In celebration of British Science Week 2021 Dr Jonathan Kay, Anthony Nolan’s Science Communications Manager, looks at the possibility of using a type of cell found in cord blood to treat COVID-19. He also highlights how these cells could possibly be used to treat other conditions in the future and how Anthony Nolan is helping with this important research.
Although the range of approved coronavirus vaccines provide the best chance of overcoming the current global pandemic, many people who develop COVID-19 symptoms will still need treatment in the coming months, and possibly years.
Due to the rapid spread of COVID-19, it has been almost impossible to develop new and specific treatments for the condition. Instead, attention has focused on repurposing existing treatments that have already been shown to be safe. These include anti-viral drugs that destroy the virus, steroids and other agents that prevent the immune system overreacting, and therapies that promote tissue regrowth and repair.
While this is possible using conventional drugs, another way to achieve these outcomes is to use cell therapies, where living cells from a volunteer donor are given as treatment. This takes advantage of the donated cell’s natural function by using them to target the effects of COVID-19. One of the most promising cell types for this treatment are mesenchymal stem cells (MSCs).
Anthony Nolan is supporting this work with our world-leading Cell & Gene Therapy Services helping to provide cells for research and development, including cell therapies for COVID-19.
What are MSCs and why are they so important?
MSCs are a type of stem cell found in our bone marrow that have the potential to develop into a wide range of cells including bone, cartilage, muscle and fat cells. They are similar to haematopoietic stem cells which make our blood cells and are also found in bone marrow.
MSCs can detect and move towards sites of injury within the body, where they stimulate the growth and repair of other tissues through the release of specific signalling molecules. They can also help to keep our immune system balanced by sending negative signals to a wide range of white blood cells.
MSCs have also been shown to be ‘immuno-privileged’ which means they are not detected by the host’s immune system following administration and so avoid rejection. All these factors combined suggest they could be the perfect candidate for cell-based therapies that target COVID-19, where 90% of all deaths are from acute respiratory distress syndrome (ARDS) caused by damage to lung tissue.
Where do we get MSCs from?
It’s possible to collect MSCs from a variety of sources including amniotic fluid that surrounds babies in the womb and cord blood – something we help provide through the Anthony Nolan cord blood bank, if and when collected cords aren’t suitable for transplant. Although it’s impractical to collect enough MSCs in this way to develop cell therapies on a large enough scale to treat patients effectively, cells from these sources are perfect for the research and development stage
There is also ongoing research into developing cell culturing techniques that allow collected MSCs to be grown in a laboratory. The challenge in this process comes from the fact it’s difficult to maintain these cells outside the body while keeping them in their stem cell state – they will very easily develop into other cell types without very careful monitoring of their surroundings. Our immunotherapy research group is currently looking at the growth conditions and cell signals needed to achieve this consistently.
MSC clinical trials for COVID-19
The first trial that used MSCs to treat COVID-19 took place in China and involved ten patients. The early results were very promising with patients generally recovering quicker and showing fewer symptoms compared to those who were given standard treatments.
Other promising results have also been reported. A recent study in the US showed that 91% of COVID-19 patients who received two infusions of MSCs derived from cord blood were still alive one month after treatment. This increased to all patients when only those under 85 years old were considered. In comparison, only 42% of patients receiving standard treatments were still alive at the same time point.
According to clinicaltrials.gov, there are over 200 planned clinical trials involving MSC based cell therapies for treating COVID-19 worldwide, with over 170 of them actively recruiting patients. This includes a cord derived MSC based cell treatment for ARDS and COVID-19 being developed by the Irish biotech firm Orbsen Therapeutics. Their promising therapy is now entering its phase 2b/3 clinical trial.
We look forward to hearing positive results from this trial and others that will validate MSCs as a suitable COVID-19 therapy.
What does the future hold for MSC based cell therapy?
The combined advantages of being accessible from donated cord blood, suitability for transplantation and ability to be grown on a large scale means we are probably only at the very beginning of a revolution in MSC based cell therapies. Their natural ability to stimulate tissue repair and control the immune system gives them the potential to treat a wide range of conditions including auto-immune diseases, certain forms of diabetes and graft vs host disease (GvHD). By altering their DNA, in a similar way to how we create CAR T-cells, it could even be possible to enhance their ability to detect and destroy cancer cells.
The scientific community is also exploring the clinical benefits of the small cellular vesicles called exosomes that are released by MSCs. These tiny ‘bubbles’ contain lots of signalling molecules that are used to communicate with and control other cells in the body. This raises the possibility of manufacturing them within the laboratory so they can be used on a large scale to treat thousands of patients.
How is Anthony Nolan helping with this research?
Through the Anthony Nolan Cell & Gene Therapy Services, ethically approved research projects can request donated cells from our cohort of volunteer research donors, or if the cord blood cells stored in our cord bank are not suitable for transplant, they can also be used to develop new cell-based therapies.
We are currently supporting the research of various academic institutions and biotech companies, including our recently announced natural killer (NK) cell therapy collaboration with ONK Therapeutics. We hope to be able to share more information about these exciting research projects very soon
More information about the research underway at Anthony Nolan to improve all aspects of the stem cell transplant journey is available on our website.