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World J Transplant. Aug 18, 2021; 11(8): 344-355
Published online Aug 18, 2021. doi: 10.5500/wjt.v11.i8.344
May mesenchymal stem cell transplantation be a solution for COVID-19 induced cytokine storm?
Hüseyin Sütlüoğlu, Öner Özdemir
Hüseyin Sütlüoğlu, Faculty of Medicine, Sakarya University, Adapazarı 54100, Sakarya, Turkey
Öner Özdemir, Division of Pediatric Allergy and Immunology, Sakarya University Medical Faculty, Adapazarı 54100, Sakarya, Turkey
Author contributions: Sütlüoğlu H performed the writing, created the figures and tables; Özdemir Ö designed the outline, and coordinated the writing of the paper.
Conflict-of-interest statement: The authors declare no conflict of interest regarding the publication of this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Öner Özdemir, MD, Full Professor, Division of Pediatric Allergy and Immunology, Sakarya University Medical Faculty, Adnan Menderes Cad., Adapazarı 54100, Sakarya, Turkey. ozdemir_oner@hotmail.com
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: May 5, 2021
Revised: June 16, 2021
Accepted: August 10, 2021
Article in press: August 10, 2021
Published online: August 18, 2021
Processing time: 171 Days and 3.4 Hours
Abstract

The recently emergent disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmitted by droplets and aerosols, was named coronavirus disease 2019 (COVID-19) by World Health Organization. Predominantly, the disease progress is asymptomatic or mild, but one-fifth of the patients advance to severe or critical illness. In severe COVID-19 patients, type-2 T helper cells release numerous cytokines; this excessive immune response is named as cytokine storm. The cytokine storm, which is the hallmark of the COVID-19 induced by the disease and aggravates due to lack of proper immune response, similar to SARS and Middle East respiratory syndrome (MERS), and the disease status may progress forward to acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome, multi-organ dysfunction syndrome, and death. Mesenchymal stromal cell transplantation is up-and-coming in treating many diseases such as HIV, hepatitis B, influenza, coronavirus diseases (SARS, MERS), lung injuries, and ARDS. Upon closer inspection on respiratory diseases, COVID-19, influenza, SARS, and MERS have similarities in pathogenesis, especially cytokine and immune response profiles. These comparable features in terms of the cytokine storm will provide hints for the treatment of COVID-19.

Keywords: Mesenchymal stem cell; Mesenchymal stromal cell; COVID-19; Cytokine storm; Immunosuppression; Transplantation

Core Tip: Upon closer inspection on respiratory diseases, coronavirus disease 2019 (COVID-19), influenza, severe acute respiratory syndrome, and Middle East respiratory syndrome have similarities in pathogenesis, especially cytokine and immune response profiles. These comparable features in terms of the cytokine storm will provide hints for the treatment of COVID-19. Transplantation of mesenchymal stromal cells provides tissue regeneration and rejuvenation with immunotolerant and immunomodulant properties on damaged tissues by exerting their effects through immune cells.