Urine-derived stem cells in kidney disease: progress, challenges, and future directions

Area of Science:

• Nephrology
• Regenerative Medicine
• Stem Cell Biology

Background:

• Chronic kidney disease (CKD) presents a significant global health challenge with limited regenerative therapies.
• Urine-derived stem cells (USCs) offer a readily accessible, non-invasive source of multipotent cells for kidney repair.
• USCs exhibit properties similar to mesenchymal stem cells, including paracrine effects, immunomodulation, and extracellular vesicle (EV) production.

Purpose of the Study:

• To review the current advancements in utilizing USCs for kidney disease therapy.
• To identify existing limitations and challenges in USC-based regenerative nephrology.
• To outline future research directions for translating USC therapies into clinical practice.

Main Methods:

• Review of preclinical studies on USC efficacy in acute and chronic kidney injury models.
• Analysis of recent developments in biomaterials and delivery systems for USCs and their EVs.
• Evaluation of USC properties such as anti-fibrotic, anti-inflammatory, and pro-regenerative effects.

Main Results:

• USCs demonstrate significant anti-fibrotic, anti-inflammatory, and pro-regenerative effects in preclinical kidney injury models.
• Advances in scaffold-free cell sheets and engineered EVs enhance USC therapeutic potential.
• Key challenges include functional integration, optimized delivery, and managing donor variability.

Conclusions:

• USC-based therapies hold considerable promise for regenerative nephrology, particularly for chronic kidney disease.
• Overcoming challenges in delivery, integration, and standardization is crucial for clinical translation.
• Continued research into USC mechanisms and delivery technologies will facilitate their application in treating kidney diseases.