shortages. At this time, there are no viable treatments for COVID-19. Several clinical studies using cell-based therapies, such as umbilical cord mesenchymal stem cells, have showed promising results (UC-MSCs). UC-MSCs have been the focus of much study because to their potential as a treatment option for COVID-19 patients. Cytokine release syndrome, often called cytokine storm, increases the risk of morbidity and mortality from COVID-19. It has been established that UC-MSCs may suppress and control both the adaptive and innate immune responses by modulating the release of immunostimulatory cytokines. The purpose of this study is to assess and clarify the use of UC-MSCs for the treatment of ARDS caused by COVID-19.

2.
Communications in Statistics: Simulation & Computation ; : 1-17, 2023.
Article in English | Academic Search Complete | ID: covidwho-2324534

ABSTRACT

The spread of COVID-19 makes it essential to investigate its prevalence. In such investigation research, as far as we know, the widely-used sampling methods didn't use the information sufficiently about the numbers of the previously diagnosed cases, which provides a priori information about the true numbers of infections. This motivates us to develop a new, two-stage sampling method in this paper, which utilizes the information about the distributions of both population and diagnosed cases, to investigate the prevalence more efficiently. The global likelihood sampling, a robust and efficient sampler to draw samples from any probability density function, is used in our sampling strategy, and thus, our new method can automatically adapt to the complicated distributions of population and diagnosed cases. Moreover, the corresponding estimating method is simple, which facilitates the practical implementation. Some recommendations for practical implementation are given. Finally, several simulations and a practical example verify its efficiency. [ FROM AUTHOR] Copyright of Communications in Statistics: Simulation & Computation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

3.
Diagnostics (Basel) ; 13(7)2023 Mar 23.
Article in English | MEDLINE | ID: covidwho-2292247

ABSTRACT

Disease severity identification using computational intelligence-based approaches is gaining popularity nowadays. Artificial intelligence and deep-learning-assisted approaches are proving to be significant in the rapid and accurate diagnosis of several diseases. In addition to disease identification, these approaches have the potential to identify the severity of a disease. The problem of disease severity identification can be considered multi-class classification, where the class labels are the severity levels of the disease. Plenty of computational intelligence-based solutions have been presented by researchers for severity identification. This paper presents a comprehensive review of recent approaches for identifying disease severity levels using computational intelligence-based approaches. We followed the PRISMA guidelines and compiled several works related to the severity identification of multidisciplinary diseases of the last decade from well-known publishers, such as MDPI, Springer, IEEE, Elsevier, etc. This article is devoted toward the severity identification of two main diseases, viz. Parkinson's Disease and Diabetic Retinopathy. However, severity identification of a few other diseases, such as COVID-19, autonomic nervous system dysfunction, tuberculosis, sepsis, sleep apnea, psychosis, traumatic brain injury, breast cancer, knee osteoarthritis, and Alzheimer's disease, was also briefly covered. Each work has been carefully examined against its methodology, dataset used, and the type of disease on several performance metrics, accuracy, specificity, etc. In addition to this, we also presented a few public repositories that can be utilized to conduct research on disease severity identification. We hope that this review not only acts as a compendium but also provides insights to the researchers working on disease severity identification using computational intelligence-based approaches.

4.
IEEE Transactions on Engineering Management ; : 1-17, 2022.
Article in English | Web of Science | ID: covidwho-2070468

ABSTRACT

Under the COVID-19 pandemic, governments worldwide have subsidized manufacturers or consumers on the production or purchase of masks. However, the impacts of these subsidies on the mask supply chain (MSC) operations are unclear. Motivated by our interview with a mask manufacturer as well as the observed real-world practices, we establish consumer utility-based stylized models to analytically examine government subsidies and policies in the MSC. We utilize the infection transmission model to capture the social health risk during the COVID-19 outbreak. The government aims to maximize social welfare, which includes the manufacturer's profit, consumer surplus, social health risk, and government subsidy expenditure. Results indicate that when the price is not controlled (i.e., the manufacturer decides it), the manufacturer and consumer subsidy programs are equally efficient in enhancing consumer surplus as well as reducing harm to social health risk under COVID-19. Thus, the government can conduct a subsidy scheme that is easier to implement in practice. However, we surprisingly find that the government's excessive intervention will cause disequilibrium in the MSC. When the price or the manufacturer's dishonest behavior is fully controlled by the government, subsidizing the MSC is not always advisable. Besides, our findings are consistent with the public interest theory;that is, the proper implementation of dishonesty prevention and pricing control policies can improve social welfare but sacrifice consumer surplus. Our results contribute to healthcare operations management and generate managerial insights for MSC management during COVID-19 with industrial validation.

5.
Gene Rep ; 29: 101691, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2061188

ABSTRACT

Background: Recently, attention has been focused on mesenchymal stem cells (MSC) because of their unique ability to suppress inflammation induced by cytokine storms caused by COVID-19. Several patients have been successfully treated in this manner. After one year of treatment with Wharton's jelly-derived MSC injections, this study evaluated the safety and efficacy of injecting MSCs intravenously in patients with COVID-19. Methods: This study treated four patients with severe COVID-19 with Wharton's jelly-derived mesenchymal stem cells. In this study, patients were followed up for routine tests, tumor markers, and whole-body imaging (spiral neck CT scan (with contrast), spiral chest CT scan (with & without contrast), and spiral abdominopelvic CT scan (with IV & Oral contrast)) one year after cell therapy. Results: The results indicated that lymphocyte; lymph count significantly increased, and neutrophil, ESR, ferritin, and CRP significantly decreased. LDH showed a non-significant decrease (P-value<0.05). One year after the WJ-MSC injection, the tumor markers were normal, and no tumors were observed in patients after one year. Also, the CT scan result was normal. Conclusions: In patients, no serious complications were observed after a one-year follow-up. After monitoring the patient via laboratory tests, tumor markers, and whole-body imaging, we concluded that the Wharton jelly-derived mesenchymal stem cells did not cause severe complications, including tumor formation, in severe COVID19 patients within a year. More clinical trials with higher sample sizes need to be performed on cell therapy with Wharton jelly-derived mesenchymal stem cells in the future.

6.
Biomedical Engineering Applications for People with Disabilities and the Elderly in the COVID-19 Pandemic and Beyond ; : 105-108, 2022.
Article in English | Scopus | ID: covidwho-2060224

ABSTRACT

Graph theory is one of the most powerful tools from the field of mathematics to help model practical problems in real time, and provides surprising answers with its wonderful methods. In this chapter, the authors describe very precisely its role in understanding the spread of the COVID-19 virus, and the efforts taken throughout the world to identify, track, isolate, treat, and reduce the rate of propagation of the virus through a network setup. © 2022 Elsevier Inc. All rights reserved.

7.
Cells ; 11(14)2022 07 21.
Article in English | MEDLINE | ID: covidwho-2032863

ABSTRACT

Aplastic anemia (AA) is a rare and serious disorder of hematopoietic stem cells (HSCs) that results in the loss of blood cells due to the failure of the bone marrow (BM). Although BM transplantation is used to treat AA, its use is limited by donor availability. In this sense, mesenchymal stem cells (MSCs) can offer a novel therapeutic approach for AA. This is because the MSCs contribute to the hematopoietic niche organization through their repopulating. In our study, we used the human immature dental pulp stem cell (hIDPSC), an MSC-like cell, to explore an alternative therapeutic approach for AA. For this, isogenic C57BL/6 mice were exposed to total body irradiation (TBI) to induce the AA. After 48 h of TBI, the mice were intraperitoneally treated with hIDPSC. The immunohistochemistry analyses confirmed that the hIDPSCs migrated and grafted in the mouse bone marrow (BM) and spleen, providing rapid support to hematopoiesis recovery compared to the group exposed to radiation, but not to those treated with the cells as well as the hematological parameters. Six months after the last hIDPSC transplantation, the BM showed long-term stable hematopoiesis. Our data highlight the therapeutic plasticity and hematoprotective role of hIDPSC for AA and potentially for other hematopoietic failures.


Subject(s)
Anemia, Aplastic , Mesenchymal Stem Cells , Anemia, Aplastic/etiology , Anemia, Aplastic/therapy , Animals , Dental Pulp , Hematopoiesis , Humans , Mice , Mice, Inbred C57BL
8.
Infect Dis Model ; 7(4): 625-636, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2031321

ABSTRACT

Background: With the emergence of the COVID-19 pandemic, all existing health protocols were tested under the worst health crisis humanity has experienced since the Black Death in the 14th century. Countries in Latin America have been the epicenter of the COVID-19 pandemic, with more than 1.5 million people killed. Worldwide health measures have included quarantines, border closures, social distancing, and mask use, among others. In particular, Chile implemented total or partial quarantine measures depending on the number of infections in each region of the country. Therefore, it is necessary to study the effectiveness of these quarantines in relation to the public health measures implemented by government entities at the national level. Objective: The main objective of this study is to analyze the effectiveness of national- and region-level quarantines in Chile during the pandemic based on information published by the Chilean Ministry of Health, and answers to the following question are sought: Were quarantine measures in Chile effective during the COVID-19 pandemic? Methods: The causal effect between the rates of COVID-19 infections and the population rates in Phase 1 and Phase 2 quarantines in the period from March 2020 to March 2021 in different regions of Chile were evaluated using intervention analyses obtained through Bayesian structural time series models. In addition, the Kendall correlation coefficient obtained through the copula approach was used to evaluate the comovement between these rates. Results: In 75% of the Chilean regions under study (12 regions out of a total of 16), an effective Phase 1 quarantine, which was implemented to control and reduce the number of cases of COVID-19 infection, was observed. The main regions that experienced a decrease in cases were those located in the north and center of Chile. Regarding Phase 2, the COVID-19 pandemic was effectively managed in 31% (5 out of 16) of the regions. In the south-central and extreme southern regions of Chile, the effectiveness of these phases was null. Conclusion: The findings indicate that in the northern and central regions of Chile, the Phase 1 quarantine application period was an effective strategy to prevent an increase in COVID-19 infections. The same observation was made with respect to Phase 2, which was effective in five regions of northern Chile; in the rest of the regions, the effectiveness of these phases was weak or null.

9.
Stem Cells and COVID-19 ; : 95-109, 2022.
Article in English | Scopus | ID: covidwho-2027792

ABSTRACT

COVID-19 is a pandemic with well-defined immunopathological sequelae of events in its disease progression. Apart from antiinflammatory agents and biologicals, cellular therapy, particularly stem cells have become a therapeutic choice, with their role of immunomodulation on the innate and adaptive arms of the immune system. Relevant is their regulatory power over the immune microenvironment in the lungs—the prime target organ of COVID-19 associated infections. With this purview in mind, an attempt has been made in this chapter to summarize the major cellular sources of MSCs, their general and specific immune modulatory actions;furthermore hematopoietic stem cells as another cell source and finale the translational potential of stem cells in COVID-19 therapeutics. © 2022 Elsevier Inc. All rights reserved.

10.
Stem Cell Res Ther ; 13(1): 365, 2022 07 28.
Article in English | MEDLINE | ID: covidwho-2021331

ABSTRACT

BACKGROUND: High morbidity and mortality rates of the COVID-19 pandemic have made it a global health priority. Acute respiratory distress syndrome (ARDS) is one of the most important causes of death in COVID-19 patients. Mesenchymal stem cells have been the subject of many clinical trials for the treatment of ARDS because of their immunomodulatory, anti-inflammatory, and regenerative potentials. The aim of this phase I clinical trial was the safety assessment of allogeneic placenta-derived mesenchymal stem cells (PL-MSCs) intravenous injection in patients with ARDS induced by COVID-19. METHODS: We enrolled 20 patients suffering from ARDS caused by COVID-19 who had been admitted to the intensive care unit. PL-MSCs were isolated and propagated using a xeno-free/GMP compliant protocol. Each patient in the treatment group (N = 10) received standard treatment and a single dose of 1 × 106 cells/kg PL-MSCs intravenously. The control groups (N = 10) only received the standard treatment. Clinical signs and laboratory tests were evaluated in all participants at the baseline and during 28 days follow-ups. RESULTS: No adverse events were observed in the PL-MSC group. Mean length of hospitalization, serum oxygen saturation, and other clinical and laboratory parameters were not significantly different in the two groups (p > 0.05). CONCLUSION: Our results demonstrated that intravenous administration of PL-MSCs in patients with COVID-19 related ARDS is safe and feasible. Further studies whit higher cell doses and repeated injections are needed to evaluate the efficacy of this treatment modality. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT); IRCT20200621047859N4. Registered 1 March 2021, https://en.irct.ir/trial/52947 .


Subject(s)
COVID-19 , Hematopoietic Stem Cell Transplantation , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Respiratory Distress Syndrome , COVID-19/therapy , Humans , Iran , Mesenchymal Stem Cell Transplantation/adverse effects , Mesenchymal Stem Cell Transplantation/methods , Pandemics , Respiratory Distress Syndrome/therapy , SARS-CoV-2
11.
Journal of Environmental Chemical Engineering ; 10(4), 2022.
Article in English | Scopus | ID: covidwho-1945561

ABSTRACT

Advancements in polymer science and engineering have helped the scientific community to shift its attention towards the use of environmentally benign materials for reducing the environmental impact of conventional synthetic plastics. Biopolymers are environmentally benign, chemically versatile, sustainable, biocompatible, biodegradable, inherently functional, and ecofriendly materials that exhibit tremendous potential for a wide range of applications including food, electronics, agriculture, textile, biomedical, and cosmetics. This review also inspires the researchers toward more consumption of biopolymer-based composite materials as an alternative to synthetic composite materials. Herein, an overview of the latest knowledge of different natural- and synthetic-based biodegradable polymers and their fiber-reinforced composites is presented. The review discusses different degradation mechanisms of biopolymer-based composites as well as their sustainability aspects. This review also elucidates current challenges, future opportunities, and emerging applications of biopolymeric sustainable composites in numerous engineering fields. Finally, this review proposes biopolymeric sustainable materials as a propitious solution to the contemporary environmental crisis. © 2022 Elsevier Ltd.

12.
BIOMEDICAL RESEARCH AND THERAPY ; 9(5):5075-5083, 2022.
Article in English | Web of Science | ID: covidwho-1912288

ABSTRACT

Coronavirus disease 2019 (COVID-19) has caused nearly 15 million deaths worldwide. The rapid development of COVID-19 vaccines and anti-viral drugs significantly decreased the level of mortality related to COVID-19. However, post-COVID-19 pulmonary fibrosis has become a severe problem for some COVID-19 patients. The previous articles present the results of mesenchymal stem cell (MSC) transplantation to treat COVID-19 patients;in this article, we would like to discuss the potential of MSC transplantation to treat and improve post- COVID-19 pulmonary fibrosis. MSCs exhibit immune modulation and anti-inflammation that can control the inflammation caused by coronavirus 2 infection and the cytokine storm that some patients experience during COVID-19. The anti-fibrotic qualities of MSCs have also been demonstrated both in vitro and in vivo. Based on the current information about the anti-fibrotic effects of MSCs, MSC transplantation can be used to improve post-COVID-19 pulmonary fibrosis.

13.
Stem Cells Transl Med ; 11(7): 675-687, 2022 07 20.
Article in English | MEDLINE | ID: covidwho-1908958

ABSTRACT

BACKGROUND: Mesenchymal stromal cells (MSCs) may reduce mortality in patients with COVID-19; however, early evidence is based on few studies with marked interstudy heterogeneity. The second iteration of our living systematic review and meta-analysis evaluates a framework needed for synthesizing evidence from high-quality studies to accelerate consideration for approval. METHODS: A systematic search of the literature was conducted on November 15, 2021, to identify all English-language, full-text, and controlled clinical studies examining MSCs to treat COVID-19 (PROSPERO: CRD42021225431). FINDINGS: Eleven studies were identified (403 patients with severe and/or critical COVID-19, including 207 given MSCs and 196 controls). All 11 studies reported mortality and were pooled through random-effects meta-analysis. MSCs decreased relative risk of death at study endpoint (RR: 0.50 [95% CI, 0.34-0.75]) and RR of death at 28 days after treatment (0.19 [95% CI], 0.05-0.78) compared to controls. MSCs also decreased length of hospital stay (mean difference (MD: -3.97 days [95% CI, -6.09 to -1.85], n = 5 studies) and increased oxygenation levels at study endpoint compared to controls (MD: 105.62 mmHg O2 [95% CI, 73.9-137.3,], n = 3 studies). Only 2 of 11 studies reported on all International Society for Cellular Therapy (ISCT) criteria for MSC characterization. Included randomized controlled trials were found to have some concerns (n = 2) to low (n = 4) risk of bias (RoB), while all non-randomized studies were found to have moderate (n = 5) RoB. INTERPRETATION: Our updated living systematic review concludes that MSCs can likely reduce mortality in patients with severe or critical COVID-19. A master protocol based on our Faster Approval framework appears necessary to facilitate the more accelerated accumulation of high-quality evidence that would reduce RoB, improve consistency in product characterization, and standardize outcome reporting.


Subject(s)
COVID-19 , Mesenchymal Stem Cells , Bias , COVID-19/therapy , Humans , Lung , Randomized Controlled Trials as Topic
14.
Stem Cells Transl Med ; 11(7): 688-703, 2022 07 20.
Article in English | MEDLINE | ID: covidwho-1873996

ABSTRACT

MSC (a.k.a. mesenchymal stem cell or medicinal signaling cell) cell therapies show promise in decreasing mortality in acute respiratory distress syndrome (ARDS) and suggest benefits in treatment of COVID-19-related ARDS. We performed a meta-analysis of published trials assessing the efficacy and adverse events (AE) rates of MSC cell therapy in individuals hospitalized for COVID-19. Systematic searches were performed in multiple databases through November 3, 2021. Reports in all languages, including randomized clinical trials (RCTs), non-randomized interventional trials, and uncontrolled trials, were included. Random effects model was used to pool outcomes from RCTs and non-randomized interventional trials. Outcome measures included all-cause mortality, serious adverse events (SAEs), AEs, pulmonary function, laboratory, and imaging findings. A total of 736 patients were identified from 34 studies, which included 5 RCTs (n = 235), 7 non-randomized interventional trials (n = 370), and 22 uncontrolled comparative trials (n = 131). Patients aged on average 59.4 years and 32.2% were women. When compared with the control group, MSC cell therapy was associated with a reduction in all-cause mortality (RR = 0.54, 95% CI: 0.35-0.85, I  2 = 0.0%), reduction in SAEs (IRR = 0.36, 95% CI: 0.14-0.90, I  2 = 0.0%) and no significant difference in AE rate. A sub-group with pulmonary function studies suggested improvement in patients receiving MSC. These findings support the potential for MSC cell therapy to decrease all-cause mortality, reduce SAEs, and improve pulmonary function compared with conventional care. Large-scale double-blinded, well-powered RCTs should be conducted to further explore these results.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Aged , COVID-19/therapy , Cell- and Tissue-Based Therapy , Female , Humans , Male , Respiratory Distress Syndrome/therapy
16.
Ann Med Surg (Lond) ; 77: 103656, 2022 May.
Article in English | MEDLINE | ID: covidwho-1800210

ABSTRACT

Background: COVID-19 was initially detected in China's Wuhan, the capital of Hubei Province, in December 2019, and has since spread throughout the world, including Ethiopia. Long-term epidemics will overwhelm the capacity of hospitals and the health system as a whole, with dire consequences for the developing world's damaged health systems. Focusing on COVID-19-related activities while continuing to provide essential services such as emergency and essential surgical care is critical not only to maintaining public trust in the health system but also to reducing morbidity and mortality from other illnesses. The goal of this study was to see how COVID-19 affected essential and emergency surgical care in Gedeo and Sidama zone hospitals. Method: ology: A cross-sectional study was carried out in ten (10) hospitals in the Gedeo and Sidama zone. The information was gathered with the help of the world health organization (WHO) situational analysis tool for determining emergency and essential surgical care (EESC) capability. Infrastructure, human resources, interventions, and EESC equipment and supplies were used to assess the hospitals' capacity. Result: 54.3% of the 35 fundamental therapies indicated in the instrument were available before COVID-19 at all sites, while 25.2 percent were available after the COVID-19 pandemic. During the COVID-19 pandemic, there was a sharing of resources for treatment centers, such as a scarcity of oxygen and anesthesia machines, and emergency surgery was postponed. Before admission, the average distance traveled was 58 km. Conclusion: The COVID-19 pandemic, as well as existing disparities in infrastructure, human resources, service provision, and essential equipment and supplies, reveal significant gaps in hospitals' capacity to provide emergency and essential surgical services and effectively address the growing surgical burden of disease and injury in Gedeo and Sidama zone primary, general, and referral hospitals.

17.
Appl Mater Today ; 27: 101473, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1777973

ABSTRACT

The pandemic of the coronavirus disease 2019 (COVID-19) has made biotextiles, including face masks and protective clothing, quite familiar in our daily lives. Biotextiles are one broad category of textile products that are beyond our imagination. Currently, biotextiles have been routinely utilized in various biomedical fields, like daily protection, wound healing, tissue regeneration, drug delivery, and sensing, to improve the health and medical conditions of individuals. However, these biotextiles are commonly manufactured with fibers with diameters on the micrometer scale (> 10 µm). Recently, nanofibrous materials have aroused extensive attention in the fields of fiber science and textile engineering because the fibers with nanoscale diameters exhibited obviously superior performances, such as size and surface/interface effects as well as optical, electrical, mechanical, and biological properties, compared to microfibers. A combination of innovative electrospinning techniques and traditional textile-forming strategies opens a new window for the generation of nanofibrous biotextiles to renew and update traditional microfibrous biotextiles. In the last two decades, the conventional electrospinning device has been widely modified to generate nanofiber yarns (NYs) with the fiber diameters less than 1000 nm. The electrospun NYs can be further employed as the primary processing unit for manufacturing a new generation of nano-textiles using various textile-forming strategies. In this review, starting from the basic information of conventional electrospinning techniques, we summarize the innovative electrospinning strategies for NY fabrication and critically discuss their advantages and limitations. This review further covers the progress in the construction of electrospun NY-based nanotextiles and their recent applications in biomedical fields, mainly including surgical sutures, various scaffolds and implants for tissue engineering, smart wearable bioelectronics, and their current and potential applications in the COVID-19 pandemic. At the end, this review highlights and identifies the future needs and opportunities of electrospun NYs and NY-based nanotextiles for clinical use.

18.
Biomolecules ; 12(4)2022 03 31.
Article in English | MEDLINE | ID: covidwho-1776123

ABSTRACT

Intercellular communication between monocytes/macrophages and cells involved in tissue regeneration, such as mesenchymal stromal cells (MSCs) and primary tissue cells, is essential for tissue regeneration and recovery of homeostasis. Typically, in the final phase of the inflammation-resolving process, this intercellular communication drives an anti-inflammatory immunomodulatory response. To obtain a safe and effective treatment to counteract the cytokine storm associated with a disproportionate immune response to severe infections, including that associated with COVID-19, by means of naturally balanced immunomodulation, our group has standardized the production under GMP-like conditions of a secretome by coculture of macrophages and MSCs. To characterize this proteome, we determined the expression of molecules related to cellular immune response and tissue regeneration, as well as its possible toxicity and anti-inflammatory potency. The results show a specific molecular pattern of interaction between the two cell types studied, with an anti-inflammatory and regenerative profile. In addition, the secretome is not toxic by itself on human PBMC or on THP-1 monocytes and prevents lipopolysaccharide (LPS)-induced growth effects on those cell types. Finally, PRS CK STORM prevents LPS-induced TNF-A and IL-1Β secretion from PBMC and from THP-1 cells at the same level as hydrocortisone, demonstrating its anti-inflammatory potency.


Subject(s)
COVID-19 , Mesenchymal Stem Cells , Anti-Inflammatory Agents/metabolism , Anti-Inflammatory Agents/pharmacology , Coculture Techniques , Culture Media, Conditioned/pharmacology , Humans , Leukocytes, Mononuclear , Lipopolysaccharides/pharmacology , Monocytes
19.
Biomed Pharmacother ; 149: 112920, 2022 May.
Article in English | MEDLINE | ID: covidwho-1767922

ABSTRACT

Since the COVID-19 pandemic started, mesenchymal stromal cells (MSC) appeared as a therapeutic option to reduce the over-activated inflammatory response and promote recovery of lung damage. Most clinical studies use intravenous injection for MSC delivery, raising several concerns of thrombogenic risk due to MSC procoagulant activity (PCA) linked to the expression of tissue factor (TF/CD142). This is the first study that demonstrated procoagulant activity of TF+ human immature dental pulp stromal cells (hIDPSC, NestaCell® product) with the percentage of TF+ cells varied from 0.2% to 63.9% in plasma of healthy donors and COVID-19 heparin-treated patients. Thrombogenic risk of TF+ hIDPSCs was evaluated by rotational thromboelastometry (in vitro) and in critically ill COVID-19 patients (clinical trial). We showed that the thromboelastography is not enough to predict the risk of TF+ MSC therapies. Using TF-negative HUVEC cells, we demonstrated that TF is not a unique factor responsible for the cell's procoagulant activity. However, heparin treatment minimizes MSC procoagulant (in vitro). We also showed that the intravenous infusion of hIDPSCs with prophylactic enoxaparin administration in moderate to critically ill COVID-19 patients did not change the values of D-dimer, neither in the PT and PTT times. Our COVID-19 clinical study measured and selected the therapeutic cells with low TF (less than 25% of TF+ hIDPSCs). Our data indicate that the concomitant administration of enoxaparin and low TF-loaded is safe even for critically ill COVID-19 patients.


Subject(s)
COVID-19 , Thromboplastin , Cell- and Tissue-Based Therapy , Clinical Trials as Topic , Critical Illness , Enoxaparin/pharmacology , Enoxaparin/therapeutic use , Heparin , Humans , Pandemics , Thromboplastin/metabolism
20.
Stem Cell Res Ther ; 13(1): 124, 2022 03 24.
Article in English | MEDLINE | ID: covidwho-1759777

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread into more than 200 countries and infected approximately 203 million people globally. COVID-19 is associated with high mortality and morbidity in some patients, and this disease still does not have effective treatments with reproducibly appreciable outcomes. One of the leading complications associated with COVID-19 is acute respiratory distress syndrome (ARDS); this is an anti-viral host inflammatory response, and it is usually caused by a cytokine storm syndrome which may lead to multi-organ failure and death. Currently, COVID-19 patients are treated with approaches that mostly fall into two major categories: immunomodulators, which promote the body's fight against viruses efficiently, and antivirals, which slow or stop viruses from multiplying. These treatments include a variety of novel therapies that are currently being tested in clinical trials, including serum, IL-6 antibody, and remdesivir; however, the outcomes of these therapies are not consistently appreciable and remain a subject of debate. Mesenchymal stem/stromal cells (MSCs), the multipotent stem cells that have previously been used to treat viral infections and various respiratory diseases such as ARDS exhibit immunomodulatory properties and can ameliorate tissue damage. Given that SARS-CoV-2 targets the immune system and causes tissue damage, it is presumable that MSCs are being explored to treat COVID-19 patients. This review summarizes the potential mechanisms of action of MSC therapy, progress of MSC, and its related products in clinical trials for COVID-19 therapy based on the outcomes of these clinical studies.


Subject(s)
COVID-19 , Mesenchymal Stem Cells , Pneumonia , Respiratory Distress Syndrome , COVID-19/therapy , Humans , Mesenchymal Stem Cells/metabolism , SARS-CoV-2
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