title: Adult stem cells as a tool for kidney regeneration.
abstract: Kidney regeneration is a challenging but promising strategy aimed at reducing the progression to end-stage renal disease (ESRD) and improving the quality of life of patients with ESRD. Adult stem cells are multipotent stem cells that reside in various tissues, such as bone marrow and adipose tissue. Although intensive studies to isolate kidney stem/progenitor cells from the adult kidney have been performed, it remains controversial whether stem/progenitor cells actually exist in the mammalian adult kidney. The efficacy of mesenchymal stem cells (MSCs) in the recovery of kidney function has been demonstrated in animal nephropathy models, such as acute tubular injury, glomerulonephritis, renal artery stenosis, and remnant kidney. However, their beneficial effects seem to be mediated largely via their paracrine effects rather than their direct differentiation into renal parenchymal cells. MSCs not only secrete bioactive molecules directly into the circulation, but they also release various molecules, such as proteins, mRNA, and microRNA, in membrane-covered vesicles. A detailed analysis of these molecules and an exploration of the optimal combination of these molecules will enable the treatment of patients with kidney disease without using stem cells. Another option for the treatment of patients with kidney disease using adult somatic cells is a direct/indirect reprogramming of adult somatic cells into kidney stem/progenitor cells. Although many hurdles still need to be overcome, this strategy will enable bona fide kidney regeneration rather than kidney repair using remnant renal parenchymal cells.
authors.affiliation: Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan.
authors.forename: Etsu
authors.initials: E
authors.lastname: Suzuki
authors.affiliation: Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan.
authors.forename: Daishi
authors.initials: D
authors.lastname: Fujita
authors.affiliation: Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Oba
authors.affiliation: Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishimatsu
keywords: Adult stem cells; Direct reprogramming; Extracellular vesicles; Indirect reprogramming; Mesenchymal stem cells; Paracrine factors