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Body recovery after coronavirus
COVID-19 exhausts the body. The lungs and the immune system are affected after the disease. Stem cells accelerate tissue regeneration and help restore strength.
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Exhaustion after the coronavirus needs rehabilitation!
Many people lose their ability to work after COVID-19. Constant fatigue and exhaustion is a real threat to your health. In this case, you should see a doctor.
Roman Sulik, MD, coordinator of cell therapy programs, neurologist of the highest qualification category
Rehabilitation after COVID-19
Temporary disability, general exhaustion, structural changes in lung tissue, nervous system damage — this is a non-exhaustive list of all complications after COVID-19.In the absence of the body's potential for rapid regeneration, the consequences for the patient's health may remain for life. Scientists from around the world are working to find effective methods of treatment and recovery after infection.Cell therapy is one of the methods that has proven its effectiveness in COVID-19.
The use of mesenchymal stem cells from adipose tissue or umbilical cord helps the body restore the immune system's cells and regenerate the affected lung tissue. Cellular therapy using mesenchymal stem cells from adipose tissue (MSCs of adipose tissue) promotes tissue regeneration and better functioning of internal organs and systems, thereby restoring beauty, strength, and energy.And the use of stem cells derived from the neural crest (NCSC from the hair follicle) fights the effects of damage to the nervous system.
For whom is cell therapy?
Indications:
This treatment is indicated for patients who had moderate to severe coronavirus disease.
Contraindications:
● oncological diseases or their presence in the anamnesis for the last five years;● pregnancy;● psychiatric disorders;● alcohol and drug addiction.
How does cell therapy affect the body?
The use of mesenchymal stem cells has a positive effect on the condition of patients with COVID-19 and helps them to recover faster. Properties of MSCs that ensure their effectiveness in recovery after infection:
● Immunomodulatory propertiesMSCs are able to suppress an over-activated immune system, which is necessary in severe and critically severe cases of coronavirus infection when acute respiratory distress syndrome (ARDS) due to uncontrolled secretion of inflammatory cytokines develops;
● Anti-apoptotic propertiesMSCs are able to protect the epithelial cells of the lungs and other organs from death (apoptosis), as they secrete a number of growth factors. MSCs produce keratinocyte growth factor (KGF), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and TGF-β1, etc., which protect the cells of the alveolar epithelium of the lungs from death. The protective effect of MSCs has also been shown in cardiac ischemia and nervous disorders;
● MSC regeneration potentialRespiratory diseases require not only the elimination of the virus, but also the restoration of damaged tissues. MSCs secrete soluble factors which can promote epithelial and endothelial regeneration, increase the alveolar clitoris, regulate the permeability of the epithelium and endothelium of the lungs and reduce inflammation in patients with affected lungs. Keratinocyte growth factor and hepatocyte growth factor secreted by MSCs have shown beneficial effects on emphysema and pulmonary fibrosis in the acute lung injury (ALI) model.
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The use of stem cells to treat COVID-19
Learn more about the use of stem cells in the fight against coronavirus.The use of mesenchymal stem cells in coronavirus infection is potentially possible for four groups of patients:
1. Elderly patients or patients with chronic diseases (diabetes, asthma, cardiovascular diseases) with suspected SARS-CoV-2 infection.
Preventive use of MSCs when SARS-CoV-2 infection is suspected. In such patients, the regenerative potential of the body is significantly reduced, and the immune system is weakened, so in case of infection, complications may occur in the form of acute respiratory distress syndrome, pulmonary fibrosis, and multiple damages to organs and tissues. Therefore, the use of MSCs as a preventive therapy will help activate the body's internal potential to fight infection.
2. Patients in serious and critical condition.
4. Patients with the so-called long COVID-19.
Patients who have overcome a coronavirus infection but have complex post-infectious symptoms. Postcovid syndrome is characterized by such persistent symptoms as:
● shortness of breath;
● fatigue;
● intermittent heartbeat;
● gastrointestinal problems;
● pain in muscles and joints.
Some patients develop irreversible cardiovascular and respiratory diseases. Between 60% and 80% of patients with COVID-19 experience symptoms of varying severity. Therefore, it is essential to pay attention not only to the treatment of COVID-19 but also to the rehabilitation after the illness.
The most common lung problem after a coronavirus infection, which can be fatal, is pulmonary fibrosis, i.e., the sites of lung damage do not regenerate, epithelial cells do not regenerate but overgrow with connective tissue. Thus, the lungs are unable to provide 100% oxygen to the body. There have been several cases where patients who have relapsed with COVID-19 have undergone lung transplantation, with pulmonary fibrosis being severe.
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COVID-19 rehabilitation:scientific evidence
Clinical trials of MSCs in the treatment of coronavirus infection.
A total of 88 studies have been reported to investigate the safety and efficiency of stem cell transplantation or stem cell-derived exosomes in cases of patients with COVID-19. COVID-19 cases with severe/critical pneumonia, respiratory failure, acute respiratory distress syndrome, and pulmonary fibrosis are studied. The vast majority of these clinical trials (63 of 88) examine the stem cell therapy for safety, feasibility, tolerance, and severe side effects (19 studies for phase 1, 24 for phase 1 /2, and 20 for phase 3).
Few clinical trials progressed after phase 2 (3.4%), only 2 trials in phase 2/3, and only 1 trial in phase 3. The most common sources of MSCs were the umbilical cord/Wharton's jelly (32 out of 88), followed by bone marrow (15 out of 88), adipose tissue (12 out of 88), the dental pulp (3 out of 88), placenta (2 out of 88), and menstrual blood (1 of 88). In 14 studies, the source of the MSC was unclear. Interestingly, in 2 studies MSCs derived from human embryonic stem cells (hES-M) were used (ChiCTR2000031139, NCT04331613). Given the limited proliferation potential of adult MSCs, extracellular vesicles derived from MSCs (MSC-EV) were also used as an alternative in 4 studies. The cell dose and the proposed schemes also differed greatly among the studies. Although the dosage of MSC infusion ranged between 0.5 × 106 and 10 × 106 cells/kg, the most commonly used infusion dose was 1 × 106 cells/kg.
Details:Li Z., et al. Stem cell therapy for COVID‐19, ARDS and pulmonary fibrosis // Cell Proliferation. - 24 oct, 2020. https://doi.org/10.1111/cpr.12939Improved immunity in patients with COVID-19 after MSC infusion
The first study on the use of MSCs in the treatment of COVID-19, conducted by Dr. Zhao (ChiCTR2000029990), showed that intravenous injection of human mesenchymal stem cells (MSCs) to 7 patients with COVID-19 resulted in improved functional outcomes and easier recovery. In this study, 7 registered patients (1 critical illness, 4 severe diseases, 2 moderate) received intravenous infusions of MSCs. 14 days after MSC injection, the functional outcomes of all 7 patients significantly improved without any side effects.
After the treatment, the number of lymphocytes increased, C-reactive protein decreased, and overactive cytokine-secreting immune cells disappeared after 3-6 days.
Another retrospective study evaluated the treatment efficiency and side effects of MSC therapy in severe COVID-19 cases. A total of 25 patients were enrolled according to their inclusion/exclusion criteria. A total of 7 patients received 1 round, 7 patients received 2 rounds, and 11 patients received 3 rounds of MSC therapy. After MSC therapy, 16 patients (64%) showed improvement in CT of the chest, and all patients showed clinical improvement. No deaths occurred during hospitalization. However, significant changes in inflammation, IgG, and IgM were not detected, and the level of lactate (LAC), cardiac troponin T (cTnT), and creatine kinase MB (CK-MB) in serum were significantly increased after MSC therapy, indicating a slight improvement in the immune system and some cardiotoxicity after MSC therapy.
Full article you can find here:Leng Z, Zhu R, Hou W, et al. Transplantation of ACE2(‐) mesenchymal stem cells improves the outcome of patients with COVID‐19 Pneumonia. Aging Dis, 2020, 11:216‐228. http://www.aginganddisease.org/EN/10.14336/AD.2020.0228Recovery of patients treated with stem cells was faster
Recovery of patients treated with stem cells was faster.More than 80% of the group of patients with stem cell treatment recovered in less than a month. More than half of them recovered so much two weeks after treatment that they could be discharged from the hospital. The percentage of healthy people in the placebo group was 37%.Levels of inflammatory markers and cytokines (GM-CSF, IFNg, IL-5, IL-6, IL-7, TNFa, TNFb, PDGF-BB, and RANTES) decreased significantly in patients after 6 days of infusion of the drug with umbilical cord MSC.
Full article you can find here:https://stemcellsjournals.onlinelibrary.wiley.com/doi/10.1002/sctm.20-0472 Diabetes Research Institute and Cell Transplant Center at the University of MiamiTreatment of severe COVID-19 with infusions of MSC of the umbilical cord
Shu et al. reported that UC-MSC infusion was effective and safe for the treatment of severe COVID-19 cases (ChiCTR2000031494). In this study, 12 patients with severe COVID-19 received intravenous infusions of UC-MSC. The results showed that the 28-day mortality rate was zero in the UC-MSC treatment group, while the mortality rate was 10.34% in the control group.
After MSC transplantation, the time before clinical improvement was shorter than in the control group. The UC-MSC infusion improved clinical symptoms, including weakness and fatigue, shortness of breath, and low oxygen saturation. UC-MSC reduced the level of inflammation of CRP and IL-6 and accelerated the recovery of lymphocytes and shortened the regeneration period of the affected lungs. Intravenous injection of UC-MSC proved to be a safe and effective treatment option for severe COVID — 19 cases.
Full article you can find here:Shu L, Niu C, Li R, et al. Treatment of severe COVID‐19 with human umbilical cord mesenchymal stem cells. Stem Cell Res Ther. 2020;11:361https://pubmed.ncbi.nlm.nih.gov/32811531/Decreased levels of proinflammatory IL-6 in patients with moderate to severe COVID-19 due to infusions of umbilical cord MSCs
Wang et al. reported phase 1 clinical trial of UC-MSC for COVID-19 (NCT04288102). 100 patients with COVID-19 with moderate to severe lung disease received 3 rounds of intravenous infusion of UC-MSC (3 × 107 cells per infusion) at 0.3 and 0.6 per day, respectively. No serious infusion-related side effects were observed. In the most severe cases, the PaO2 / FiO2 ratio improved after the UC-MSC treatment.
In the UC-MSC treatment group, 2 moderate patients and 2 severe patients with high initial IL-6 levels had a decrease in IL-6 for 3 days after the UC-MSC infusion and remained stable for the next 4 days. Chest CT showed that lung damage in patients receiving the UC-MSC infusions was well controlled for 6 days and completely disappeared within 2 weeks after the UC-MSC infusion. In the control group, 1 severe patient still had obvious pulmonary lesions at the site of discharge.
Full article you can find here:Meng F, Xu R, Wang S, et al. Human umbilical cord‐derived mesenchymal stem cell therapy in patients with COVID‐19: a phase 1 clinical trial. Signal Transduct Target Therap.2020;5:172.https://www.nature.com/articles/s41392-020-00286-5Treatment of severe COVID-19 with infusions of MSCs of adipose tissue
Sanchez-Guijo et al. reported an adipose tissue MSC study (AD-MSC) to treat patients with severe pneumonia associated with COVID-19 (NCT04348461). Patients received intravenous injections of AD-MSC. No side effects related to cell therapy were observed. Clinical improvement was observed in 9 patients (69.2%), 7 patients were extubated and discharged from intensive care, and 4 patients remained intubated. Injection of AD-MSC decreased the level of inflammatory markers of C-reactive protein, IL-6, ferritin, LDH, and D-dimer and increased the number of lymphocytes.
Full article you can find here:Sánchez‐Guijo F, Garcia‐Arranz M, Lopez‐Parra M, et al. Adipose‐derived mesenchymal stromal cells for the treatment of patients with severe SARS‐CoV‐2 pneumonia requiring mechanical ventilation. A proof of concept study. EClinicalMedicine. 2020;25(100454). https://doi.org/10.1016/j.eclinm.2020.100454Exosomal therapy for severe COVID-19
Sengupta and others reported that exosomes (ExoFloTM) derived from BM-MSC can be useful in severe COVID-19 cases. In this study, 24 PCR-positive patients on SARS-CoV-2 received a single 15 ml intravenous dose of ExoFlo derived from allogeneic BM-MSC. No side effects were observed for 72 hours after using ExoFlo. 83% of patients survived and 71% of patients recovered. Moreover, the clinical status of patients and the oxygenation index improved after a single treatment.
Meanwhile, there was a decrease in the absolute number of neutrophils and an increase in the absolute number of lymphocytes. Similarly, ExoFlo reduced such inflammatory markers as C-reactive protein, ferritin, and D-dimer. This study demonstrated that only a single intravenous dose of BM-MSC-derived exosomes can effectively and safely treat patients with severe COVID-19. Indirectly, the clinical success of MSC-derived exosomes also proves the idea that MSCs are likely to treat COVID-19 lung diseases through paracrine and secretory mechanisms.
Full article you can find here:Sengupta V, Sengupta S, Lazo A, Woods P, Nolan A, Bremer N. Exosomes derived from bone marrow mesenchymal stem cells as treatment for severe COVID‐19. Stem Cells Dev. 2020;29:747‐754.
https://doi.org/10.1089/scd.2020.0080
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The treatment process
1. Online consultation
Contact our managers. At this step, we gather your medical information and confirm the diagnosis. After that, we'll arrange a free online or offline consultation with a doctor.
2. Consultation with a doctor
A personal consultation with a doctor is an excellent opportunity for you to find out all details of the program and get an individual prognosis. All the medical information you provide will be carefully reviewed so that you get the most effective treatment. The procedures take place in our clinical institutions in Kyiv, Ukraine.
The course of the treatment is developed individually and lasts between 1 and 7 days.3. Assessment
During the checkup, the doctor assesses your readiness for cell therapy. If the assessment is positive, biological materials are taken. Depending on your doctor's recommendations, you may be prescribed your own* or donor stem cells.
* If you are prescribed the treatment with your own cells, you will have an ear punch biopsy performed under anesthesia in an operating room. The procedure lasts for 15 minutes. The punch depth is up to 4 mm, and the diameter is up to 3 mm.4. Preparation of the stem cell product
OWN CELLSAfter the biomaterials are collected, our team of biotechnologists will prepare a therapeutic dose of stem cells. In our laboratory, we will select stem cells from your sample, grow the required number of cells, test them, then create a stem cell product for your treatment. Usually, the production takes up to 21 days.
DONOR CELLSAccording to the doctor's prescription, the biotechnologist will select a ready-made and pre-tested sample of donor cells from our cryobank in the required quantity. In this case, cell injection can happen immediately after diagnosis and drug preparation.5. Start of treatment
Any course of treatment has to include preliminary diagnosis, analysis, and examination (ultrasound of the thyroid gland, ultrasound of the pelvis, abdominal ultrasound, ECG, diagnosis of affected target organs, and all the tests and screenings prescribed to you).
6. Medical preparation
Based on the diagnostic results, the doctor will prescribe metabolic therapy to improve the functioning of the affected tissues, also will prepare you for cell therapy.
7. Injection of the cellular product, the regeneration phase
Intravenous injection is usually prescribed. The number of injections will depend on the degree of morbidity: usually from 1 to 3 injections.
8. Medical report
At the end of the course, you will be provided with a medical report, including the diagnosis, the results of the diagnostic (clinical, laboratory, and instrumental), course of treatment, and recommendations. Your doctor will examine you, perform an analysis, and provide recommendations for maintaining and improving your condition. Your personal manager will stay in touch with you to monitor the implementation of the doctor's advice, record the positive dynamics, and coordinate your recovery.
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Do you have any questions left?
Please contact us, our managers are always ready to answer your questions. Consultation by phone is completely free and does not oblige you to anything.We will be happy to provide you with comprehensive information so that you could make the right choice!