Stem cells for lupus nephritis: a concise review of current knowledge

Sattwika, Prenali Dwisthi; Mustafa, Rima; Paramaiswari, Ayu; Herningtyas, Elizabeth Henny

doi:10.1177/0961203318793206

Cited by 16 publications

(12 citation statements)

References 127 publications

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“…When the clinical condition is serious, high-dose immunoglobulin, plasma exchange, or haematopoietic stem cell or mesenchymal stem cell transplantation can be selected. However, the long-term use of corticosteroids or immunosuppressants may lead to serious infection and secondary malignant tumours, and the use of biological agents is also limited to a certain extent because of its high cost [13].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Zhou

Liao

et al. 2020

Stem Cells International

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Systemic lupus erythematosus (SLE) is a polymorphic, multisystemic autoimmune disease that causes multiorgan damage in which cellular communication occurs through the involvement of autoantibodies directed against autoantigen production. Mesenchymal stem cells (MSCs), which have strong protective and immunomodulatory abilities, are obtained not only from bone marrow but also from medical waste such as adipose tissue and umbilical cord tissue and have been recognized as a promising tool for the treatment of various autoimmune diseases and inflammatory disorders. This meta-analysis is aimed at assessing whether MSCs can become a new treatment for SLE with good efficacy and safety. Based on predetermined criteria, a bibliographical search was performed from January 1, 2000, to July 31, 2019, by searching the following databases: ISI Web of Science, Embase, PubMed, the Cochrane Library, and the Chinese Biomedical Literature Database (CBM). Eligible studies and data were identified. Statistical analysis was conducted to assess the efficacy (proteinuria, systemic lupus erythematosus disease activity index (SLEDAI), Scr, BUN, albumin, C3, and C4) and safety (rate of adverse events) of MSCs for SLE using Cochrane Review Manager Version 5.3. Ten studies fulfilled the inclusion criteria and were eligible for this meta-analysis, which comprised 8 prospective or retrospective case series and four randomized controlled trails (RCTs) studies. In the RCT, the results indicated that the MSC group had lower proteinuria than the control group at 3 months and 6 months and the MSC group displayed a lower SLEDAI than the control group at 2 months and 6 months. Furthermore, the MSC group showed a lower rate of adverse events than the control group (OR=0.26, 95% CI: 0.07, 0.89, P=0.03). In the case series trials, the results indicated that the MSC group had lower proteinuria at 1 month, 2 months, 3 months, 4 months, 6 months, and 12 months. In conclusion, MSCs might be a promising therapeutic agent for patients with SLE.

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Section: Introductionmentioning

confidence: 99%

“…Cell therapy has become an attractive therapeutic strategy for various types of diseases [17][18][19][20], and it has achieved certain curative effects in induction therapy in patients with SLE [13]. The purpose of this study was to evaluate the efficacy of MSCs in the treatment of SLE by meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Zhou

Liao

et al. 2020

Stem Cells International

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“…Since the standard immunosuppressive treatment is mostly insufficient in patients with severe proliferative lupus nephritis [93], the cell-based therapies are a promising alternative owing to their immunomodulatory properties. To date, many pre-clinical studies regarding the use of MSC transplantation in the context of lupus nephritis therapy have been performed giving mostly positive outcomes in terms of proteinuria and renal histopathology, as reviewed lately [94]. In one of the most recent experimental studies, Tani et al applied systemic treatment with low-dose allogenic bone marrow MSC (10 6 cells/kg body weight intravenously) in a mouse model of spontaneously developing lupus with co-occurring glomerulonephritis.…”

Section: Research On the Use Of Mesenchymal Stem Cells In Kidney Dmentioning

confidence: 99%

Mesenchymal Stem Cells—Potential Applications in Kidney Diseases

Bochon¹,

Kozubska²,

Surygała³

et al. 2019

IJMS

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Mesenchymal stem cells constitute a pool of cells present throughout the lifetime in numerous niches, characteristic of unlimited replication potential and the ability to differentiate into mature cells of mesodermal tissues in vitro. The therapeutic potential of these cells is, however, primarily associated with their capabilities of inhibiting inflammation and initiating tissue regeneration. Owing to these properties, mesenchymal stem cells (derived from the bone marrow, subcutaneous adipose tissue, and increasingly urine) are the subject of research in the settings of kidney diseases in which inflammation plays the key role. The most advanced studies, with the first clinical trials, apply to ischemic acute kidney injury, renal transplantation, lupus and diabetic nephropathies, in which beneficial clinical effects of cells themselves, as well as their culture medium, were observed. The study findings imply that mesenchymal stem cells act predominantly through secreted factors, including, above all, microRNAs contained within extracellular vesicles. Research over the coming years will focus on this secretome as a possible therapeutic agent void of the potential carcinogenicity of the cells.

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“…An analysis of LN patients even showed that there had not been a major improvement in outcome in the last 30 years to 2011 [10], indicating that the conventional drugs are unlikely to produce any further clinically important improvements. Aside from the poor efficacy, long-term usage of nonspecific immunosuppressive regimens may increase the risk of serious infection and secondary malignant tumors; besides, because of its high cost, the use of biological agents is also limited [11, 12]. Thus, there is an urgent need for safer and more effective treatments for LN.…”

Section: Introductionmentioning

confidence: 99%

An Update for Mesenchymal Stem Cell Therapy in Lupus Nephritis

Li¹,

Chen²,

Sun³

2021

Kidney Dis

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Background: Lupus nephritis (LN) is the most severe organ manifestations of systemic lupus erythematosus (SLE). Although increased knowledge of the disease pathogenesis has improved treatment options, outcomes have plateaued as current immunosuppressive therapies have failed to prevent disease relapse in more than half of treated patients. Thus, there is still an urgent need for novel therapy. Mesenchymal stem cells (MSCs) possess a potently immunosuppressive regulation on immune responses, and intravenous transplantation of MSCs ameliorates disease symptoms and has emerged as a potential beneficial therapy for LN. The objective of this review is to discuss the defective functions of MSCs in LN patients and the application of MSCs in the treatment of both LN animal models and patients. Summary: Bone marrow MSCs from SLE patients exhibit impaired capabilities of migration, differentiation, and immune regulation and display senescent phenotype. Allogeneic MSCs suppress autoimmunity and restore renal function in mouse models and patients with LN by inducing regulatory immune cells and suppressing Th1, Th17, T follicular helper cell, and B-cell responses. In addition, MSCs can home to the kidney and integrate into tubular cells and differentiate into mesangial cells. Key Messages: The efficacy of MSCs in the LN treatment remains to be confirmed, and future advances from stem cell science can be expected to pinpoint significant MSC subpopulations, as well as specific mechanisms of action, leading the way to the use of more potent stimulated or primed pretreated MSCs to treat LN.

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Stem cells for lupus nephritis: a concise review of current knowledge

Cited by 16 publications

References 127 publications

Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

Mesenchymal Stem Cells—Potential Applications in Kidney Diseases

An Update for Mesenchymal Stem Cell Therapy in Lupus Nephritis

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