Management of Fibrosis: The Mesenchymal Stromal Cells Breakthrough

Abstract

Fibrosis is the endpoint of many chronic inflammatory diseases and is defined by an abnormal accumulation of extracellular matrix components. Despite its slow progression, it leads to organ malfunction. Fibrosis can affect almost any tissue. Due to its high frequency, in particular in the heart, lungs, liver, and kidneys, many studies have been conducted to find satisfactory treatments. Despite these efforts, current fibrosis management therapies either are insufficiently effective or induce severe adverse effects. In the light of these facts, innovative experimental therapies are being investigated. Among these, cell therapy is regarded as one of the best candidates. In particular, mesenchymal stromal cells (MSCs) have great potential in the treatment of inflammatory diseases. The value of their immunomodulatory effects and their ability to act on profibrotic factors such as oxidative stress, hypoxia, and the transforming growth factor-β1 pathway has already been highlighted in preclinical and clinical studies. Furthermore, their propensity to act depending on the microenvironment surrounding them enhances their curative properties. In this paper, we review a large range of studies addressing the use of MSCs in the treatment of fibrotic diseases. The results reported here suggest that MSCs have antifibrotic potential for several organs.

Effects of human amnion–derived mesenchymal stromal cell transplantation in rats with radiation proctitis

“…Around 30 clinical trials are currently registered worldwide for evaluating MSC therapy for fibrosis [45]. Furthermore, a first-in-human clinical trial of FM-MSC transplantation in nine patients with steroid-refractory acute graft-versus-host disease (GVHD) demonstrated that the use of FM-MSCs appeared safe for intravenous infusion and the overall response rate in severe refractory acute GVHD was similar to the rate observed by using bone marrow-derived MSCs [42].…”

Hypoxia-Induced Mesenchymal Stromal Cells Exhibit an Enhanced Therapeutic Effect on Radiation-Induced Lung Injury in Mice due to an Increased Proliferation Potential and Enhanced Antioxidant Ability

“…Therefore, an effective treatment strategy for RILI is urgently required. Development of RILI is a complex and continuous process, which is pathologically divided into two phases: the early pneumonitis phase and the later fibrosis phase [4]. Considerable inflammation in early pneumonitis and restricted breathing in later fibrosis make it difficult to treat RILI.…”

A clinical study of bone mesenchymal stem cells for the treatment of hepatic fibrosis induced by hepatolenticular degeneration

“…In recent years, BMSCs have been used to treat various diseases and have been shown to improve hepatic fibrosis to some extent (Usunier et al, 2014). Studies have shown that six-months after an intravenous injection of cultured BMSCs, patients' liver function indexes, pathological results of hepatic tissue and color Doppler ultrasound were improved, indicating the safety and effectiveness of BMSCs for treating cirrhosis (Mohamadnejad et al, 2007).…”