Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
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DOI：
10.1016/j.eng.2020.02.006
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发表时间：
2020-10-01
期刊：
影响因子：
12.8
通讯作者：
Li, Lanjuan
中科院分区：
文献类型：
--
作者：
Chen, Jiajia;Hu, Chenxia;Li, Lanjuan
H7N9病毒在哺乳动物宿主之间迅速传播，并具有人际传播的风险，如2013年爆发所示。急性呼吸窘迫综合征（ARDS）、肺衰竭和急性肺炎是H7N9患者的主要肺部疾病。间充质干细胞（MSC）移植是治疗病毒诱导的肺炎的一种有希望的选择，并在2013年用于治疗H7N9诱导的ARDS。通过开放标签临床试验，在单个中心将MSC移植到患有H7N9诱导的ARDS的患者中。根据自愿和知情同意原则，选择44例H7N9致ARDS患者作为对照组，17例H7N9致ARDS患者作为实验组，采用同种异体自体血来源的MSCs进行治疗。值得注意的是，与对照组相比，MSC移植显著降低了实验组的死亡率（实验组死亡率为17.6%，而对照组死亡率为54.5%）。此外，MSC移植没有对四名参与五年随访期的患者的身体产生有害影响。综上所述，MSCs能显著提高H7N9诱导的ARDS的存活率，为临床前研究和临床研究H7N9诱导的ARDS的治疗提供了理论依据。由于H7N9和2019年冠状病毒病（COVID-19）具有相似的并发症（例如，急性呼吸窘迫综合征和肺衰竭）和相应的多器官功能障碍，基于MSC的治疗可能是治疗COVID-19的一种可能的替代方案。(c)2020年的走廊。由爱思唯尔有限公司代表中国工程院和高等教育出版社有限公司出版。这是一个在CC BY许可证下的开放获取文章（http：//creativecommons.org/licenses/by/4.0/）。
H7N9 viruses quickly spread between mammalian hosts and carry the risk of human-to-human transmission, as shown by the 2013 outbreak. Acute respiratory distress syndrome (ARDS), lung failure, and acute pneumonia are major lung diseases in H7N9 patients. Transplantation of mesenchymal stem cells (MSCs) is a promising choice for treating virus-induced pneumonia, and was used to treat H7N9-induced ARDS in 2013. The transplant of MSCs into patients with H7N9-induced ARDS was conducted at a single center through an open-label clinical trial. Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs. It was notable that MSC transplantation significantly lowered the mortality of the experimental group, compared with the control group (17.6% died in the experimental group while 54.5% died in the control group). Furthermore, MSC transplantation did not result in harmful effects in the bodies of four of the patients who were part of the five-year follow-up period. Collectively, these results suggest that MSCs significantly improve the survival rate of H7N9-induced ARDS and provide a theoretical basis for the treatment of H7N9-induced ARDS in both preclinical research and clinical studies. Because H7N9 and the coronavirus disease 2019 (COVID-19) share similar complications (e.g., ARDS and lung failure) and corresponding multi-organ dysfunction, MSC-based therapy could be a possible alternative for treating COVID-19. (c) 2020 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).