title: Mesenchymal stromal cells to promote solid organ transplantation tolerance.
abstract: OBJECTIVE
  Mesenchymal stromal cells (MSCs) possess unique immunomodulatory features. MSCs dampen effector T-cell response while promoting the emergence of regulatory T cells. By skewing this balance, MSC could represent the ideal strategy for tolerance induction in organ transplantation. Here we review recent evidence on the efficacy of MSC-based therapy in experimental models of solid organ transplantation as well as the early clinical experiences in kidney transplantation.
  
  
  RESULTS
  MSC infusion in experimental models of solid organ transplantation resulted in a Treg-mediated tolerance. MSC also synergized with low-dose or transient pharmacological immunosuppression in inducing long-term graft survival indicating that these cells could allow safe minimization of maintenance drug therapy. Early results from clinical studies in kidney transplant recipients reported encouraging results on the immunoregulatory effect of MSC, although posttransplant MSC infusion could associate with acute graft dysfunction (engraftment syndrome).
  
  
  CONCLUSIONS
  Immunoregulatory functions of MSC are not fixed but rather the result of microenvironment they encounter in vivo. Further studies are needed to establish how and wherein these cells have to be administered and how they may function to safely modulate host immune response in vivo in clinical transplant setting.
authors.affiliation: Department of Immunology and Transplantation, Transplant Research Center Chiara Cucchi de Alessandri e Gilberto Crespi, Mario Negri Institute for Pharmacological Research, Ospedali Riuniti - Mario Negri Institute for Pharmacological Research, Bergamo, Italy. federica.casiraghi@marionegri.it
authors.forename: Federica
authors.initials: F
authors.lastname: Casiraghi
authors.forename: Norberto
authors.initials: N
authors.lastname: Perico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Remuzzi
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016030:Kidney Transplantation / Q000276:immunology; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000276:immunology / Q000502:physiology*; D023421:Models, Animal; D050378:T-Lymphocytes, Regulatory / Q000166:cytology / Q000276:immunology; D023001:Transplantation Tolerance / Q000276:immunology*
chemical_list: D007166:Immunosuppressive Agents