Potential application of mesenchymal stromal cells as a new therapeutic approach in acute respiratory distress syndrome and pulmonary fibrosis

Giulia Gazzaniga*, Marta Voltini, Alessandro Carletti, Elisa Lenta, Federica Meloni, Domenica Federica Briganti, Maria Antonietta Avanzini, Patrizia Comoli, Mirko Belliato

*Corresponding author for this work

Research output: Contribution to journalComment/Letter to the editorAcademicpeer-review

Abstract

While the COVID-19 outbreak and its complications are still under investigation, post-inflammatory pulmonary fibrosis (PF) has already been described as a long-term sequela of acute respiratory distress syndrome (ARDS) secondary to SARS-CoV2 infection. However, therapeutical strategies for patients with ARDS and PF are still limited and do not significantly extend lifespan. So far, lung transplantation remains the only definitive treatment for end-stage PF. Over the last years, numerous preclinical and clinical studies have shown that allogeneic mesenchymal stromal cells (MSCs) might represent a promising therapeutical approach in several lung disorders, and their potential for ARDS treatment and PF prevention has been investigated during the COVID-19 pandemic. From April 2020 to April 2022, we treated six adult patients with moderate COVID-19-related ARDS in a late proliferative stage with up to two same-dose infusions of third-party allogeneic bone marrow-derived MSCs (BM-MSCs), administered intravenously 15 days apart. No major adverse events were registered. Four patients completed the treatment and reached ICU discharge, while two received only one dose of MSCs due to multiorgan dysfunction syndrome (MODS) and subsequent death. All four survivors showed improved gas exchanges (PaO2/FiO2 ratio > 200), contrary to the others. Furthermore, LDH trends after MSCs significantly differed between survivors and the deceased. Although further investigations and shared protocols are still needed, the safety of MSC therapy has been recurrently shown, and its potential in treating ARDS and preventing PF might represent a new therapeutic strategy.
Original languageEnglish
Article number170
Number of pages6
JournalRespiratory Research
Volume25
Issue number1
DOIs
Publication statusPublished - 18 Apr 2024

Keywords

  • Acute respiratory distress syndrome
  • ARDS
  • Pulmonary fibrosis
  • Mesenchymal stromal cells
  • COVID-19

Fingerprint

Dive into the research topics of 'Potential application of mesenchymal stromal cells as a new therapeutic approach in acute respiratory distress syndrome and pulmonary fibrosis'. Together they form a unique fingerprint.

Cite this