a Nephrology and Dialysis Unit , Meyer Children's University Hospital , Florence , Italy.
b Department of Biomedical Experimental and Clinical Sciences "Mario Serio" , University of Florence , Florence , Italy.
Expert Opin Biol Ther. 2018 Jul;18(7):795-806. doi: 10.1080/14712598.2018.1492546. Epub 2018 Jul 9.
Chronic kidney disease is a major health-care problem worldwide and its cost is becoming no longer affordable. Indeed, restoring damaged renal structures or building a new kidney represents an ambitious and ideal alternative to renal replacement therapy. Streams of research have explored the possible application of pluripotent stem cells (SCs) (embryonic SCs and induced pluripotent SCs) in different strategies aimed at regenerate functioning nephrons and at understanding the mechanisms of kidney regeneration.
In this review, we will focus on the main potential applications of human pluripotent SCs to kidney regeneration, including those leading to rebuilding new kidneys or part of them (organoids, scaffolds, biological microdevices) as well as those aimed at understanding the pathophysiological mechanisms of renal disease and regenerative processes (modeling of kidney disease, genome editing). Moreover, we will discuss the role of endogenous renal progenitors cells in order to understand and promote kidney regeneration, as an attractive alternative to pluripotent SCs.
Opportunities and pitfalls of all these strategies will be underlined, finally leading to the conclusion that a deeper knowledge of the biology of pluripotent SCs is mandatory, in order to allow us to hypothesize their clinical application.
慢性肾脏病是全球范围内的一个主要医疗保健问题，其成本已变得难以承受。事实上，修复受损的肾脏结构或构建新的肾脏，代表了一种替代肾脏替代疗法的有抱负和理想的替代方案。许多研究探索了多能干细胞（SCs）（胚胎干细胞和诱导多能干细胞）在不同策略中的可能应用，旨在再生有功能的肾单位，并了解肾脏再生的机制。
在这篇综述中，我们将重点关注人类多能干细胞在肾脏再生中的主要潜在应用，包括那些旨在重建新肾脏或其部分（类器官、支架、生物微器件）的应用，以及旨在理解肾脏疾病和再生过程的病理生理机制的应用（肾脏疾病建模、基因组编辑）。此外，我们将讨论内源性肾脏祖细胞在理解和促进肾脏再生中的作用，作为多能干细胞的一种有吸引力的替代方法。
所有这些策略的机遇和陷阱都将被强调，最终得出的结论是，为了使我们能够假设其临床应用，必须深入了解多能干细胞的生物学。
