Since the beginning of March 2020, Indonesia has continued its fight against the COVID-19 pandemic, and until now there is no sign that the pandemic will end, but it even gets worse. In August 7, 2020, COVID-19 cases in Indonesia surpassed China and set a new record with a total of 121,226 cases, 5,593 deaths, and 77,557 recover patients.
Various efforts and interventions have been carried out by the government to reduce the increasing cases, such as the implementation of large-scale social restrictions (PSBB), appeals to stay at home, tightening 3M health protocols (washing hands, keeping safe distance, and wearing masks), and increasing the capacity of testing for COVID-19 every day. However, this strategy is still considered to be less than optimal as proven by the increasing number of daily cases, even the addition of positive cases has skyrocketed and set a new record with more than 6000 cases per day.
In addition to efforts to flatten the virus transmission curve, new strategies in the treatment of infected patients are needed to reduce the number of deaths. Although until now there is no standard therapy or definitive cure for COVID-19, one promising alternative is mesenchymal stem cells (MSC). MSC has the potential to be used as a therapeutic modality because MSC has several mechanisms of action such as anti-apoptosis, anti-inflammatory, antibacterial, antiviral, and the most unique is its ability to improve lung function.
As an anti-apoptosis, MSC secretes various types of cytokines and growth factors. For its anti-inflammatory activity, MSC will stimulate paracrine factors and modulate the balance of pro and anti-inflammatory cytokine production. In addition, MSC directly increases bacterial eradication. Regarding COVID-19 infection, MSC will increase the activation of genes with antiviral role and interact with the immune system to increase viral clearance. The interesting thing about MSC that others do not have is its ability to improve lung function in COVID-19 patients with acute respiratory distress syndrome (ARDS). MSC functions to reduce leaky pulmonary capillaries and increase the cleansing of lung fluids, which in turn improves lung function.
Despite the common use of stem cells, studies have shown that MSC have easy accessibility and the ability to remain in injured lung tissue. Furthermore, several studies have shown that MSC can be administered to COVID-19 patients with severe ARDS. Current clinical trials show that MSC is an alternative to suppress cytokine storms and help regulate the immune system. This study summarizes the general functions of MSC and highlights its therapeutic assets to help contain the pandemic. Further research on MSC-based therapy in ARDS is urgently needed, including investigations for its safety.
Author: Hanik Badriyah Hidayati
Details of the article can be viewed on:
Hanik Badriyah Hidayati. 2020. A current update in COVID-19 associated acute respiratory distress syndrome: focus on mesenchymal stem cell therapy. Journal of Anesthesia, Pain, and Intensive Care. Vol 24 Issue 6.