The role of mesenchymal stem cells in IgA nephropathy: current evidence and future directions

Primary glomerular disease, particularly IgA Nephropathy (IgAN), is one of the leading causes of kidney disease burden. IgAN is characterized by IgA deposition in the mesangial area; this is a typical pathological feature that leads to nephritis symptoms. Though the cause is unknown, the quadripartite attack theory is generally accepted. There are many reasons, but the biggest is an imbalance in the immune system. Recently, some studies have shown that mesenchymal stem cells (MSCs) can regulate IgA production and clearance by controlling B cells, T cells, and mucosal epithelial cells. Currently, the standard treatment for IgAN primarily relies on supportive care and immunosuppression, but these approaches are ineffective and have serious side effects. In contrast, stem cell therapy is a promising option and shows great promise in diagnosing and treating various kidney diseases. This review provides an update on recent advances in IgAN using stem cell therapy, including disease mechanisms, treatment pathways, clinical trials, case reports, safety concerns, current challenges, and prospects.