Page 90 - Mesenchymal Stem cells, Exosomes and vitamins in the fight aginst COVID

Intravascular Mesenchymal Stem Cells to Treat Organ Failure and Possible Application in COVID-19

Improvement in LVEF at 4 and Improvement in ventricular function. MSC infusion during No change in LVEF, systolic and diastolic volumes, as well as which are RCTs, have assessed the
York Heart Association Functional Classification; LVEDD, left ventricular end-diastolic diameter; PCI, percutaneous coronary intervention; BNP, B-type natriuretic peptide; IL-6, interleukin-6;
At least 52 studies, many of
PCT, prospective controlled trial; BM MNC, bone marrow mononuclear cells; BM MSC, bone marrow mesenchymal stem cells; UC MSC, umbilical cord mesenchymal stem cells; PAS, passage;
ability of intravascular stem cells
to treat heart failure of ischemic
and nonischemic etiology . These
studies have been summarized in
Findings No change. 12 months. CABG. infarct size. Table 2. Studies that injected stem
cells into the cardiac muscle were
excluded. Ischemic heart disease
Follow- Up was addressed in most studies;
however, heart failure and dilated
24
12
12
6
cardiomyopathy was treated in 6
and 5 studies, respectively. Carotid
LVEF Impact No Yes - improvement Not assessed No sinus infusion was used in one study
and IV infusion in 2 studies with
intracoronary in the rest. In 3 trials,
MSC infusion was performed into
Outcome No Yes Yes No the grafts during coronary artery
bypass grafting (CABG) surgery
(48-52). Thirty-nine of the 52 tri-
Condition IHD IHD IHD IHD als used autologous bone marrow
mononuclear cells. Twenty-nine of
these 39 studies showed beneficial
effects. Seven studies utilized ex-
Delivery Method CABG SVF, stromal vascular fraction; UNK, unknown; IC, intracardiac injection; CS, coronary sinus; CABG, coronary artery bypass grafting; IV, intravenous injection; IHD, ischemic heart disease; DCM, dilated cardiomyopathy; HF, heart failure; LVEF, left ventricular ejection fraction; LVEDV, left ventricular end-diastolic volume; EDV, end-diastolic volume; ESV, end-systolic volume; NYHA, New TNF-α, tumor necrosis factor-alpha
one of these trials used allogeneic
IC
IC
IC
expanded bone marrow MSCs and
Type of Stem Cell BM MNC BM MSC [?Pas#] BM MNC BM MNC the rest were autologous. Positive
outcomes were noted in all but 1 of
these 7 trials. Umbilical cord MSCs
Number of 150 million 70 million 130 million 100 million concentrate using bedside devices
were used in 4 studies, bone marrow
were used in 2 studies, both bone
SCs
marrow MNC and expanded bone
Table 2 con't. MSC therapy studies treating cardiac failure.
marrow stem cells were used in 2
BMA (mL) 100 20–25 60 100 studies, and all these trials reported
statistically significant favorable

dices in the treatment cohort when
No. of Patients in Treatment Group stem cells; NA, not available; Allo, allogeneic; BMC, bone marrow concentrate; E/e, heart failure ratio. outcomes in various measured in-
compared with controls. Most stud-
66
79
24
14
ies enhanced left ventricular ejec-
tion fraction (LVEF) and a few also
Type of Study RCT Controlled trial RCT RCT improved ventricular remodeling
parameters, such as left ventricular
end diastolic and systolic volumes.
Year 2018 2018 2018 2018 Although not observed in all stud-
ies, many studies showed improved
death/hospitalization/myocardial
Author Traverse et al, Circ Res 2018; 122:479-488 Kim et al, Cardiovasc Drugs Ther 2018; 32:329-338 Qi et al, J Clin Ultrasound 2018; 46:512-518 Nicalau et al, J Cardiothoracic Vasc Anesth 2018; 41:392-399 reinfarction rates and New York
Heart Association scores (Table 2). In
3 trials, MSC infusion into the grafts
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