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Cell therapy in patients with COVID-19 using Wharton’s jelly mesenchymal stem cells: a phase 1 clinical trial

Mahshid SalehDepartment of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, IranAmir Abbas VaeziDepartment of Internal Medicine, Alborz University of Medical Sciences, Karaj, IranRasoul AliannejadAdvanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, IranAmir Ali SohrabpourAssociate Professor of Gastroenterology and Hepatology, Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, IranSeyedeh Zahra Fotook KiaeiAdvanced Thoracic Research Centre, Tehran University of Medical Science, Tehran, IranMahdi ShadnoushDepartment of Clinical Nutrition, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IranVahid SiavashiDepartment of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, IranLeila AghaghazviniAssociate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranBatoul KhoundabiIran Helal Institute of Applied-Science and Technology, Research Center for Health Management in Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, IranShahriyar AbdoliPasteur Institute of Iran, National Cell Bank of Iran, Tehran, IranBahram ChahardouliHematology, Oncology, and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IranIman SeyhounDepartment of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. [email protected]Neda AlijaniDepartment of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. [email protected]Javad VerdiDepartment of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. [email protected]

2021en

ABI

Annotatsiya

BACKGROUND: Mesenchymal stem cells (MSCs) have received particular attention because of their ability to modulate the immune system and inhibit inflammation caused by cytokine storms due to SARS-CoV-2. New alternative therapies may reduce mortality rates in patients with COVID19. This study aimed to assess the safety and efficacy of injecting intravenous Wharton's jelly-derived MSCs in patients with COVID-19 as a treatment. METHODS: In this study, five patients with severe COVID-19 were treated with Wharton's jelly-derived mesenchymal stem cells (150 × 106 cells per injection). These patients were subject to three intravenous injections 3 days apart, and monitoring was done on days 0, 3, 6, and 14 in routine tests, inflammatory cytokines, and flow cytometry of CD4 and CD8 markers. A lung CT scan was performed on base and days 14 and 28. In addition, IgM and IgG antibodies against SARS-CoV-2 were measured before and after treatment. RESULTS: The results showed that IL-10 and SDF-1 increased after cell therapy, but VEGF, TGF-β, IFN-γ, IL-6, and TNFα decreased. Routine hematology tests, myocardial enzyme tests, biochemical tests, and inflammation tests were performed for all patients before and after cell therapy on base and days 3, 6, and 14, which indicated the improvement of test results over time. COVID-19 antibody tests rose in 14 days after WJ-MSC injection. The total score of zonal involvement in both lungs was improved. CONCLUSIONS: In patients, the trend of tests was generally improving, and we experienced a reduction in inflammation. No serious complications were observed in patients except the headache in one of them, which was resolved without medication. In this study, we found that patients with severe COVID-19 in the inflammatory phase respond better to cell therapy. More extensive clinical trials should be performed in this regard. TRIAL REGISTRATION: IRCT, IRCT20190717044241N2 . Registered April 22, 2020.

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DOI: 10.1186/s13287-021-02483-7

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