间充质干细胞治疗人感染H7N9禽流感病毒所致急性呼吸窘迫综合征的临床研究——为新冠病毒肺炎救治提供新策略

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2013年,H7N9病毒在哺乳动物宿主之间迅速传播,并具有人与人之间传播的风险.患者表现为重症肺炎、急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)和呼吸衰竭.间充质干细胞(mesenchymal stem cell,MSC)移植在病毒性肺炎的治疗中有广阔的前景,并于2013年作为应急性治疗方法来治疗H7N9感染的ARDS.该研究在单中心开展,为开放式临床研究.根据自愿和知情同意的原则,17例H7N9感染的ARDS患者移植同种异体经血来源的MSC作为治疗组,44例H7N9感染的ARDS患者作为对照组.与对照组相比,MSC移植显著降低了ARDS病死率(MSC治疗组和对照组死亡率分别为17.6%和54.5%).此外,在对4名MSC移植患者进行为期5年的随访中,未发现MSC移植产生有害影响.总体而言,该研究结果表明MSC移植显著提高了H7N9感染的ARDS的存活率,并为开展临床前和临床应用MSC治疗H7N9感染的ARDS的研究提供了理论基础.由于H7N9和新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)临床表现相似(如ARDS和呼吸衰竭),并继发多器官功能障碍,因此基于MSC的疗法可能为COVID-19所致的ARDS患者获益.“,”H7N9 viruses quickly spread between mammalian hosts and carry the risk of human-to-human transmis-sion, 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 H7N9-induced 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, com-pared 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.
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