Tsuji Kenji, Kitamura Shinji, Wada Jun
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Front Cell Dev Biol. 2022 May 2;10:892356. doi: 10.3389/fcell.2022.892356. eCollection 2022.
Kidney diseases are a major health problem worldwide. Despite advances in drug therapies, they are only capable of slowing the progression of kidney diseases. Accordingly, potential kidney regeneration strategies with stem cells have begun to be explored. There are two different directions for regenerative strategies, whole kidney fabrication with stem cells, and stem cell therapy. De novo whole kidney strategies include: 1) decellularized scaffold technology, 2) 3D bioprinting based on engineering technology, 3) kidney organoid fabrication, 4) blastocyst complementation with chimeric technology, and 5) the organogenic niche method. Meanwhile, stem cell therapy strategies include 1) injection of stem cells, including mesenchymal stem cells, nephron progenitor cells, adult kidney stem cells and multi-lineage differentiating stress enduring cells, and 2) injection of protective factors secreted from these stem cells, including growth factors, chemokines, and extracellular vesicles containing microRNAs, mRNAs and proteins. Over the past few decades, there have been remarkable step-by-step developments in these strategies. Here, we review the current advances in the potential strategies for kidney regeneration using stem cells, along with their challenges for possible clinical use in the future.
肾脏疾病是全球主要的健康问题。尽管药物治疗取得了进展，但它们只能减缓肾脏疾病的进展。因此，利用干细胞进行肾脏再生的潜在策略已开始被探索。再生策略有两个不同的方向，即利用干细胞构建完整肾脏和干细胞治疗。从头构建完整肾脏的策略包括：1）去细胞支架技术；2）基于工程技术的3D生物打印；3）肾脏类器官构建；4）利用嵌合技术进行囊胚互补；5）器官发生微环境方法。同时，干细胞治疗策略包括：1）注射干细胞，包括间充质干细胞、肾祖细胞、成年肾脏干细胞和多谱系分化应激耐受细胞；2）注射这些干细胞分泌的保护因子，包括生长因子、趋化因子以及含有微小RNA、信使RNA和蛋白质的细胞外囊泡。在过去几十年里，这些策略取得了显著的逐步进展。在此，我们综述了利用干细胞进行肾脏再生的潜在策略的当前进展，以及它们在未来可能用于临床的挑战。
