Abstract
The need for more effective therapies of chronic and acute diseases has led to the attempts of developing more adequate and less invasive treatment methods. Regenerative medicine relies mainly on the therapeutic potential of stem cells. Mesenchymal stem cells (MSCs), due to their immunosuppressive properties and tissue repair abilities, seem to be an ideal tool for cell-based therapies. Taking into account all available sources of MSCs, perinatal tissues become an attractive source of allogeneic MSCs. The allogeneic MSCs provide “off-the-shelf” cellular therapy, however, their allogenicity may be viewed as a limitation for their use. Moreover, some evidence suggests that MSCs are not as immune-privileged as it was previously reported. Therefore, understanding their interactions with the recipient’s immune system is crucial for their successful clinical application. In this review, we discuss both autologous and allogeneic application of MSCs, focusing on current approaches to allogeneic MSCs therapies, with a particular interest in the role of human leukocyte antigens (HLA) and HLA-matching in allogeneic MSCs transplantation. Importantly, the evidence from the currently completed and ongoing clinical trials demonstrates that allogeneic MSCs transplantation is safe and seems to cause no major side-effects to the patient. These findings strongly support the case for MSCs efficacy in treatment of a variety of diseases and their use as an “off-the-shelf” medical product.
Highlights
Regenerative medicine is currently a dynamically growing field of modern medicine
This review focuses on recent discoveries in the field of autologous and allogeneic stem cell transplants with special emphasis on mesenchymal stem cells (MSCs)-based clinical trials in the context of therapeutic properties of MSCs, and of immunological hurdles in allogeneic cell therapies
The analysis showed that: (1) both autologous and allogeneic cell therapy exhibit similar effects—similar improvement in left ventricular ejection fraction, and most importantly (2) there were no serious immune reactions reported in any of the studies, which suggested that this cell therapy was safe
Summary
Regenerative medicine is currently a dynamically growing field of modern medicine. The use of different kinds of stem cells can be viewed as an alternative to organ transplantation and treatment of many diseases such as neurological or cardiovascular diseases [1,2] that cannot be effectively treated by conventional methods. MSCs are relatively easy to isolate and expand in vitro They secrete cytokines and growth factors and have the ability to migrate to the site of an injury where they exert immunomodulatory and regenerative effects [8]. The results of hitherto studies have demonstrated several properties of MSCs that promote their beneficial effects, including, (i) ability to migrate to the site of injury, (ii) secretion of soluble factors, (iii) modulation of immune response, and (iv) ability to differentiate and transdifferentiate into various cell types. In vivo studies have revealed that MSCs promote angiogenesis, proliferation, and differentiation of progenitor cells They prevent fibrosis and apoptosis, and modulate immune responses [23,24,25,26]. A better understanding of immunological interactions between the donor cells and the recipient will enable development of safe, effective, and personalized cell therapy based on allogenic MSCs
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