Kidney diseases and failure is a prevalent condition that is emerging as a public health concern. The causes of kidney failure in humans are vast including trauma to kidneys, diabetes mellitus, nephritic syndrome, and hypertension. When more than one-third of the kidney has impaired function, chronic kidney disease begins to set in. If this disease is left untreated, your kidneys will start to fail. The treatment, in this case, is regular dialysis and kidney transplant. However, as medicine progresses in its therapeutic practices and advanced treatments are developed, the need for a kidney transplant is reducing dramatically. Stem cell therapy is becoming increasingly effective in the treatment of kidney failure. Here is how and why.
How Can Stem Cells Help Kidney Disease?
Two of the most important characteristics of a stem cell are its perpetual potential for self-renewal and its ability to differentiate into different cell types. When present in the right environment, stem cells can both repair damaged tissues and reduced inflammation by modulating the immune system. This is why stem cells can be an incredible help in treating kidney diseases or even kidney failure. Stem cell therapy is a highly anti-inflammatory procedure that helps reduce the degree of chronic inflammation to allow the kidney to recover which was pending earlier due to the extensive inflammation of tissues. By regenerating kidney tissue, it can propagate kidney cells required for normal function.
Stem Cells for Cell-Based Therapy
The plasticity, self-renewal potency, and clonogenicity of stem cells are useful features in repairing a damaged organ, in this case, the kidney. However, not all stem cells are useful in a particular stem cell therapy. The choice of stem cells depends on which organ you want to repair. Different stem cells have different therapeutic indexes and differentiative potential.
Pluripotent stem cells, IPSCs, and ESCs are being considered as the chief stem cells involved in tissue regeneration in kidney diseases. The first step in using these cells for therapeutic purposes is to differentiate them into Renal Precursors Cells (RPCs) or more mature renal cells. This step is important to reduce the chances of developing tumors or to suppress the tumorigenicity which is intrinsic in pluripotent stem cells. Secondly, this step is useful in target differentiation because obtaining these cell types makes them more prone to differentiate into the desired target tissue.
Growth factors and chemical substances potentiate the process of differentiation. The differentiation of Renal Precursor Cells from pluripotent cells is crucial to understand the development of the kidney, mechanism of pathology, and for therapeutic uses.
Another kind of stem cells used in treating kidney diseases is the Mesenchyme Stem Cells (MSCs) derived from the pluripotent stem cells that are typically found in the bone marrow. Mesenchyme Stem Cells contribute to tissue repair by differentiating into organ-specific cells and replacing damaged tissue. MSCs active through the release of paracrine or endocrine secretion of exosomes and bioactive factors. These bioactive factors include growth factors, cytokines, pro-angiogenic factors, and antioxidants. The purpose of these factors is to regulate the local and systemic inflammatory response, modulate the immune response, minimize the response to apoptosis of damaged cells and the effect of stress, and release factors that are efficient in causing cell proliferation and angiogenesis.
These stem cells can be transplanted into the body to promote regeneration of damaged kidney tissue and reduction of overall inflammation. Moreover, stem cells have already been used therapeutically in conjunction with organ transplants to reduce the dependency on immunosuppressant drugs for life.
Renal Stem/Progenitor Cells (RSPCs) are considered the ideal sources of cell therapy for kidney diseases due to their high potency, specificity, self-renewal potential, and differentiating ability.
Effectiveness of Treatment
The use of stem cells is a promising therapeutic strategy for kidney diseases. Results are being obtained where stem cells were used in the treatment of Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD). They show that there is a significant therapeutic potential in the repair of renal injury which is helpful in preserving kidney structure and sustaining kidney function. Multiple pieces of evidence also suggest the mechanism of stem cell action. Stem cells act through the secretion of bioactive paracrine factors and/or by reducing inflammation through the release of microvesicles with immuno-modulatory and pro-regenerative properties.
Cases have been observed where stem cells derived from the bone marrow and fat were transplanted into the body of patients suffering from chronic nephritis which ultimately leads to renal failure. Stem cell therapy is also useful in treating complicated conditions such as multiple myeloma by transplanting bone marrow stem cells.
While stem cell therapy may not completely cure the disease or reverse kidney failure, it may be incredibly helpful in slowing down the progression of the disease and preserving the organ from other future insults. In Chronic Kidney Disease, stem cell therapy is definitely helpful in improving kidney function and treating the long-term effects of the chronic condition.
Since the renal system is a very specialized organ system, and kidneys are vital organs in providing filtration actions, it is important to fully understand the impact of stem cell therapy on this system before we can fully adopt them as a therapeutic strategy.
Right now, researchers and doctors are only recommending and executing general system stem cell therapy for kidney diseases which slows down the progression. Specific cells needed for renal repair are still under research and development. General systemic stem cell therapy would not completely heal the patient but the objective is to improve renal function however it can and reduce the frequency of dialysis in end-stage kidney diseases.
While the sources of stem cells may have a wide range such as ESCS, RSCPs, IPSCs, and MSCs, the objective is the same. Stem cell therapy is a promising therapeutic strategy that has yet to be fully understood and developed. Recent studies show enough progress in patients with AKI, CKD, or DN to indicate the future of stem cell therapy as a way to restore normal kidney function. The current experimental results can turn into clinical practice with the right knowledge, improvisation, and advanced technology.