Nephrology, Dialysis and Renal Transplantation Unit, Centre for Experimental Medical Research (CeRMS) and Department of Internal Medicine, University of Torino, Torino, Italy.
Am J Kidney Dis. 2013 Feb;61(2):300-9. doi: 10.1053/j.ajkd.2012.05.027. Epub 2012 Aug 30.
Numerous preclinical and clinical studies suggest that mesenchymal stem cells, also known as multipotent mesenchymal stromal cells (MSCs), may improve pathologic conditions involving different organs. These beneficial effects initially were ascribed to the differentiation of MSCs into organ parenchymal cells. However, at least in the kidney, this is a very rare event and the kidney-protective effects of MSCs have been attributed mainly to paracrine mechanisms. MSCs release a number of trophic, anti-inflammatory, and immune-modulatory factors that may limit kidney injury and favor recovery. In this article, we provide an overview of the biologic activities of MSCs that may be relevant for the treatment of kidney injury in the context of a case vignette concerning a patient at high immunologic risk who underwent a second kidney transplantation followed by the development of ischemia-reperfusion injury and acute allograft rejection. We discuss the possible beneficial effect of MSC treatment in the light of preclinical and clinical data supporting the regenerative and immunomodulatory potential of MSCs.
大量的临床前和临床研究表明，间充质干细胞，也被称为多能间充质基质细胞（MSCs），可能改善涉及不同器官的病理状况。这些有益的效果最初归因于 MSCs 分化为器官实质细胞。然而，至少在肾脏中，这是一个非常罕见的事件，MSCs 的肾脏保护作用主要归因于旁分泌机制。MSCs 释放许多营养、抗炎和免疫调节因子，这些因子可能限制肾脏损伤并有利于恢复。在本文中，我们提供了 MSCs 的生物学活性概述，这些活性可能与高免疫风险患者的病例情况有关，该患者接受了第二次肾移植，随后发生了缺血再灌注损伤和急性移植物排斥反应。我们根据支持 MSCs 的再生和免疫调节潜力的临床前和临床数据，讨论了 MSC 治疗的可能有益效果。
