Application of cellular technologies in the treatment of neurological disorders caused by COVID-19 SARS-CoV-2

Aim: to systematize the results of studies devoted to the treatment and rehabilitation of patients with neurological consequences of «postcoid syndrome» and with vascular, post-inflammatory and traumatic lesions of the nervous system using adult stem cells.

Materials and methods. A search was carried out for literary sources including those published in peer-reviewed journals indexed in PubMed, Wos, Scopus and RSCI. We analyzed 45 articles on cell technologies and immunotherapy in neurology, of which 39 are included in this review. 72 articles devoted to cell technologies and immunotherapy in neurology were analyzed, of which 63 are included in this review.

Results. The inclusion of stem cells (SC) in rehabilitation programs for patients with various injuries and diseases of the central nervous system is a new, promising direction of research. Possible mechanisms of therapy for spinal cord injury based on the use of adult-type stem cells from the bone marrow, including CD34+, include many aspects. On the background of SC transplantation, damaged nerve cells and surrounding tissues, including neurons and glial cells, can be restored, which helps to ensure the integrity of the nerve conduction pathway and, thus, restore nerve function. SС therapy can suppress genes involved in inflammation and apoptosis, as well as activate genes with neuroprotective action, thereby protecting spinal neurons from secondary damage. The introduction of autoCD34+ SC will be performed intrathecally by spinal (lumbar) puncture performed in the L2–L3 gap, under local anesthesia with 1% lidocaine solution. The dose of autoCD34+ SC is determined by the content of CD34+ cells and is not less than 1 × 10⁶ CD34+ cells per 1 injection. Autologous hematopoietic stem cells (HSC) obtained from the patient himself do not cause immunological conflicts, and, accordingly, do not require immunosuppressive therapy, unlike donor (allogeneic) and xenogenic cells. Thus, the patient does not experience disturbances in the natural mechanisms of anti-infectious and antitumor control. At the same time, autologous HSCs are relatively easy to obtain and cultivate if necessary, and when using this type of cells, doctors do not face ethical and legislative challenges.

Conclusion. Taking into account the previously obtained data on the effectiveness of the use of autologous HSC SD34+ for the rehabilitation of patients with various types of damage to the nervous system and the universality of pathophysiological mechanisms in the central nervous system, it can be assumed that this area of cell therapy can be used to treat post-COVID-19 syndrome.

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