Stem Cell Therapy for Glomerular Disease

Abstract

Stem cell therapy holds great promise for the repair of injured tissues and organs, including the kidney. Although still surrounded by uncertainties, such as the role of specific stem cell or progenitor populations, the relative contribution of local versus circulating cells or the modes of action, recent years have witnessed considerable progress in bringing stem cells closer to the bedside in nephrology. Concerning the kidney, most studies on repair have concentrated on the tubulointerstitial compartment, and less information is available for glomerular repair. In this issue of JASN, Kunter et al. demonstrate that intrarenal administration of bone marrow– derived mesenchymal stem cells (MSC) can be used as cell therapy in the anti-Thy1.1– mediated model of antibody-mediated mesangiolysis and glomerular capillary destruction. Importantly, recovery of the glomerular lesions is accelerated when MSC are instilled locally 2 d after the induction of disease. The study elegantly demonstrates that these beneficial effects are not mediated through replacement of damaged glomerular cells by differentiated MSC but rather are caused by paracrine effects. The authors convincingly show that these actions are specific for MSC and dependent on local delivery. MSC are a rare minority of cells in the bone marrow and are