Mesenchymal Stem Cell-Based Therapies against Podocyte Damage in Diabetic Nephropathy

Abstract

Injury to podocytes is an early event in diabetic nephropathy leading to proteinuria with possible progression to end-stage renal failure. The podocytes are unique and highly specialized cells that cover the outer layer of kidney ultrafiltration barrier and play an important role in glomerular function. In the past few decades, adult stem cells, such as mesenchymal stem cells (MSCs) with a regenerative and differentiative capacity have been extensively used in cell-based therapies. In addition to their capability for regeneration and differentiation, MSCs contributes to their milieu by paracrine action of a series of growth factors via antiapoptotic, mitogenic and other cytokine actions that actively participate in treatment of podocyte damage through prevention of podocyte effacement, detachment and apoptosis. It is hoped that novel stem cell-based therapies will be developed in the future to prevent podocyte injury, thereby reducing the burden of kidney disease.

Human umbilical cord-derived mesenchymal stem cells prevent the progression of early diabetic nephropathy through inhibiting inflammation and fibrosis

“…The main sources are the bone marrow MSCs (BM-MSCs), adipose-derived MSCs (AD-MSCs), and umbilical cord MSCs (UC-MSCs). A large number of studies have investigated the role of MSCs in many diseases, including diabetic retinopathy [12], myocardial infarction [13], diabetes [14], and DN [15][16][17][18][19] in mice and rats. However, the underlying mechanisms of these beneficial effects are not completely elucidated.…”

The effect of Substance P/Heparin conjugated PLCL polymer coating of bioinert ePTFE vascular grafts on the recruitment of both ECs and SMCs for accelerated regeneration

“…Thus, many MSCs could be recruited inside of the grafts through these newly created neo-vessels into the grafts 44 . Many studies have demonstrated that host stem cells promote tissue repair by differentiating into multiple lineages and also by the secreting of factors that enhance regeneration, stimulate proliferation and differentiation, and decrease inflammation and immune reactions 45–47 . MSCs have the potential to modulate macrophage polarization from the inflammatory M1 phenotype toward the anti-inflammatory and tissue-regenerative M2 phenotypes by secreting various factors, such as IL-10, transforming growth factor β1 (TGF-β1), indoleamine-2,3-dioxygenase (IDO) and prostaglandin E2 (PGE2).…”

The appropriate management algorithm for diabetic foot

“…Recently, acellular dermal matrix has been widely used to add elasticity under split-thickness skin graft. [ 29 , 30 ] As a form of artificial dermis, it supports the superficial skin.…”