COVID-19 Inflammatory Diversity: Could MSC-derived Exosomes Solve This Mystery?

 The coronavirus disease-19 (COVID-19) pandemic has caused the world unspeakable harm. Given how quickly the pandemic has spread, it is crucial to think of a variety of treatment alternatives in order to successfully treat people worldwide. Since the immune system is the focal point of the infection, it is crucial to control the dynamic equilibrium in order to avoid exaggerated immunological responses that ultimately cause harm to several organs. 



In the last ten years, there has been a significant increase in the use of stem cells for medical purposes. Mesenchymal stem cells (MSCs) and exosomes isolated from MSCs (MSC-Exo) have been made available to the world as potential therapeutics for a wide range of ailments as a result of scientifically ground-breaking methods. Patients with COVID-19 may benefit from using MSCs and MSC-Exos as a therapy to regulate their immune systems because they have immunomodulatory properties. 


MSC-Exosomes and Immunomodulation

It is now recognised that MSCs produce therapeutic properties via a paracrine pathway by releasing bioactive molecules known as secretomes. MSC-secretomes are composed of soluble proteins such as cytokines, chemokines, growth factors, and extracellular vesicles (EVs), which include micro-vesicles and exosomes. These secretomes are released by stem cells through shared secretory pathways. When the culture media or secretome is administered to the patients, the molecules are absorbed by nearby cells via paracrine signalling. Exosomes contain a variety of bioactive chemicals, including microRNAs (miRNA), transfer RNAs (tRNA), growth factors, proteins, and lipids.


When molecules in the secretome are internalised, surrounding cells affect a variety of downstream pathways, including immunomodulation, apoptotic suppression, fibrosis prevention, and tissue remodelling. MSC-Exos have the ability to suppress CD4+, CD8+, and NK cells. They suppressed inflammation by inhibiting T cells that express IL-17 and inducing IL-10-expressing regulatory cells. 


How does exosome help Covid-19 patients?

Multiple organ damage has been observed in COVID-19-affected patients. Stem cell derived-exosome is known to reduce lung injury in asthmatic and ARDS models. MSC-Exos may potentially be effective in the treatment of cardiovascular and renal problems. As a result, they can be primarily used to treat organ damage linked with COVID-19.


Furthermore, these exosomes contain adhesion molecules that direct them to the damaged site. Exosomes may be chosen over MSCs because they may easily penetrate the blood-brain barrier, are affordable, and cannot undertake autonomous self-renewal, hence avoiding negative implications such as tumour formation. MSC-Exos may be a good treatment option in this pandemic condition to relieve the effects of SARS-CoV-2 infection.



Future Prospects

Of late, exosome therapy has been gaining momentum in various Covid-19 related studies and has shown remarkable improvement in reducing ARDS in a number of patients. COVID-19 has enraged people all over the world. The unending rise in infection and death has put a stop to the lives of citizens all across the world. As a result, it is critical to identify fresh therapy platforms and productive approaches as soon as possible. The medicines developed must be easily replicable and widely available in order to provide enough bioactive molecules to all individuals who have succumbed to COVID-19. Individuals with COVID-19 potentially benefit from the immunomodulatory effects of MSCs and MSC-Exos. Because the healing effects of MSCs can be attributable mostly to secretomes or exosomes, utilising them may be more successful than employing MSCs alone. 

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