COVID-19 Tedavisinde Mezenkimal Kök Hücrelerin Potansiyel Kullanımı Üzerine Kapsamlı Bir İnceleme

Year 2021, Volume: 4 Issue: 3, 31 - 65, 31.12.2021

Tugce Kurt , Isa Sevinc , Feyza Uysal , Elif Demiray , Hilal Yılmaz , Yavuz Emre Arslan

https://doi.org/10.54537/tusebdergisi.983736

Abstract

İlk olarak Çin’in Wuhan kentinde tespit edildiği düşünülen yeni tip koronavirüs (SARS-CoV-2), raporlandığı ilk vakadan bu yana kısa süre içinde tüm dünyayı etkisi altına alarak bir salgına dönüşmüştür. Virüs, COVID-19 adı verilen bulaşıcı bir hastalığa neden olarak 150 milyondan fazla kişiyi etkilemiştir. Ayrıca yoğun virüs yükü ile enfekte olmuş bireylerde oluşan sitokin fırtınasının hastalarda akut solunum yolu bozukluğu (ARDS), pulmoner fibrozis ve hatta çoklu organ yetmezliği gibi durumlara neden olabildiği görülmüştür. Yapılan in vitro ve preklinik çalışmalarda mezenkimal kök hücrelerin (MKH) rejeneratif özelliklerinin yanında anti-enflamatuar ve immünmodülatör etkilerinin olduğu belirlenmiştir. Bu nedenle bilim insanları, rejeneratif bir umut olarak COVID-19 tedavisinde konvansiyonel ilaç veya plazma temelli tedavilere alternatif olarak MKH’leri kullanmayı önermektedir. Böylece hastalarda yoğun ilaç kullanımına bağlı yan etkilerin görülmeden MKH terapisi ile immünmodülasyon ve anti-enflamatuar etkilerin sağlanabileceği ve ARDS, pulmoner fibrosiz, sepsis ve çoklu organ yetmezliği gibi olumsuz senaryoların önüne geçileceği düşünülmektedir. Ayrıca MKH'lerin rejenerasyon özelliği sayesinde hasarlı doku tamirinin de sağlanabileceği öngörülmektedir. Ancak klinik uygulamalardaki tedavinin başarısı ve hasta güvenliği için yapılacak detaylı çalışmalarla COVID-19 tedavisi için MKH uygulamalarının standardize edilmesi gerekmektedir. Bu derlemede temel olarak COVID-19 tedavisi için yapılan MKH uygulamaları incelenmiştir. Metin içerisinde sırasıyla SARS-CoV-2 ve COVID-19 hastalığı kısaca açıklandıktan sonra yapılan aşı çalışmaları ile enfeksiyon sonrası uygulanan terapiler özetlenerek COVID-19 tedavisi için geliştirilen ve umut vaat eden MKH uygulamaları, MKH'lerin tedavideki rolü, hareket mekanizması, uygulama güvenliği ve etik konusu tartışılmıştır.

Keywords

SARS-CoV-2, COVID-19, Mezenkimal kök hücre (MKH), İmmünomodulasyon, Anti-enflamatuar

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