Abstract

Background Cell-based therapies are being developed to meet the need for curative therapy in chronic kidney disease (CKD). Bone marrow- (BM-) derived mesenchymal stromal cells (MSCs) enhance tissue repair and induce neoangiogenesis through paracrine action of secreted proteins and extracellular vesicles (EVs). Administration of allogeneic BM MSCs is less desirable in a patient population likely to require a kidney transplant, but potency of autologous MSCs should be confirmed, given previous indications that CKD-induced dysfunction is present. While the immunomodulatory capacity of CKD BM MSCs has been established, it is unknown whether CKD affects wound healing and angiogenic potential of MSC-derived CM and EVs. Methods MSCs were cultured from BM obtained from kidney transplant recipients (N = 15) or kidney donors (N = 17). Passage 3 BM MSCs and BM MSC-conditioned medium (CM) were used for experiments. EVs were isolated from CM by differential ultracentrifugation. BM MSC differentiation capacity, proliferation, and senescence-associated β-galactosidase activity was assessed. In vitro promigratory and proangiogenic capacity of BM MSC-derived CM and EVs was assessed using an in vitro scratch wound assay and Matrigel angiogenesis assay. Results Healthy and CKD BM MSCs exhibited similar differentiation capacity, proliferation, and senescence-associated β-galactosidase activity. Scratch wound migration was not significantly different between healthy and CKD MSCs (P = 0.18). Healthy and CKD BM MSC-derived CM induced similar tubule formation (P = 0.21). There was also no difference in paracrine regenerative function of EVs (scratch wound: P = 0.6; tubulogenesis: P = 0.46). Conclusions Our results indicate that MSCs have an intrinsic capacity to produce proangiogenic paracrine factors, including EVs, which is not affected by donor health status regarding CKD. This suggests that autologous MSC-based therapy is a viable option in CKD.

Highlights

  • Cell-based therapies are being developed to meet the need for curative therapy in chronic kidney disease (CKD)

  • One week prior to bone marrow collection, all CKD patients started an oral immunosuppressive regimen to prepare for kidney transplantation, which consisted of mycophenolate mofetil (MMF) 750 mg twice daily and prednisone 7.5 mg once daily

  • mesenchymal stromal cells (MSCs) were obtained from bone marrow of 32 study participants (17 healthy kidney donors and 15 kidney recipients) participating in the living donor kidney transplantation program at the University Medical Center Utrecht

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Summary

Introduction

Cell-based therapies are being developed to meet the need for curative therapy in chronic kidney disease (CKD). Our results indicate that MSCs have an intrinsic capacity to produce proangiogenic paracrine factors, including EVs, which is not affected by donor health status regarding CKD. This suggests that autologous MSC-based therapy is a viable option in CKD. BM MSC-based regenerative medicine approaches are being developed to treat CKD, aiming to halt progression of fibrosis by vascular regeneration, stimulate kidney regeneration, or enhance immunomodulation after renal transplantation. These therapies include administration of cells or products secreted by cells [9,10,11]. Clinical applications of BM MSCs are being investigated in phase I and II studies [13]

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