Recent Updates on Mesenchymal Stem Cell Based Therapy for Acute Renal Failure

Abstract

Acute kidney injury, formerly known as acute renal failure, is a pathological condition in which ischemia or toxic damage contributes to the loss of renal proximal tubule epithelial cells. Pathophysiological events such as oxidative stress, mitochondrial dysfunction, and direct renal tubular epithelial cells toxicity are responsible for the progression of the disease. This devastating decline in renal function affects mostly patients in the intensive care units and requires costly and invasive treatments such as dialysis and organ transplant. Fortunately, recent therapies such as the use of mesenchymal stem cells (MSCs) were proven to be effective in ameliorating renal failure via paracrine and immunomodulatory mechanisms. These fibroblast-like adult stem cells that differentiate multilineagely can be isolated from dental pulps, umbilical cords, amniotic fluids, adipose tissues, and bone marrows. Depending on their sources, the therapeutical application of each MSC type has its own capacities, advantages, and drawbacks. The review discusses and compares the latest research studies on the use of different MSCs sources to treat renal failure. Concerns about the future clinical application of MSCs such as homing, toxicity, and the risk of immune rejection are also highlighted.

Exosomal miR-125b-5p deriving from mesenchymal stem cells promotes tubular repair by suppression of p53 in ischemic acute kidney injury

“…However, the extraction of bone marrow is a highly invasive procedure, and the differentiation potential is declined with increasing age. By contrast, hucMSCs possess many desirable advantages, such as non-invasive, non-ethical controversy, low immunogenicity, easy to expand in vitro and prominent tissue repair properties 40 , 41 . Moreover, hucMSCs improved GFR and tubular function better than adipose-derived MSCs in I/R-induced renal damage 42 .…”

The Application of MSCs-Derived Extracellular Vesicles in Bone Disorders: Novel Cell-Free Therapeutic Strategy

“…With the above characteristics, MSCs are commonly used in cell therapy for regenerative medicine and immunotherapy (Squillaro et al, 2016;Galipeau and Sensebe, 2018). MSCT has caused increasing attention and is regarded as a potential new therapy for a variety of human diseases associated with brain, liver, kidney, bone, and so on (Hu et al, 2018;Chakari-Khiavi et al, 2019;Hu et al, 2019;Missoum, 2020). However, the direct use of MSCs for treating diseases encounters some problems.…”

Mesenchymal Stromal Cell Uses for Acute Kidney Injury—Current Available Data and Future Perspectives: A Mini-Review

“…MSCs might also assist in preserving tubular mitochondria, thus preserving the functionality of these cells ( 35 ). By improving oxygen metabolism and energy utilization, MSCs reduce the oxidative stress and induce antioxidant activity ( 36 ).…”

“…In the setting of AKI, MSCs promote protective effects on the injured kidney and ameliorate tissue damage ( 34 , 36 ). The beneficial effects of MSCs are noticeable early after their injection and can be attributed to the following paracrine related mechanisms ( Table 1 and Figure 1 ):…”

“…In a CKD trial, none of the patients developed persistent donor-specific anti-HLA antibodies ( 60 ). In particular, fetal MSCs have very low immunogenicity by nature and can be used to overcome this potential barrier ( 36 ). The last concern is related to the proliferation and differentiation of pluripotent cells injected to a living body, with their potential of being transformed into malignant cells.…”