Fan Min, Zhang Jing, Xin Hong, He Xiaozhou, Zhang Xuemei
The Third Affiliated Hospital of Soochow University, Changzhou, China.
Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai, China.
Front Physiol. 2018 Sep 20;9:1323. doi: 10.3389/fphys.2018.01323. eCollection 2018.
In the course of the development and worsening of kidney disease, the treatments available are expensive and may cause adverse effects such as immune rejection, inadequate renal resources, or post-operative complications. Therefore, there is an urgent to develop more effective treatments. The advent of mesenchymal stem cells (MSCs) represents a new direction in this context. The current use of MSCs for the treatment of kidney disease has mostly involved experimental studies on animals and only a few clinical trials have been conducted. This review focused on the mechanisms of MSC involvement from different sources in the improvement of renal pathophysiology in recent years. These mechanisms include homing to damaged kidney tissue, and differentiating into or fusing with the innate cells of the kidney. The paracrine or endocrine action through secreting protective cytokines and/or releasing microvesicle from MSCs also plays a critical role in amelioration of kidney disease. With modern engineering technology like microRNA delivery and a combinational therapy approach such as reduction of renal fibrosis in obstructive nephropathy with MSCs and serelaxin, MSC may make great contribution to the improvement of renal pathophysiology. However, the therapeutic effects of MSC are still controversial and several problems remain unsolved. While it is too early to state that MSCs are useful for the treatment of renal diseases in clinic, it is thought that solutions to the existing problems will enable effective modulation of the biological characteristics of MSCs, thereby providing new and effective approaches for the treatment of renal diseases.
在肾脏疾病的发展和恶化过程中，现有的治疗方法昂贵，且可能会引起诸如免疫排斥、肾脏资源不足或术后并发症等不良反应。因此，迫切需要开发更有效的治疗方法。在这种背景下，间充质干细胞（MSCs）的出现代表了一个新的方向。目前，将MSCs用于治疗肾脏疾病大多涉及动物实验研究，仅有少数临床试验。这篇综述聚焦于近年来不同来源的MSCs参与改善肾脏病理生理学的机制。这些机制包括归巢至受损的肾脏组织，以及分化为肾脏固有细胞或与肾脏固有细胞融合。通过分泌保护性细胞因子和/或从MSCs释放微泡的旁分泌或内分泌作用在改善肾脏疾病中也起着关键作用。借助诸如微小RNA递送等现代工程技术以及诸如用MSCs和松弛素减轻梗阻性肾病中的肾纤维化等联合治疗方法，MSCs可能会对改善肾脏病理生理学做出巨大贡献。然而，MSCs的治疗效果仍存在争议，且有几个问题尚未解决。虽然现在就说MSCs在临床上对治疗肾脏疾病有用还为时过早，但人们认为，解决现有问题将能够有效调节MSCs的生物学特性，从而为治疗肾脏疾病提供新的有效方法。
