The exciting "bench to bedside" journey of cell therapies for acute kidney injury and renal transplantation

J Nephrol. 2017 Jun;30(3):319-336. doi: 10.1007/s40620-017-0384-z. Epub 2017 Mar 21.

Abstract

Acute kidney injury (AKI) is characterized by an increasing incidence and poor outcomes in both developed and undeveloped countries. AKI is also acquiring importance in the setting of kidney transplantation (KT): besides all the classical forms of AKI that KT patients may undergo, several transplant-specific injuries can also lead to the loss of graft function. The mechanisms of tissue damage in native and grafted kidneys share several common pathogenic elements. Since appropriate therapeutic treatments are still lacking-probably due to the disease complexity-clinicians are forced to provide only supportive care. In this composite scenario, cell therapies represent an evolving frontier for AKI treatment in native and transplanted kidneys: ex-vivo manipulated stem or immune cells are able to counteract renal dysfunction by a wide range of biological mechanisms. In this review, we will discuss the potential applications of cell therapies in AKI and KT by analyzing the available clinical data and the most promising experimental prospects from a "bench to bedside" perspective.

Keywords: Acute kidney injury; Acute rejection; Cell therapy; Immune tolerance; Kidney transplantation; Stem cells; Tissue regeneration.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / immunology
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / therapy*
  • Adoptive Transfer* / adverse effects
  • Animals
  • Graft Rejection / immunology
  • Graft Rejection / pathology
  • Graft Rejection / physiopathology
  • Graft Rejection / therapy*
  • Graft Survival
  • Humans
  • Kidney / immunology
  • Kidney / pathology
  • Kidney / physiopathology
  • Kidney / surgery*
  • Kidney Transplantation / adverse effects*
  • Regeneration
  • Risk Factors
  • Stem Cell Transplantation* / adverse effects
  • Translational Research, Biomedical / methods*
  • Treatment Outcome