Studies Explore Stem Cell Treatments for COVID-19

On April 5th, the US Food and Drug Administration approved mesenchymal stem cell (MSC) treatments for use in the very sickest COVID-19 patients under what’s known as expanded access compassionate use.

Many stem cell clinical studies are rapidly being organized or already being conducted in the hopes of controlling the mortality associated with this pandemic. The rationale for using MSCs in COVID patients is that MSCs may help to combat what is called a “cytokine storm”. Cytokines are small proteins released by immune cells to help us fight disease. Cytokines beneficially orchestrate a patient’s immune system to mount an attack toward threatening foreign invaders. But if levels of these proteins (cytokines) surge out of control, they can cause the immune system to go into overdrive which then causes a severe inflammatory reaction causing the patient’s own tissues and organs to be damaged, often fatally. This cytokine storm is the process that occurs in patients with acute respiratory distress syndrome (ARDS). ARDS is a common manifestation of cytokine stroms and is the cause of death in many COVID-19 patients. 

To give background on the therapeutic cells being used, MSCs are multipotent stem cells found in various tissues of the body including bone marrow, placenta, fat, reproductive organs and umbilical cord tissue. These MSCs are reported to have anti-inflammatory and immunomodulatory abilities. MSCs are a living, regenerative medicine which are isolated from a donor’s tissue, expanded in a controlled ladratory then infused into patients as experimental treatments for a number of different diseases. For example, successful trials examining the use of MSCs for graft versus host disease have occured in patients who have undergone bone marrow transplats and suffered from a cytokine storm. This is the same as the cytokine stom, which is causing ARDS, in very ill COVID patients.

New York’s Mount Sinai had previously treated 12 seriously ill COVID patients, who were on ventilators, with an allogeneic stem cell therapy. Ten of the patients were able to come off the ventilators and recovered. This small study yielded positive results and has prompted a larger study. 

Mount Sinai will soon serve as the clinical center for a randomized, controlled clinical trial evaluating the therapeutic benefit and safety of the same allogeneic stem cell therapy in 240 patients with COVID-related ARDS in the United States and Canada. The trial will be conducted as a public-private partnership between the Cardiothoracic Surgical Trials Network and Mesoblast, the manufacturer of the cells.

The therapy being tested and Mount Sinai consists of Mesoblast’s mesenchymal stem cells originating from donor bone marrow. The interest is to test the anti-inflammatory, immunomodulating and tissue repair benefits of these cells in COVID patients suffering from ARDS.

Although larger, controlled trials are needed to confirm the initial studies, the promising outcome of using MSCs in this novel illness only emphasizes the numerous conditions that stem cells may be of benefit in treating in the not too distant future. 

– Dr. Shelly Zacharias, DVM, MS, VPM, BCMAS

COVID- 19 Resources:

• CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html
• NIH: https://www.nih.gov/health-information/coronavirus
• WHO: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

COVID- 19 Veterinary Resources:

• AVMA: https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19
• OIE: https://www.oie.int/