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Perico, Norberto; Casiraghi, Federica; Introna, Martino; Gotti, Eliana; Todeschini, Marta; Cavinato, Regiane Aparecida; Capelli, Chiara; Rambaldi, Alessandro; Cassis, Paola; Rizzo, Paola; Cortinovis, Monica; Marasà, Maddalena; Golay, Josee; Noris, Marina; Remuzzi, Giuseppe

Autologous Mesenchymal Stromal Cells and Kidney Transplantation : A Pilot Study of Safety and Clinical Feasibility : A Pilot Study of Safety and Clinical Feasibility

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  • Media type: E-Article
  • Title: Autologous Mesenchymal Stromal Cells and Kidney Transplantation : A Pilot Study of Safety and Clinical Feasibility : A Pilot Study of Safety and Clinical Feasibility
  • Contributor: Perico, Norberto; Casiraghi, Federica; Introna, Martino; Gotti, Eliana; Todeschini, Marta; Cavinato, Regiane Aparecida; Capelli, Chiara; Rambaldi, Alessandro; Cassis, Paola; Rizzo, Paola; Cortinovis, Monica; Marasà, Maddalena; Golay, Josee; Noris, Marina; Remuzzi, Giuseppe
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2011
  • Published in: Clinical Journal of the American Society of Nephrology
  • Language: English
  • DOI: 10.2215/cjn.04950610
  • ISSN: 1555-9041
  • Keywords: Transplantation ; Nephrology ; Critical Care and Intensive Care Medicine ; Epidemiology
  • Origination:
  • Footnote:
  • Description: <jats:title>Summary</jats:title> <jats:sec> <jats:title>Background and objectives</jats:title> <jats:p>Mesenchymal stromal cells (MSCs) abrogate alloimmune response <jats:italic toggle="yes">in vitro</jats:italic>, suggesting a novel cell-based approach in transplantation. Moving this concept toward clinical application in organ transplantation should be critically assessed.</jats:p> </jats:sec> <jats:sec> <jats:title>Design, setting, participants &amp; measurements</jats:title> <jats:p>A safety and clinical feasibility study (ClinicalTrials.gov, NCT00752479) of autologous MSC infusion was conducted in two recipients of kidneys from living-related donors. Patients were given T cell–depleting induction therapy and maintenance immunosuppression with cyclosporine and mycophenolate mofetil. On day 7 posttransplant, MSCs were administered intravenously. Clinical and immunomonitoring of MSC-treated patients was performed up to day 360 postsurgery.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Serum creatinine levels increased 7 to 14 days after cell infusion in both MSC-treated patients. A graft biopsy in patient 2 excluded acute graft rejection, but showed a focal inflammatory infiltrate, mostly granulocytes. In patient 1 protocol biopsy at 1-year posttransplant showed a normal graft. Both MSC-treated patients are in good health with stable graft function. A progressive increase of the percentage of CD4<jats:sup>+</jats:sup>CD25<jats:sup>high</jats:sup>FoxP3<jats:sup>+</jats:sup>CD127<jats:sup>−</jats:sup> Treg and a marked inhibition of memory CD45RO<jats:sup>+</jats:sup>RA<jats:sup>−</jats:sup>CD8<jats:sup>+</jats:sup> T cell expansion were observed posttransplant. Patient T cells showed a profound reduction of CD8<jats:sup>+</jats:sup> T cell activity.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Findings from this study in the two patients show that MSC infusion in kidney transplant recipients is feasible, allows enlargement of Treg in the peripheral blood, and controls memory CD8<jats:sup>+</jats:sup> T cell function. Future clinical trials with MSCs to look with the greatest care for unwanted side effects is advised.</jats:p> </jats:sec>
  • Access State: Open Access