One of the main causes of acute respiratory distress syndrome in coronavirus disease 2019 (COVID-19) is cytokine storm, although the exact cause is still unknown. Umbilical cord mesenchymal stromal cells (UC-MSCs) influence proinflammatory T-helper 2 (Th 2 ) cells to shift to an anti-inflammatory agent. To investigate efficacy of UC-MSC administration as adjuvant therapy in critically ill patients with COVID-19, we conducted a double-blind, multicentered, randomized controlled trial at four COVID-19 referral hospitals in Jakarta, Indonesia. This study included 40 randomly allocated critically ill patients with COVID-19; 20 patients received an intravenous infusion of 1 Â 10 6 /kg body weight UC-MSCs in 100 ml saline (0.9%) solution (SS) and 20 patients received 100 ml 0.9% SS as the control group. All patients received standard therapy. The primary outcome was measured by survival rate and/or length of ventilator usage. The secondary outcome was measured by clinical and laboratory improvement, with serious adverse events. Our study showed the survival rate in the UC-MSCs group was 2.5 times higher than that in the control group (P = .047), which is 10 patients and 4 patients in the UC-MSCs and control groups, respectively. In patients with comorbidities, UC-MSC administration increased the survival rate by 4.5 times compared with controls. The length of stay in the intensive care unit and ventilator usage were not statistically significant, and no adverse events were reported. The application of infusion UC-MSCs significantly decreased interleukin 6 in the recovered patients (P = .023). Therefore, application of intravenous UC-MSCs as adjuvant treatment for critically ill patients with COVID-19 increases the survival rate by modulating the immune system toward an antiinflammatory state.

BackgroundThe treatment of congenital pseudoarthrosis of the tibia (CPT) remains challenging in pediatric orthopedics due to the difficulties in bone union, continuous angulation, joint stiffness, and severe limb length discrepancy. Mesenchymal stem cells (MSCs) therapy offers a complementary approach to improve the conventional surgical treatments. Although the autologous MSC treatment shows a promising strategy to promote bone healing in CPT patients, the quality of MSCs from CPT patients has not been well studied. The purpose of this study is to investigate the quality of MSCs isolated from patients with CPT.MethodsThe bone marrow-derived MSCs from the fracture site and iliac crest of six CPT patients were isolated and compared. The cumulative population doubling level (cPDL), phenotype characteristics, and trilineage differentiation potency were observed to assess the quality of both MSCs.ResultsThere were no significant differences of the MSCs derived from the fracture site and the MSCs from the iliac crest of the subjects, in terms of cPDL, phenotype characteristics, and trilineage differentiation potency (all p > 0.05). However, MSCs from the fracture site had a higher senescence tendency than those from the iliac crest.ConclusionMSC quality is not the main reason for delayed bone regeneration in those with CPT. Thus, autologous MSC is a promising source for treating CPT patients

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To compare the viability and characteristics of umbilical cord mesenchymal stromal cells (UC-MSCs) when they were kept in culture in three types of αMEM after confluence for various time points. Viability and characteristic assessments were done after keeping UC-MSC confluent cultures for 0, 24, 48, 72, and 96hours in αMEM with glutamax (Himedia), and without glutamax (Himedia or Gibco).There were thirty cultures, which each ten of them were kept in the three types of basal media, and for each time point and type of basal medium, two flasks were harvested. All viability and characteristic assessments were done after harvest. Viability assessments were done in duplicate, while characteristics assessment by flowcytometry for CD73, CD90 and CD105 were done only once.Further, differences between the various time points in terms of viability and CD73, CD90 and CD105 percentage after various time points were compared and tested by appropriate statistical analysis. Viability was >70% upto 72 hours and 48 hours when the cells were kept in Himediaglutamax containing αMEM and αMEM without glutamax respectively. Flow cytometry showed that CD73, CD90 and CD negative percentage did not differ to initial percentage, but after 24 hours CD105 was slightly decreased to > 60% in Himediaglutamax containing αMEM, while in the two αMEM media without glutamaxthe percentages were below 40%. For our UC-MSC culture, glutamax containing αMEM is better compared to αMEM without glutamax as temporary storage solution, and storage should be restricted to 24 hours.

Background : Severe burns are among the commonly occurring trauma with lethal outcome. One of the important aspects of severe burn therapy is to quickly achieve wound healing. Previous reports indicated that mesenchymal stem cells (MSCs) therapy contributes in facilitating better wound healing. In this report, we investigated the effects of MSCs derived from human bone marrow and umbilical cord on wound healing in patients with severe burns and its mechanism. Method : We performed human bone marrow and human umbilical cord MSCs therapy on 3 severe burns patients. Two of the patients had inadequate donor to close raw surface with skin graft, whilst one patient had infected chronic burn wound which have failed to epithelialize despite repeated attempts of skin graft and wound care. Result : We observed that MSCs therapy significantly accelerated wound healing. The effects after MSCs migrated into wound were decreased infiltration of inflammatory cells and faster epithelialization. Conclusion : This study suggests that MSCs therapy has positive effects in improving wound healing in severe burns patients. Data provided by this research may serve as theoretical basis for further study of MSCs application in burn wound therapy.