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间充质干细胞治疗肾脏疾病的叙述性综述:作用机制、临床应用及未来方向

Narrative Review of Mesenchymal Stem Cell Therapy in Renal Diseases: Mechanisms, Clinical Applications, and Future Directions.

作者信息

Wang Yanjun, Luo Pengli, Wuren Tana

机构信息

Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China.

High-Altitude Medicine Key Laboratory of the Ministry of Education, Xining 810001, China.

出版信息

Stem Cells Int. 2024 Dec 11;2024:8658246. doi: 10.1155/sci/8658246. eCollection 2024.

Abstract

Renal diseases, particularly acute kidney injury (AKI) and chronic kidney disease (CKD), are significant global health challenges. These conditions impair kidney function and can lead to serious complications, including cardiovascular diseases, which further exacerbate the public health burden. Currently, the global AKI mortality rate is alarmingly high (20%-50%); CKD is projected to emerge as a major global health burden by 2040. Existing treatments such as hemodialysis and kidney transplantation have limited effectiveness and are often associated with adverse effects. Mesenchymal stem cells (MSCs) offer considerable potential for treating renal diseases owing to their regenerative and immunomodulatory properties. Thus, this review focuses on the application of MSCs in renal disease, discusses fundamental research findings, and evaluates their application in clinical trials. Moreover, we discuss the impact and safety of MSCs as a therapeutic option and highlight challenges and potential directions for their clinical application. We selected research articles from PubMed published within the last 5 years (from 2019), focusing on high-impact journals and clinical trial data, and included a few key studies predating 2019. Considerations included the novelty of the research, sample size, experimental design, and data reliability. With advancements in single-cell sequencing, CRISPR/Cas9 gene editing, and other cutting-edge technologies, future MSC research will explore combination therapies and personalized treatments to provide more promising, safer treatments with reduced adverse reactions and enhanced therapeutic outcomes. These advances will improve kidney disease treatment methods, enhance patient quality of life, and maximize the benefits of MSC therapies.

摘要

肾脏疾病,尤其是急性肾损伤(AKI)和慢性肾脏病(CKD),是全球重大的健康挑战。这些病症会损害肾功能,并可能导致严重并发症,包括心血管疾病,进而加重公共卫生负担。目前,全球急性肾损伤死亡率高得惊人(20%-50%);预计到2040年,慢性肾脏病将成为全球主要的健康负担。血液透析和肾移植等现有治疗方法效果有限,且常常伴有不良反应。间充质干细胞(MSCs)因其再生和免疫调节特性,在治疗肾脏疾病方面具有巨大潜力。因此,本综述聚焦于间充质干细胞在肾脏疾病中的应用,讨论基础研究结果,并评估其在临床试验中的应用。此外,我们还讨论了间充质干细胞作为一种治疗选择的影响和安全性,并强调其临床应用面临的挑战和潜在方向。我们从过去5年(2019年以来)发表在PubMed上的研究文章中进行筛选,重点关注高影响力期刊和临床试验数据,并纳入了一些2019年之前的关键研究。考虑因素包括研究的新颖性、样本量、实验设计和数据可靠性。随着单细胞测序、CRISPR/Cas9基因编辑等前沿技术的进步,未来间充质干细胞研究将探索联合疗法和个性化治疗,以提供更有前景、更安全的治疗方法,减少不良反应并提高治疗效果。这些进展将改善肾脏疾病的治疗方法,提高患者生活质量,并最大限度地发挥间充质干细胞疗法的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24d9/11655143/96b7bea44ac4/SCI2024-8658246.001.jpg

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