Preconditioning strategies for improving the survival rate and paracrine ability of mesenchymal stem cells in acute kidney injury

J Cell Mol Med. 2019 Feb;23(2):720-730. doi: 10.1111/jcmm.14035. Epub 2018 Nov 28.

Abstract

Acute kidney injury (AKI) is a common, severe emergency case in clinics, with high incidence, significant mortality and increased costs. Despite development in the understanding of its pathophysiology, the therapeutic choices are still confined to dialysis and renal transplantation. Considering their antiapoptotic, immunomodulatory, antioxidative and pro-angiogenic effects, mesenchymal stem cells (MSCs) may be a promising candidate for AKI management. Based on these findings, some clinical trials have been performed, but the results are contradictory (NCT00733876, NCT01602328). The low engraftment, poor survival rate, impaired paracrine ability and delayed administration of MSCs are the four main reasons for the limited clinical efficacy. Investigators have developed a series of preconditioning strategies to improve MSC survival rates and paracrine ability. In this review, by summarizing these encouraging studies, we intend to provide a comprehensive understanding of various preconditioning strategies on AKI therapy and improve the prognosis of AKI patients by regenerative medicine.

Keywords: acute kidney injury; mesenchymal stem cells; preconditioning strategy; survival and paracrine ability.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury / metabolism
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / therapy*
  • Animals
  • Cell Culture Techniques
  • Cell Hypoxia / physiology
  • Cell Survival / drug effects
  • Clinical Trials as Topic
  • Cytokines / pharmacology*
  • Gene Editing / methods
  • Graft Rejection / prevention & control
  • Graft Survival*
  • Humans
  • Hydrogels / pharmacology
  • Intercellular Signaling Peptides and Proteins / pharmacology*
  • Mesenchymal Stem Cell Transplantation / methods*
  • Mesenchymal Stem Cells / cytology
  • Mesenchymal Stem Cells / drug effects*
  • Mesenchymal Stem Cells / metabolism
  • Paracrine Communication / drug effects
  • Paracrine Communication / genetics

Substances

  • Cytokines
  • Hydrogels
  • Intercellular Signaling Peptides and Proteins

Associated data

  • ClinicalTrials.gov/NCT00733876
  • ClinicalTrials.gov/NCT01602328