Abstract
In the course of the development and worsening of kidney disease, the treatments available are expensive and may cause adverse effects such as immune rejection, inadequate renal resources, or post-operative complications. Therefore, there is an urgent to develop more effective treatments. The advent of mesenchymal stem cells (MSCs) represents a new direction in this context. The current use of MSCs for the treatment of kidney disease has mostly involved experimental studies on animals and only a few clinical trials have been conducted. This review focused on the mechanisms of MSC involvement from different sources in the improvement of renal pathophysiology in recent years. These mechanisms include homing to damaged kidney tissue, and differentiating into or fusing with the innate cells of the kidney. The paracrine or endocrine action through secreting protective cytokines and/or releasing microvesicle from MSCs also plays a critical role in amelioration of kidney disease. With modern engineering technology like microRNA delivery and a combinational therapy approach such as reduction of renal fibrosis in obstructive nephropathy with MSCs and serelaxin, MSC may make great contribution to the improvement of renal pathophysiology. However, the therapeutic effects of MSC are still controversial and several problems remain unsolved. While it is too early to state that MSCs are useful for the treatment of renal diseases in clinic, it is thought that solutions to the existing problems will enable effective modulation of the biological characteristics of MSCs, thereby providing new and effective approaches for the treatment of renal diseases.
Highlights
Mesenchymal stem cells (MSCs) are a type of pluripotent stem cells of the mesodermal origin that play a very important role among different stem cells
The Second Functional Mechanism of mesenchymal stem cells (MSCs) Involves the Promotion of the Repair of Damaged Kidneys Through Paracrine or Endocrine Action. This comprises two types of processes as follows: Secretion of Protective Factors to Promote Endogenous Repair Mesenchymal stem cells can exert a reparative effect on kidney injury through a series of protective factors secreted by endocrine/paracrine mechanisms, including anti-inflammatory factors, insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), hepatocyte growth factor, soluble factors, growth factors, and chemokines (Nigam and Lieberthal, 2000)
Further exploration of the use of MSCs for the treatment of such conditions and the development of related technologies and mechanisms will hasten the introduction of this treatment strategy into clinical settings and its more effective application in practice
Summary
Mesenchymal stem cells (MSCs) are a type of pluripotent stem cells of the mesodermal origin that play a very important role among different stem cells. In the case of chronic renal injury and continuous gene selection, bone marrow-derived stem cells or MSCs can be induced to fuse with renal tubular cells to restore renal function This comprises two types of processes as follows: Secretion of Protective Factors to Promote Endogenous Repair Mesenchymal stem cells can exert a reparative effect on kidney injury through a series of protective factors secreted by endocrine/paracrine mechanisms, including anti-inflammatory factors, insulin-like growth factor-1 (IGF-1), VEGF, hepatocyte growth factor, soluble factors, growth factors, and chemokines (Nigam and Lieberthal, 2000). Ninichuk et al (2006) has found that weekly injection of MSCs prevents the loss of capillaries surrounding perirenal tubules but could not delay the rate of renal failure and ensure the survival of COL4A3-deficient mice Another controversy is what roles of autophagy induced by MSC play in kidney disease.
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