The Potential of Extracellular Vesicles Derived from Amniotic Fluid vs. Hydroxychloroquine in the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Human Patients
Keywords:
Covid-19, SARS-CoV-2, Amniotic fluid, CytoSomesAbstract
Recently a lot of attention has been focused on fast-tracking repurposed drugs for the treatment of a novel coronavirus; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent leading to the devastating coronavirus disease-2019 (Covid-19). One of the first and most well-known examples is hydroxychloroquine (HCQ), which has been used for years as a treatment for malaria, rheumatoid arthritis and lupus. HCQ was rolled out as a miracle treatment for Covid-19, which was inexpensive, effective and causing few side-effects. However, its effectiveness in treating Covid-19 has recently been questioned leaving doctors and patients confused and desperate. Here the proposed mechanisms of action of HCQ are discussed and compared with an inexpensive, safe and effective alternative, which is derived from natural, healthy amniotic fluid.
References
Totura AL, Bavari S. Broad-spectrum coronavirus antiviral drug discovery. Expert Opin Drug Discov. 2019; 14: 397-412. doi: 10.1080/17460441.2019.1581171
Antounians L, Tzanetakis A, Pellerito O, Catania VD, Sulistyo A, Montalva L, et al. The regenerative potential of amniotic fluid stem cell extracellular vesicles: Lessons learned by comparing dif-ferent isolation techniques. Sci Rep. 2019; 9: 1837. doi: 10.1038/ s41598-018-38320-w
Balbi C, Lodder K, Costa A, Moimas S, Moccia F, van Her-waarden T, et al. Supporting data on in vitro cardioprotective 11 White IA and proliferative paracrine effects by the human amniotic fluid stem cell secretome. Data Brief. 2019; 25: 104324. doi: 10.1016/j. dib.2019.104324
Balbi C, Piccoli M, Barile L, Papait A, Armirotti A, Principi E, et al. First characterization of human amniotic fluid stem cell ex-tracellular vesicles as a powerful paracrine tool endowed with re-generative potential. Stem Cells Transl Med. 2017; 6: 1340-1355. doi: 10.1002/sctm.16-0297
Beretti F, Zavatti M, Casciaro F, Comitini G, Franchi F, Barbieri V, et al. Amniotic fluid stem cell exosomes: Therapeutic perspec-tive. Biofactors. 2018; 44: 158-167. doi: 10.1002/biof.1407
Loukogeorgakis SP, De Coppi P. Stem cells from amniotic fluid--Potential for regenerative medicine. Best Pract Res Clin Obstet Gynae-col. 2016; 31: 45-57. doi: 10.1016/j.bpobgyn.2015.08.009
Mirabella T, Poggi A, Scaranari M, Mogni M, Lituania M, Baldo C, et al. Recruitment of host's progenitor cells to sites of human amniotic fluid stem cells implantation. Biomaterials. 2011; 32: 4218- 4227. doi: 10.1016/j.biomaterials.2010.12.028
Zhao B, Zhang Y, Han S, Zhang W, Zhou Q, Guan H, et al. Exosomes derived from human amniotic epithelial cells accelerate wound healing and inhibit scar formation. J Mol Histol. 2017; 48: 121-132. doi: 10.1007/s10735-017-9711-x
Atri C, Guerfali FZ, Laouini D. Role of human macrophage polarization in inflammation during infectious diseases. Int J Mol Sci. 2018; 19(6): 1801. doi: 10.3390/ijms19061801
Perecko T, Kassab RB, Vasicek O, Pekarova M, Jancinova V, Lojek A. The effects of chloroquine and hydroxychloroquine on nitric oxide production in RAW 264.7 and bone marrow-derived macrophages. Folia Biol (Praha). 2014; 60 Suppl 1: 39-44.
Hartwig SM, Holman KM, Varga SM. Depletion of alveolar macrophages ameliorates virus-induced disease following a pul-monary coronavirus infection. PLoS One. 2014; 9: e90720. doi: 10.1371/journal.pone.0090720
Miura TA and Holmes KV. Host-pathogen interactions during coronavirus infection of primary alveolar epithelial cells. J Leukoc Biol. 2009; 86: 1145-1151. doi: 10.1189/jlb.0209078
Al-Bari MAA. Targeting endosomal acidification by chloro-quine analogs as a promising strategy for the treatment of emerg-ing viral diseases. Pharmacol Res Perspect. 2017; 5: e00293. doi: 10.1002/prp2.293
Loffredo FS, Steinhauser ML, Jay SM, Gannon J, Pancoast JR, Yalamanchi P, et al. Growth differentiation factor 11 is a circulating factor that reverses age-related cardiac hypertrophy. Cell. 2013; 153: 828-839. doi: 10.1016/j.cell.2013.04.015
Caplan AI. Adult mesenchymal stem cells for tissue engineer-ing versus regenerative medicine. J Cell Physiol. 2007; 213: 341-347. doi: 10.1002/jcp.21200
Porrello ER, Mahmoud AI, Simpson E, Hill JA, Richardson JA, Olson EN, Sadek HA. Transient regenerative potential of the neonatal mouse heart. Science. 2011; 331: 1078-1080. doi: 10.1126/ science.1200708
White IA, Gordon J, Balkan W, Hare JM. Sympathetic rein-nervation is required for mammalian cardiac regeneration. Circ Res. 2015; 117: 990-994. doi: 10.1161/CIRCRESAHA.115.307465
Mulvihill SJ, Stone MM, Fonkalsrud EW, Debas HT. Trophic effect of amniotic fluid on fetal gastrointestinal development. J Surg Res. 1986; 40: 291-296. doi: 10.1016/0022-4804(86)90189-7
Trahair JF, Sangild PT. Fetal organ growth in response to oe-sophageal infusion of amniotic fluid, colostrum, milk or gastrin-releasing peptide: A study in fetal sheep. Reprod Fertil Dev. 2000; 12: 87-95. doi: 10.1071/rd00024
Gao X, Devoe LD, Given KS. Effects of amniotic fluid on proteases: A possible role of amniotic fluid in fetal wound healing. Ann Plast Surg. 1994; 33: 128-134; discussion 134-135.
Docimo SG, Luetic T, Crone RK, Davies P, Reid L, Retik AB, Mandell J. Pulmonary development in the fetal lamb with severe bladder outlet obstruction and oligohydramnios: A morphometric study. J Urol. 1989; 142: 657-660; discussion 667-668. doi: 10.1016/ s0022-5347(17)38845-6
King JC, Mitzner W, Butterfield AB, Queenan JT. Effect of induced oligohydramnios on fetal lung development. Am J Obstet Gynecol. 1986; 154: 823-830. doi: 10.1016/0002-9378(86)90465-5
Moessinger AC, Collins MH, Blanc WA, Rey HR, James LS. Oligohydramnios-induced lung hypoplasia: the influence of tim-ing and duration in gestation. Pediatr Res. 1986; 20: 951-954. doi: Submit your article to this journal | https://openventio.org/submit-manuscript/ White IA 10.1203/00006450-198610000-00012
Moessinger AC, Singh M, Donnelly DF, Haddad GG, Collins MH, James LS. The effect of prolonged oligohydramnios on fetal lung development, maturation and ventilatory patterns in the new-born guinea pig. J Dev Physiol. 1987; 9: 419-427.
Thomas IT, Smith DW. Oligohydramnios, cause of the nonre-nal features of Potter's syndrome, including pulmonary hypoplasia. J Pediatr. 1974; 84: 811-815. doi: 10.1016/s0022-3476(74)80753-5
Goldschmidt-Clermont DD, White IA. Amniotic Exosomes and Pregnancy. Web site. https://stmsciencemag.org/con-tent/11/492/eaav8521/tab-e-letters. 2019.
van Oppen AC, Stigter RH, Bruinse HW. Cardiac output in normal pregnancy: A critical review. Obstet Gynecol. 1996; 87: 310- 318. doi: 10.1016/0029-7844(95)00348-7
Russo IH, Russo J. Pregnancy-induced changes in breast can-cer risk. J Mammary Gland Biol Neoplasia. 2011; 16: 221-233. doi: 10.1007/s10911-011-9228-y
Sedrakyan S, Da Sacco S, Milanesi A, Shiri L, Petrosyan A, Varimezova R, et al. Injection of amniotic fluid stem cells delays progression of renal fibrosis. J Am Soc Nephrol. 2012; 23: 661-673. doi: 10.1681/ASN.2011030243
Wiklander OPB, Brennan MA, Lotvall J, Breakefield XO, El Andaloussi S. Advances in therapeutic applications of extracellu-lar vesicles. Sci Transl Med. 2019; 11(492): eaav8521. doi: 10.1126/ scitranslmed.aav8521
Caplan AI. Adult mesenchymal stemcells for tissue engineer-ingversus regenerative medicine. Journal of Cellular Physiology. 2007; 341-347. doi: 10.1002/jcp.21200
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Epidemiology (EOJ) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.