Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China.
Renal Division, Peking University Shenzhen Hospital, Shenzhen, 518000, China.
Stem Cell Res Ther. 2022 Jun 7;13(1):240. doi: 10.1186/s13287-022-02917-w.
Primary membranous nephropathy (MN) is a kidney-specific autoimmune disease. Human embryonic stem cells-derived immunity-and-matrix regulatory cells (hESC-IMRCs) have immunoregulatory functions. We hypothesized that hESC-IMRCs might have therapeutic effects on MN and be a potential treatment in clinical practice.
Rats of Heymann nephritis were injected with sheep anti-rat Fx1A serum. hESC-IMRCs were intravenously administrated upon the detection of proteinuria, with 6 × 10 cells (high-dose) or 3 × 10 cells (low-dose) in 1 ml every other day. Splenocytes and IMRCs were co-cultured at different times and ratios. Cell types and cytokines were detected by flow cytometry and enzyme-linked immunosorbent assay.
The urinary protein of rats with Heymann nephritis was reduced remarkably to a level comparable to negative controls, in both low-dose (45.6 vs. 282.3 mg/d, P < 0.001) and high-dose (35.2 vs. 282.3 mg/d, P < 0.001) hESC-IMRC treatment groups. IgG and C3 deposit, glomerular basement membrane thickness and foot process effacement were alleviated and the reduced podocin was recovered in the kidneys. The proportions of CD4 + CD25 + T cells in circulation and spleen were increased, and the circulating level of IL-10 was increased, after IMRC interventions. IL-17 and TNF-α were reduced after IMRCs treatments. IL-10 increased remarkably in the co-culture supernatant of lymphocytes and IMRCs at 48 h with ratio 10:1.
The intravenously delivered hESC-IMRCs alleviated proteinuria and kidney injuries of Heymann nephritis, by their immunosuppressive functions through regulatory T cells and IL-10. These pre-clinical results indicate that IMRCs worth careful consideration for human trials in the treatment of MN.
原发性膜性肾病(MN)是一种肾脏特异性自身免疫性疾病。人胚胎干细胞衍生的免疫和基质调节细胞(hESC-IMRCs)具有免疫调节功能。我们假设 hESC-IMRCs 可能对 MN 有治疗作用,并可能成为临床实践中的一种潜在治疗方法。
在检测到蛋白尿后,给 Heymann 肾炎大鼠注射绵羊抗大鼠 Fx1A 血清,静脉内给予 hESC-IMRCs,高剂量组(6×10 个细胞,1ml 中每两天给予 1 次,每次 6×10 个细胞)或低剂量组(3×10 个细胞,1ml 中每两天给予 1 次,每次 3×10 个细胞)。脾细胞和 IMRCs 在不同时间和比例下共培养。通过流式细胞术和酶联免疫吸附试验检测细胞类型和细胞因子。
Heymann 肾炎大鼠的尿蛋白显著减少,低剂量组(45.6 与 282.3mg/d,P<0.001)和高剂量组(35.2 与 282.3mg/d,P<0.001)与阴性对照组相比,尿蛋白水平相当。肾小球基底膜厚度和足突融合减轻,肾脏中 podocin 恢复。IMRC 干预后,循环和脾脏中 CD4+CD25+T 细胞的比例增加,循环中 IL-10 水平增加。IMRC 治疗后 IL-17 和 TNF-α 减少。淋巴细胞和 IMRCs 以 10:1 的比例共培养 48 小时后,共培养上清液中 IL-10 显著增加。
静脉给予的 hESC-IMRCs 通过调节性 T 细胞和 IL-10 发挥免疫抑制功能,减轻 Heymann 肾炎大鼠的蛋白尿和肾脏损伤。这些临床前结果表明,IMRCs 在治疗 MN 方面值得在人类临床试验中进行仔细考虑。