The Effect of Mesenchymal Stromal Cells on the Mortality of Patients with Sepsis and Septic Shock: A Promising Therapy

间充质干细胞对脓毒症和脓毒性休克患者死亡率的影响:一种有前景的疗法

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Abstract

PURPOSE: Sepsis and septic shock are the major causes of death in intensive care units. This study aimed to evaluate the clinical safety and efficacy of mesenchymal stem cells (MSCs) in sepsis and septic shock patients. METHODS: Ten patients were enrolled in the study. Adipose-derived MSC infusions were given (1 × 10(6)/kg, on the 1(st), 3(rd), 5(th), 7(th), and 9(th) days of therapy) together with standard therapy. Before the MSC applications, blood samples were collected for cytokine assessment (TNF-α, IFN-γ, IL-2, IL-4, IL-6, IL-10). The clinical and laboratory improvements were recorded and compared with control groups selected retrospectively. The clinical trial was registered on 16.03.2022 with the registration number NCT05283317. RESULTS: In the study group, the ages of patients ranged from 22 to 68 years, and APACHE II scores ranged from 14 to 42. In the control group, ages ranged from 22 to 80 years and their APACHE II scores were between 14-35. The survival rate in the study group was 100% on the 14(th) day whereas it was 70% on the 28(th) day. A significant decrease in the SOFA score (adjusted), clinical, and laboratory improvements were observed during the MSC administration. However, no significant cytokine level changes were observed. In the control group, the survival rate of 20 patients was 70% on the 14(th) day, whereas 60% was on the 28(th) day. While deaths were observed in the control group in the first week of treatment, deaths in the MSCs group were observed between the 15(th) and 28(th) days. CONCLUSION: MSCs treatment may have a positive impact on the survival rates of sepsis during the early phase. However, further randomized controlled studies with a large group of patients are needed. Trial Registration. This trial is registered with ClinicalTrials.gov Identifier: NCT05283317.

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