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Microbioreactor-Based Production of Anchorage-Dependent Mesenchymal Stromal Cells Primed for Acute Respiratory Distress Syndrome
Published on: December 12, 2025
Mesenchymal stem cell therapy for acute respiratory distress syndrome: from basic to clinics
Hua Qin1, Andong Zhao2,3
1Research Center for Tissue Repair and Regeneration Affiliated to the Medical Innovation Research Department, PLA General Hospital and PLA Medical College, Beijing, 100853, China. qinh0116@126.com.
Abstract:
The 2019 novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has occurred in China and around the world. SARS-CoV-2-infected patients with severe pneumonia rapidly develop acute respiratory distress syndrome (ARDS) and die of multiple organ failure. Despite advances in supportive care approaches, ARDS is still associated with high mortality and morbidity. Mesenchymal stem cell (MSC)-based therapy may be an potential alternative strategy for treating ARDS by targeting the various pathophysiological events of ARDS. By releasing a variety of paracrine factors and extracellular vesicles, MSC can exert anti-inflammatory, anti-apoptotic, anti-microbial, and pro-angiogenic effects, promote bacterial and alveolar fluid clearance, disrupt the pulmonary endothelial and epithelial cell damage, eventually avoiding the lung and distal organ injuries to rescue patients with ARDS. An increasing number of experimental animal studies and early clinical studies verify the safety and efficacy of MSC therapy in ARDS. Since low cell engraftment and survival in lung limit MSC therapeutic potentials, several strategies have been developed to enhance their engraftment in the lung and their intrinsic, therapeutic properties. Here, we provide a comprehensive review of the mechanisms and optimization of MSC therapy in ARDS and highlighted the potentials and possible barriers of MSC therapy for COVID-19 patients with ARDS.
Insights
Mesenchymal stem cell (MSC) therapy shows promise for treating acute respiratory distress syndrome (ARDS) by reducing inflammation and organ damage. Optimization strategies are being explored to improve MSC efficacy for ARDS, including in COVID-19 patients.
Area of Science:
- Regenerative Medicine
- Pulmonology
- Infectious Diseases
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, often leading to acute respiratory distress syndrome (ARDS) with high mortality.
- Current supportive care for ARDS has limitations, necessitating novel therapeutic strategies.
- Mesenchymal stem cells (MSCs) offer potential therapeutic benefits for ARDS.
Purpose of the Study:
- To review the mechanisms of mesenchymal stem cell (MSC) therapy for acute respiratory distress syndrome (ARDS).
- To discuss strategies for optimizing MSC therapy to enhance engraftment and therapeutic properties in the lungs.
- To highlight the potential and challenges of MSC therapy for ARDS in COVID-19 patients.
Main Methods:
- Review of experimental animal and early clinical studies on MSC therapy for ARDS.
- Analysis of MSC mechanisms, including paracrine factor and extracellular vesicle release.
- Examination of strategies to improve MSC engraftment and function in the lung.
Main Results:
- MSCs exert anti-inflammatory, anti-apoptotic, anti-microbial, and pro-angiogenic effects.
- MSC therapy can promote clearance of bacteria and alveolar fluid, protecting lung and distal organs.
- Studies indicate the safety and efficacy of MSC therapy in ARDS models and early clinical trials.
Conclusions:
- MSC therapy is a potential alternative strategy for treating ARDS by addressing its complex pathophysiology.
- Optimizing MSC engraftment and function is crucial for maximizing therapeutic potential.
- MSC therapy holds promise for ARDS in COVID-19 patients, but further research and clinical trials are needed to overcome barriers.
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