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Published on: October 8, 2016
Cell-based therapy for acute organ injury: preclinical evidence and ongoing clinical trials using mesenchymal stem
Antoine Monsel1, Ying-Gang Zhu, Stephane Gennai
1From the Multidisciplinary Intensive Care Unit (Jean-Jacques Rouby, M.D., Ph.D., Director), Department of Anesthesiology and Critical Care (Pierre Coriat, M.D., Ph.D., Chairman), La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, France (A.M.); UPMC Université Paris, Paris, France (A.M.); Department of Anesthesiology, University of California San Francisco, San Francisco, California (A.M., Y.-g.Z., S.G., Q.H., J.L., J.W.L.).
Abstract:
Critically ill patients often suffer from multiple organ failures involving lung, kidney, liver, or brain. Genomic, proteomic, and metabolomic approaches highlight common injury mechanisms leading to acute organ failure. This underlines the need to focus on therapeutic strategies affecting multiple injury pathways. The use of adult stem cells such as mesenchymal stem or stromal cells (MSC) may represent a promising new therapeutic approach as increasing evidence shows that MSC can exert protective effects following injury through the release of promitotic, antiapoptotic, antiinflammatory, and immunomodulatory soluble factors. Furthermore, they can mitigate metabolomic and oxidative stress imbalance. In this work, the authors review the biological capabilities of MSC and the results of clinical trials using MSC as therapy in acute organ injuries. Although preliminary results are encouraging, more studies concerning safety and efficacy of MSC therapy are needed to determine their optimal clinical use. (ANESTHESIOLOGY 2014; 121:1099-121).
Insights
Mesenchymal stem cells (MSC) show promise for treating acute organ injuries by releasing protective factors. Further research is needed to confirm the safety and efficacy of MSC therapy in clinical settings.
Area of Science:
- Regenerative Medicine
- Critical Care Medicine
- Stem Cell Biology
Background:
- Critically ill patients frequently experience multi-organ failure (lung, kidney, liver, brain).
- Genomic, proteomic, and metabolomic studies reveal shared injury mechanisms in acute organ failure.
- Therapeutic strategies targeting multiple injury pathways are essential.
Purpose of the Study:
- To review the biological capabilities of mesenchymal stem or stromal cells (MSC).
- To examine clinical trial results of MSC therapy in acute organ injuries.
- To assess the potential of MSC as a therapeutic approach for critical organ damage.
Main Methods:
- Review of existing literature on MSC biology and function.
- Analysis of data from clinical trials investigating MSC for acute organ injury.
- Evaluation of MSC-mediated protective effects, including soluble factor release.
Main Results:
- MSC demonstrate protective effects through the release of promitotic, antiapoptotic, anti-inflammatory, and immunomodulatory factors.
- MSC can help mitigate metabolomic and oxidative stress imbalances associated with organ injury.
- Preliminary clinical trial results using MSC for acute organ injuries are encouraging.
Conclusions:
- Mesenchymal stem or stromal cells (MSC) represent a promising therapeutic avenue for acute organ injuries.
- MSC exert protective effects via soluble factors and by addressing metabolic and oxidative stress.
- Additional studies are required to establish the safety and efficacy of MSC therapy for optimal clinical application.
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