Challenges and opportunities for stem cell therapy in patients with chronic kidney disease

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Chronic kidney disease (CKD) is a global health care burden affecting billions of individuals worldwide. The kidney has limited regenerative capacity from chronic insults, and for the most common causes of CKD, no effective treatment exists to prevent progression to end-stage kidney failure. Therefore, novel interventions, such as regenerative cell-based therapies, need to be developed for CKD. Given the risk of allosensitization, autologous transplantation of cells to boost regenerative potential is preferred. Therefore, verification of cell function and vitality in CKD patients is imperative. Two cell types have been most commonly applied in regenerative medicine. Endothelial progenitor cells contribute to neovasculogenesis primarily through paracrine angiogenic activity and partly by differentiation into mature endothelial cells in situ. Mesenchymal stem cells also exert paracrine effects, including proangiogenic, anti-inflammatory, and antifibrotic activity. However, in CKD, multiple factors may contribute to reduced cell function, including older age, coexisting cardiovascular disease, diabetes, chronic inflammatory states, and uremia, which may limit the effectiveness of an autologous cell-based therapy approach. This Review highlights current knowledge on stem and progenitor cell function and vitality, aspects of the uremic milieu that may serve as a barrier to therapy, and novel methods to improve stem cell function for potential transplantation.

Original languageEnglish (US)
Pages (from-to)767-778
Number of pages12
JournalKidney International
Volume89
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Cell- and Tissue-Based Therapy
Chronic Renal Insufficiency
Stem Cells
Regenerative Medicine
Autologous Transplantation
Uremia
Mesenchymal Stromal Cells
Renal Insufficiency
Anti-Inflammatory Agents
Cardiovascular Diseases
Endothelial Cells
Transplantation
Delivery of Health Care
Kidney
Therapeutics

Keywords

  • end-stage renal disease
  • senescence
  • stem cells
  • uremia

ASJC Scopus subject areas

  • Nephrology

Cite this

@article{f2183fc2d1db4bed847c9219cb373437,
title = "Challenges and opportunities for stem cell therapy in patients with chronic kidney disease",
abstract = "Chronic kidney disease (CKD) is a global health care burden affecting billions of individuals worldwide. The kidney has limited regenerative capacity from chronic insults, and for the most common causes of CKD, no effective treatment exists to prevent progression to end-stage kidney failure. Therefore, novel interventions, such as regenerative cell-based therapies, need to be developed for CKD. Given the risk of allosensitization, autologous transplantation of cells to boost regenerative potential is preferred. Therefore, verification of cell function and vitality in CKD patients is imperative. Two cell types have been most commonly applied in regenerative medicine. Endothelial progenitor cells contribute to neovasculogenesis primarily through paracrine angiogenic activity and partly by differentiation into mature endothelial cells in situ. Mesenchymal stem cells also exert paracrine effects, including proangiogenic, anti-inflammatory, and antifibrotic activity. However, in CKD, multiple factors may contribute to reduced cell function, including older age, coexisting cardiovascular disease, diabetes, chronic inflammatory states, and uremia, which may limit the effectiveness of an autologous cell-based therapy approach. This Review highlights current knowledge on stem and progenitor cell function and vitality, aspects of the uremic milieu that may serve as a barrier to therapy, and novel methods to improve stem cell function for potential transplantation.",
keywords = "end-stage renal disease, senescence, stem cells, uremia",
author = "LaTonya Hickson and Alfonso Eirin and Lerman, {Lilach O}",
year = "2016",
month = "4",
day = "1",
doi = "10.1016/j.kint.2015.11.023",
language = "English (US)",
volume = "89",
pages = "767--778",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "4",

}

TY - JOUR

T1 - Challenges and opportunities for stem cell therapy in patients with chronic kidney disease

AU - Hickson, LaTonya

AU - Eirin, Alfonso

AU - Lerman, Lilach O

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Chronic kidney disease (CKD) is a global health care burden affecting billions of individuals worldwide. The kidney has limited regenerative capacity from chronic insults, and for the most common causes of CKD, no effective treatment exists to prevent progression to end-stage kidney failure. Therefore, novel interventions, such as regenerative cell-based therapies, need to be developed for CKD. Given the risk of allosensitization, autologous transplantation of cells to boost regenerative potential is preferred. Therefore, verification of cell function and vitality in CKD patients is imperative. Two cell types have been most commonly applied in regenerative medicine. Endothelial progenitor cells contribute to neovasculogenesis primarily through paracrine angiogenic activity and partly by differentiation into mature endothelial cells in situ. Mesenchymal stem cells also exert paracrine effects, including proangiogenic, anti-inflammatory, and antifibrotic activity. However, in CKD, multiple factors may contribute to reduced cell function, including older age, coexisting cardiovascular disease, diabetes, chronic inflammatory states, and uremia, which may limit the effectiveness of an autologous cell-based therapy approach. This Review highlights current knowledge on stem and progenitor cell function and vitality, aspects of the uremic milieu that may serve as a barrier to therapy, and novel methods to improve stem cell function for potential transplantation.

AB - Chronic kidney disease (CKD) is a global health care burden affecting billions of individuals worldwide. The kidney has limited regenerative capacity from chronic insults, and for the most common causes of CKD, no effective treatment exists to prevent progression to end-stage kidney failure. Therefore, novel interventions, such as regenerative cell-based therapies, need to be developed for CKD. Given the risk of allosensitization, autologous transplantation of cells to boost regenerative potential is preferred. Therefore, verification of cell function and vitality in CKD patients is imperative. Two cell types have been most commonly applied in regenerative medicine. Endothelial progenitor cells contribute to neovasculogenesis primarily through paracrine angiogenic activity and partly by differentiation into mature endothelial cells in situ. Mesenchymal stem cells also exert paracrine effects, including proangiogenic, anti-inflammatory, and antifibrotic activity. However, in CKD, multiple factors may contribute to reduced cell function, including older age, coexisting cardiovascular disease, diabetes, chronic inflammatory states, and uremia, which may limit the effectiveness of an autologous cell-based therapy approach. This Review highlights current knowledge on stem and progenitor cell function and vitality, aspects of the uremic milieu that may serve as a barrier to therapy, and novel methods to improve stem cell function for potential transplantation.

KW - end-stage renal disease

KW - senescence

KW - stem cells

KW - uremia

UR - http://www.scopus.com/inward/record.url?scp=84964661462&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964661462&partnerID=8YFLogxK

U2 - 10.1016/j.kint.2015.11.023

DO - 10.1016/j.kint.2015.11.023

M3 - Article

C2 - 26924058

AN - SCOPUS:84964661462

VL - 89

SP - 767

EP - 778

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 4

ER -