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Shafeghat Z, Dorfaki M, Dehrouyeh S, Arab FL, Roozbehani M, Falak R, Faraji F, Jafari R. Mesenchymal stem cell-derived exosomes for managing graft-versus-host disease: An updated view. Transpl Immunol 2023; 81:101957. [PMID: 37935319 DOI: 10.1016/j.trim.2023.101957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
Graft-versus-host disease (GvHD) is the most common complication after stem cell transplantation, and also it is one of the primary limiting factors for the use of hematopoietic stem cell transplantation (HSCT) in the treatment of hematologic cancers. GvHD, a systemic inflammatory disease, is caused by donor T cells recognizing the recipient's foreign antigens. In addition, an immune dysregulation, caused by autoreactive immune cells, complicates potent inflammatory process following HSCT. While there is no one approved treatment method for GvHD, corticosteroids are the most common first-line treatment. Exosomes are biological vesicles between 30 and 120 nm in diameter, which carry various biologically active molecules. They are known to play a key role in the paracrine effect of mesenchymal stem cells with therapeutic and tissue repair effects, including an immunosuppressive potential. Exosomes are unable to replicate themselves but because of their small size and fluid-like structure, they can pass through physiological barriers. Exosome are relatively easy to prepare and they can be quickly sterilized by a filtration process. Administration of exosomes, derived from mesenchymal stem cells, effectively reduced GvHD symptoms and significantly increased HSCT recipients' survival. Mesenchymal stem cell-derived exosome therapy reduced clinical symptoms of GvHD in patients after HSCT. Studies in patients with GvHD described that that mesenchymal stem cell-derived exosomes inhibited the release of IFN-γ and TNF-α by activated natural killer (NK cells), thereby reducing the lethal function of NK cells and inflammatory responses. Current review provides a comprehensive overview about the use of mesenchymal stem cells and their derived exosomes for the treatment of GvHD.
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Affiliation(s)
- Zahra Shafeghat
- Department of Immunology, School of medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Dorfaki
- Department of Microbiology and Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Shiva Dehrouyeh
- Department of Immunology, School of medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fahime Lavi Arab
- Department of Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Roozbehani
- Vaccine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Faraji
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| | - Reza Jafari
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran.
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Seganfredo FB, Dias AR, Santos PR, Rebelo M, João C, Mendes D, Carmo E. Successful treatment of persistent and severe SARS-CoV-2 infection in a high-risk chronic lymphocytic leukemia patient using Ronapreve™ antibodies. Clin Case Rep 2022; 10:e6548. [PMID: 36408087 PMCID: PMC9666912 DOI: 10.1002/ccr3.6548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/17/2022] Open
Abstract
Patients with lymphoproliferative diseases are at an increased risk of an incomplete immune response following vaccination or SARS-CoV-2 infection and might develop persistent viral infection and severe COVID-19 disease. We present a case of successful treatment of persistent and mechanical-ventilation-requiring SARS-CoV-2 infection in a del17+ CLL patient using exogenous antibodies.
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Affiliation(s)
- Fernanda Braga Seganfredo
- Haematology DepartmentInstituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG)LisbonPortugal
| | - Ana Raquel Dias
- Haematology DepartmentHospital do Divino Espírito Santo de Ponta DelgadaPonta DelgadaPortugal
| | - Pedro R. Santos
- Intensive Care UnitCentro Hospitalar Lisboa Ocidental – Hospital Egas MonizLisbonPortugal
| | - Marta Rebelo
- Intensive Care UnitCentro Hospitalar Lisboa Ocidental – Hospital Egas MonizLisbonPortugal
| | - Cristina João
- Haematology DepartmentFundação ChampalimaudLisbonPortugal
| | - Dina Mendes
- Pharmaceutical DepartmentCentro Hospitalar Lisboa Ocidental – Hospital Egas MonizLisbonPortugal
| | - Eduarda Carmo
- Intensive Care UnitCentro Hospitalar Lisboa Ocidental – Hospital Egas MonizLisbonPortugal
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Visco V, Lippi ME, Salerno G, Licata MAVAC, de Dominicis C, Antolino G, La Verde G, Santino I, Simmaco M, Sciacchitano S. Challenges in Diagnosis and Clinical Management of COVID-19 in Patient with B-Cell Chronic Lymphocytic Leukemia (CLL): Report of One Case. Hematol Rep 2022; 14:31-37. [PMID: 35323177 PMCID: PMC8950198 DOI: 10.3390/hematolrep14010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/03/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
We report here a case of a patient affected by B-cell chronic lymphocytic leukemia (CLL) that developed COVID-19 during the actual SARS-CoV-2 outbreak. The coexistence of CLL and COVID-19 raises many questions regarding the possible increased risk of developing COVID-19 among patients with CLL, the problems in managing therapies for both diseases and, above all, the difficulties in diagnosing COVID-19 in patients affected by CLL. In our patient, an 84-year-old man, the recognition of COVID-19 was delayed because of its atypical clinical presentation and technical problems related to the methods used for the diagnosis. Based on the symptoms and the radiological aspect of the lung, the occurrence of COVID-19 was suspected. Repeated tests on oro/nasopharyngeal swabs gave negative results, causing a delay in the diagnosis. Moreover, different methods used to identify the SARS-CoV-2 antibodies in serum gave conflicting results, and only two tests were able to identify SARS-CoV-2 Abs of the IgG type. During the clinical course of unrecognized COVID-19, our patient developed severe complications and did not receive any specific treatment for the two diseases. Recognition of COVID-19 in patients with CLL is a challenging task and the most accurate methods are necessary to overcome the diagnostic difficulties encountered.
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Affiliation(s)
- Vincenzo Visco
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.S.); (G.A.); (G.L.V.); (S.S.)
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
- Correspondence: ; Tel.: +39-06-33776771
| | | | - Gerardo Salerno
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.S.); (G.A.); (G.L.V.); (S.S.)
| | - Maria Angela Vittoria A. C. Licata
- Pulmonary Diseases Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy;
| | - Chiara de Dominicis
- Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Giusy Antolino
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.S.); (G.A.); (G.L.V.); (S.S.)
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
| | - Giacinto La Verde
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.S.); (G.A.); (G.L.V.); (S.S.)
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
| | - Iolanda Santino
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), “Sapienza” University of Rome, 00185 Rome, Italy
| | - Maurizio Simmaco
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), “Sapienza” University of Rome, 00185 Rome, Italy
| | - Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (G.S.); (G.A.); (G.L.V.); (S.S.)
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (I.S.); (M.S.)
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, 00166 Rome, Italy
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