Cellular therapies in Covid-19 patients

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The project for an anti-Covid-19 therapy based on stem cells that give rise to bone, skin and cartilage (mesenchymal) tissues is ready and presented to the Italian Medicines Agency (Aifa).

This was said by Massimo Dominici, director of the complex oncology structure of the hospital-university of Modena, during the hearing in the Chamber's Social Affairs Commission.

Dominici explained that they have developed, together with several Italian centers, an experiment to administer mesenchymal cells to Covid patients. The project is awaiting evaluation by AIFA.

It is a study that has never happened before in the world and it is also the first time that in Italy, Cell Factory structures from different centers come together for an alliance aimed at curing Covid pathology.

In addition to the University of Modena, the multicenter study project includes cell therapy centers in Milan, Monza, Mario Negri and the University of Florence.

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Mesenchymal stem cells present in many tissues, from muscles to bones, are isolated with relatively simple technologies, amplified in the laboratory and, thanks to their plasticity, they are able to produce different types of effects: anticoagulants, antimicrobials, anticancer and in general they are able to restore a pathological to physiological environment.

These faculties become useful to stem the body's violent response to the virus that leads to the destruction of lung tissue: they soothe inflammation and regenerate damage.

Adult mother cells are used in the COVID-19 convalescent patient, in whom the presence of fibrotic inflammatory lesions was verified, hospitalized as serious and critical, who had presented acute respiratory symptoms.

Covid patients will be selected on the basis of eligibility and randomly divided into two groups: some will receive mesenchymal and others the standard of care.

Periodic assessments will be made to evaluate the safety, feasibility and effectiveness of the treatment. In Italy, compared to research on cell therapies, there are difficulties in creating a system and transferring the results within the National Health System.
Creating an Italian Cell Factory network can be a strategic goal for the country, as well as raising awareness of the therapeutic possibilities of this type of research, which is much closer to clinical use than you can imagine.

Stem cell powder

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Another technique developed and patented by the University of Pavia could be the solution to reduce the harmful effects on the lungs caused by the COVID-19 infection.

It is a stem cell powder called secretome obtained from a cocktail of lipids, genetic material, proteins and other cell structures derived from mesenchymal cells.

In preclinical tests, this material would have important anti-inflammatory, antifibrotic and regenerative effects, intervening in an essential way in the restoration of patients' respiratory functions.
Dr. Luisa Torre, coordinator of the project and head of the Cell Delivery System Lab of the University of Pavia, said that the secretome studied is produced by mesenchymal stem cells found in various tissues, including the marrow, fatty tissues, umbilical cord and also placenta obtained from derivatives of mesenchymal organs.

These cells can have a therapeutic effect and a regenerative function on the respiratory system affected by COVID-19 precisely through the mix of substances they produce.

The Italian Pneumology Society with StemNet, federation of stem cell research associations, and the Italian Mesenchymal Stem Group (GISIM) during the annual congress, organized this time in digital form, said that the secretome could also be produced in the laboratory in absence of cells, in such a way as to transform it into lyophilized powder and packaged as a drug in solution for injection.

By doing so, it would be possible to produce the product on a large scale and make it available at costs comparable to traditional biological drugs, so as not to create disparities in access to care.

Transplant on a child with leukemia and positive to Covid-19

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Meanwhile, from the Bambino Gesù Hospital in Rome they let it be known that a 6-year-old boy suffering from acute lymphoblastic leukemia underwent a bone marrow transplant after a treatment with hyperimmune plasma obtained from a person recovered from the viral infection.

The boy, from an Italian family living in London, had a positive test in Sars-Cov-2 with the whole family in March.

The treatment with hyperimmune plasma made him negative, then the transplantation of hematopoietic stem cells taken from his father, who in the meantime had also recovered from the virus.

On 29 May, the child's stem cells are infused at the site of the Bambino Gesù of the Janiculum, specially manipulated to eliminate the alpha/beta + T lymphocytes, cells dangerous for the recipient's organism.
This is the technique developed by the team of Dr. Franco Locatelli, director of the Department of Onco-hematology and Cellular and Gene Therapy and developed in the Holy See Pediatric Hospital with the largest case studies in the world (about 700 parent transplants performed to date) on children with leukemia and blood cancers.

The child is now in excellent general condition, has had no post-transplant complications, dad's cells are multiplying and he is moving towards complete recovery. He will undergo normal post-transplantation checks.

With the cell manipulation methods currently available, the percentage of healing with bone marrow transplantation by one of the parents is comparable to that obtained using a perfectly suitable donor.

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