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?:abstract
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Coronavirus disease 2019 (COVID-19), a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), is growing at an exponential rate worldwide Manifestations of this disease are heterogeneous;however, advanced cases often exhibit various acute respiratory distress syndrome-like symptoms, systemic inflammatory reactions, coagulopathy, and organ involvements A common theme in advanced COVID-19 is unrestrained immune activation, classically referred to as a \'cytokine storm\', as well as deficiencies in immune regulatory mechanisms such as T regulatory cells While mesenchymal stem cells (MSCs) themselves are objects of cytokine regulation, they can secrete cytokines to modulate immune cells by inducing anti-inflammatory regulatory Treg cells, macrophages and neutrophils;and by reducing the activation of T and B cells, dendritic and nature killer cells Consequently, they have therapeutic potential for treating severe cases of COVID-19 Here we discuss the unique ability of MSCs, to act as a \'living anti-inflammatory\', which can \'rebalance\' the cytokine/immune responses to restore equilibrium We also discuss current MSC trials and present different concepts for optimization of MSC therapy in patients with COVID-19 acute respiratory distress syndrome
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