Allogeneic mesenchymal stem cell infusion for the stabilization of focal segmental glomerulosclerosis

Belingheri, Mirco; Lazzari, Lorenza; Parazzi, Valentina; Groppali, Elena; Biagi, Ettore; Gaipa, Giuseppe; Giordano, Rosaria; Rastaldi, Maria Pia; Croci, Daniela; Biondi, Andrea; Rebulla, Paolo; Edefonti, A.; Ghio, Luciana

doi:10.1016/j.biologicals.2013.09.004

Cited by 29 publications

(19 citation statements)

References 43 publications

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“…However, because abatacept is a safe drug that has been used for other indications, it will be essential to evaluate the efficacy of this antibody for the treatment of recurrent FSGS in a randomized clinical trial. Finally, there have been two recent reports in which infusion of allogeneic mesenchymal stem cells was used to successfully stabilize kidney function in children with recurrent FSGS or prevent this complication [83,84]. In view of the high cost and potential serious adverse events associated with this approach to treat recurrent FSGS, more investigation is warranted to provide rational for stem cell-based treatments.…”

Section: Treatmentmentioning

confidence: 99%

Recurrent focal segmental glomerulosclerosis after kidney transplantation

2015

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Focal segmental glomerulosclerosis (FSGS) is an important cause of glomerular disease in children and adolescents and nearly 50 % of affected patients will progress to endstage kidney disease over a 5 to 10-year period. Unfortunately, there is no established treatment for disease in the native kidney. Moreover, up to 55 % of patients develop recurrent disease after receiving a kidney transplant, with a substantially higher risk in patients who have already experienced recurrent disease in a prior transplant. A number of clinical and laboratory factors have been identified as risk factors for this complication. In addition, new investigations into podocyte biology and circulating permeability factors have shed light on the cause of recurrent the disease. While a number of novel therapeutic agents have been applied in the management of this problem, there still is no proven treatment. In this review, we summarize recent advances in the epidemiology, pathophysiology, and treatment of recurrent FSGS in pediatric patients who have received a kidney transplant.

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Section: Treatmentmentioning

confidence: 99%

Recurrent focal segmental glomerulosclerosis after kidney transplantation

2015

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“…Recently, BM-MSCs have been demonstrated as effective treatment for a wide range of immunomediated diseases [112][113][114] . Belingheri et al [115] reported successful application of their innovative approach with BM-MSCs in a 13-yearold kidney transplanted patient who had developed an immediate biopsy proven FSGS recurrence after renal transplantation and who was non-responsive to PE and Rituximab ® (2 doses). The patient had received allogeneic BM-MSCs infusions (6 doses, according to the most commonly adopted protocol for treatment of graft vs host disease) at months 7, 10 and 14 after transplantation and at month 5 after Rituximab ® administration.…”

Section: Human Allogeneic Bone Marrow Mesenchymal Stem Cellsmentioning

confidence: 99%

Update on the treatment of focal segmental glomerulosclerosis in renal transplantation

Messina¹,

Gallo²,

Mella³

et al. 2016

WJT

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Focal segmental glomerulosclerosis (FSGS) represents one of the most severe glomerular diseases, with frequent progression to end-stage renal disease and a high rate of recurrence in renal allografts (30%-50%). Recurrent FSGS portends a negative outcome, with the hazard ratio of graft failure being two-fold higher then that of other glomerulonephritis. Two patterns of clinical presentations are observed: Early recurrence, which is characterized by massive proteinuria within hours to days after implantation of the renal graft, and late recurrence, which occurs several months or years after the transplantation. Many clinical conditions have been recognized as risk factors for recurrence, including younger age, rapid progression of the disease to end-stage renal disease on native kidneys, and loss of previous renal allografts due to recurrence. However, much less is known about the incidence and risk factors of the so-called "de novo " type of FSGS, for which sufferers are transplanted patients without disease on native kidneys; but, rapid development of allograft failure is frequently observed. Management of both forms is challenging, and none of the approaches proposed to date have been demonstrated as consistently beneficial or effective. In the present review we report an update on the available therapeutic strategies for FSGS in renal transplantation within the context of a critical overview of the current literature.

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“…73 Infusion of allogeneic mesenchymal stem cells Infusion of allogeneic mesenchymal stem cells has been used successfully to stabilize kidney function in children with recurrent FSGS and to prevent renal dysfunction. 92,93 However, more investigations are warranted to provide a rationale for stem-cell-based treatments.…”

Section: Cyclophosphamidementioning

confidence: 99%

Optimal management of primary focal segmental glomerulosclerosis in adults

Beaudreuil¹,

Lorenzo²,

Elias³

et al. 2017

IJNRD

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Focal segmental glomerulosclerosis (FSGS) is a frequent glomerular kidney disease that is revealed by proteinuria or even nephrotic syndrome. A diagnosis can be established from a kidney biopsy that shows focal and segmental glomerulosclerosis. This histopathological lesion may be caused by a primary podocyte injury (idiopathic FSGS) but is also associated with other pathologies (secondary FSGS). The first-line treatment for idiopathic FSGS with nephrotic syndrome is a prolonged course of corticosteroids. However, steroid resistance or steroid dependence is frequent, and despite intensified immunosuppressive treatment, FSGS can lead to end-stage renal failure. In addition, in some cases, FSGS can recur on a graft after kidney transplantation: an unidentified circulating factor may be implicated. Understanding of its physiopathology is unclear, and it remains an important challenge for the scientific community to identify a specific diagnostic biomarker and to develop specific therapeutics. This study reviews the treatment of primary FSGS and the recurrence of FSGS after kidney transplantation in adults.

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Allogeneic mesenchymal stem cell infusion for the stabilization of focal segmental glomerulosclerosis

Cited by 29 publications

References 43 publications

Recurrent focal segmental glomerulosclerosis after kidney transplantation

Recurrent focal segmental glomerulosclerosis after kidney transplantation

Update on the treatment of focal segmental glomerulosclerosis in renal transplantation

Optimal management of primary focal segmental glomerulosclerosis in adults

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