Velikova Tsvetelina, Dekova Tereza, Miteva Dimitrina Georgieva
Department of Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria.
Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, Sofia 1164, Bulgaria.
World J Transplant. 2024 Jun 18;14(2):90554. doi: 10.5500/wjt.v14.i2.90554.
Mesenchymal stem cells (MSCs) have tantalized regenerative medicine with their therapeutic potential, yet a cloud of controversies looms over their clinical transplantation. This comprehensive review navigates the intricate landscape of MSC controversies, drawing upon 15 years of clinical experience and research. We delve into the fundamental properties of MSCs, exploring their unique immunomodulatory capabilities and surface markers. The heart of our inquiry lies in the controversial applications of MSC transplantation, including the perennial debate between autologous and allogeneic sources, concerns about efficacy, and lingering safety apprehensions. Moreover, we unravel the enigmatic mechanisms surrounding MSC transplantation, such as homing, integration, and the delicate balance between differentiation and paracrine effects. We also assess the current status of clinical trials and the ever-evolving regulatory landscape. As we peer into the future, we examine emerging trends, envisioning personalized medicine and innovative delivery methods. Our review provides a balanced and informed perspective on the controversies, offering readers a clear understanding of the complexities, challenges, and potential solutions in MSC transplantation.
间充质干细胞（MSCs）凭借其治疗潜力在再生医学领域引发了广泛关注，然而其临床移植却笼罩着诸多争议。本综述基于15年的临床经验与研究，全面梳理了围绕MSCs的复杂争议局面。我们深入探究了MSCs的基本特性，探讨了其独特的免疫调节能力和表面标志物。我们研究的核心在于MSCs移植的争议性应用，包括自体与异体来源之间长期存在的争论、对疗效的担忧以及挥之不去的安全顾虑。此外，我们还揭示了围绕MSCs移植的神秘机制，如归巢、整合以及分化与旁分泌效应之间的微妙平衡。我们还评估了临床试验的现状以及不断演变的监管环境。展望未来，我们审视新兴趋势，展望个性化医学和创新给药方法。我们的综述为这些争议提供了平衡且深入的视角，使读者清晰了解MSCs移植中的复杂性、挑战及潜在解决方案。
