Rendra Erika, Crigna Adriana Torres, Daniele Cristina, Sticht Carsten, Cueppers Maike, Kluth Mark Andreas, Ganss Christoph, Frank Markus H, Gretz Norbert, Bieback Karen
Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany.
Medical Faculty Mannheim, Medical Research Centre, Heidelberg University, Mannheim, Germany.
Front Immunol. 2024 Jan 11;14:1228928. doi: 10.3389/fimmu.2023.1228928. eCollection 2023.
Acute kidney injury (AKI) is characterized by a rapid reduction in renal function and glomerular filtration rate (GFR). The broadly used anti-cancer chemotherapeutic agent cisplatin often induces AKI as an adverse drug side effect. Therapies targeted at the reversal of AKI and its potential progression to chronic kidney disease or end-stage renal disease are currently insufficiently effective. Mesenchymal stromal cells (MSCs) possess diverse immunomodulatory properties that confer upon them significant therapeutic potential for the treatment of diverse inflammatory disorders. Human dermal MSCs expressing ATP-Binding Cassette member B5 (ABCB5) have shown therapeutic efficacy in clinical trials in chronic skin wounds or recessive dystrophic epidermolysis bullosa. In preclinical studies, ABCB5+ MSCs have also shown to reverse metabolic reprogramming in polycystic kidney cells, suggesting a capacity for this cell subset to improve also organ function in kidney diseases. Here, we aimed to explore the therapeutic capacity of ABCB5+ MSCs to improve renal function in a preclinical rat model of cisplatin-induced AKI. First, the anti-apoptotic and immunomodulatory capacity was compared against research-grade adipose stromal cells (ASCs). Then, cross-species immunomodulatory capacity was checked, testing first inhibition of mitogen-driven peripheral blood mononuclear cells and then modulation of macrophage function. Finally, therapeutic efficacy was evaluated in a cisplatin AKI model. First, ABCB5+ MSCs suppressed cisplatin-induced apoptosis of human conditionally-immortalized proximal tubular epithelial cells , most likely by reducing oxidative stress. Second, ABCB5+ MSCs inhibited the proliferation of either human or rat peripheral blood mononuclear cells, in the human system via the Indoleamine/kynurenine axis and in the murine context via nitric oxide/nitrite. Third, ABCB5+ MSCs decreased TNF-α secretion after lipopolysaccharide stimulation and modulated phagocytosis and in both human and rat macrophages, involving prostaglandin E2 and TGF-β1, respectively. Fourth, clinical-grade ABCB5+ MSCs grafted intravenously and intraperitoneally to a cisplatin-induced AKI murine model exerted modulatory effects on mRNA expression patterns toward an anti-inflammatory and pro-regenerative state despite an apparent lack of amelioration of renal damage at physiologic, metabolic, and histologic levels. Our results demonstrate anti-inflammatory and pro-regenerative effects of clinical grade ABCB5+ MSCs and and suggest potential therapeutic utility of this cell population for treatment or prevention of cisplatin chemotherapy-induced tissue toxicity.
急性肾损伤(AKI)的特征是肾功能和肾小球滤过率(GFR)迅速下降。广泛使用的抗癌化疗药物顺铂常常作为药物副作用诱发AKI。目前,针对逆转AKI及其向慢性肾病或终末期肾病潜在进展的治疗方法效果欠佳。间充质基质细胞(MSC)具有多种免疫调节特性,使其在治疗多种炎症性疾病方面具有显著的治疗潜力。表达ATP结合盒成员B5(ABCB5)的人真皮MSC在慢性皮肤伤口或隐性营养不良性大疱性表皮松解症的临床试验中已显示出治疗效果。在临床前研究中,ABCB5+ MSC也已显示可逆转多囊肾细胞中的代谢重编程,表明该细胞亚群也有改善肾脏疾病器官功能的能力。在此,我们旨在探讨ABCB5+ MSC在顺铂诱导的AKI临床前大鼠模型中改善肾功能的治疗能力。首先,将其抗凋亡和免疫调节能力与研究级脂肪基质细胞(ASC)进行比较。然后,检查跨物种免疫调节能力,首先测试对丝裂原驱动的外周血单个核细胞的抑制作用,然后测试对巨噬细胞功能的调节作用。最后,在顺铂AKI模型中评估治疗效果。首先,ABCB5+ MSC抑制顺铂诱导的人条件永生化近端肾小管上皮细胞凋亡,最有可能是通过降低氧化应激来实现。其次,ABCB5+ MSC抑制人或大鼠外周血单个核细胞的增殖,在人类系统中通过吲哚胺/犬尿氨酸轴,在小鼠模型中通过一氧化氮/亚硝酸盐。第三,ABCB5+ MSC在脂多糖刺激后减少TNF-α分泌,并分别通过前列腺素E2和TGF-β1调节人和大鼠巨噬细胞的吞噬作用。第四,将临床级ABCB5+ MSC静脉内和腹腔内移植到顺铂诱导的AKI小鼠模型中,尽管在生理、代谢和组织学水平上肾损伤没有明显改善,但对mRNA表达模式朝着抗炎和促再生状态发挥了调节作用。我们的结果证明了临床级ABCB5+ MSC的抗炎和促再生作用,并表明该细胞群体在治疗或预防顺铂化疗诱导的组织毒性方面具有潜在的治疗用途。