Department of Medicine, Weill Cornell College of Medicine and New York Presbyterian Hospital, New York, NY 10021, USA.
Nat Rev Nephrol. 2010 Mar;6(3):179-83. doi: 10.1038/nrneph.2009.229.
Acute kidney injury (AKI) is a common clinical complication, associated with poor outcomes and the development of chronic kidney disease. Despite major advances in the understanding of its pathophysiology, available therapies for AKI are only supportive; therefore, adequate functional recovery from AKI must predominantly rely on the kidney's own reparative ability. An extensive body of preclinical data from our own and from other laboratories has shown that administration of adult multipotent marrow stromal cells (commonly referred to as mesenchymal stem cells [MSCs]), effectively ameliorates experimental AKI by exerting paracrine renoprotective effects and by stimulating tissue repair. Based on these findings, a clinical trial has been conducted to investigate the safety and efficacy of MSCs administered to open-heart surgery patients who are at high risk of postoperative AKI. In this Perspectives article, we discuss some of the early data from this trial and describe potential applications for stem cell therapies in other fields of nephrology.
急性肾损伤(AKI)是一种常见的临床并发症,与不良预后和慢性肾脏病的发展有关。尽管人们对其病理生理学有了重大的认识进展,但 AKI 的可用治疗方法仅为支持性治疗;因此,AKI 的充分功能恢复主要依赖于肾脏自身的修复能力。来自我们自己和其他实验室的大量临床前数据表明,给予成人多能骨髓基质细胞(通常称为间充质干细胞[MSCs])通过发挥旁分泌肾保护作用和刺激组织修复,可有效改善实验性 AKI。基于这些发现,已经进行了一项临床试验,以研究给予心脏直视手术患者间充质干细胞的安全性和有效性,这些患者术后发生 AKI 的风险很高。在这篇观点文章中,我们讨论了该试验的一些早期数据,并描述了干细胞疗法在肾脏病学其他领域的潜在应用。