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Review
. 2023 Feb 26;15(2):16-30.
doi: 10.4252/wjsc.v15.i2.16.

Mesenchymal stem cells in ischemic tissue regeneration

Renata Szydlak  1
Affiliations
Review

Mesenchymal stem cells in ischemic tissue regeneration

Renata Szydlak. World J Stem Cells. .

Abstract

Diseases caused by ischemia are one of the leading causes of death in the world. Current therapies for treating acute myocardial infarction, ischemic stroke, and critical limb ischemia do not complete recovery. Regenerative therapies opens new therapeutic strategy in the treatment of ischemic disorders. Mesenchymal stem cells (MSCs) are the most promising option in the field of cell-based therapies, due to their secretory and immunomodulatory abilities, that contribute to ease inflammation and promote the regeneration of damaged tissues. This review presents the current knowledge of the mechanisms of action of MSCs and their therapeutic effects in the treatment of ischemic diseases, described on the basis of data from in vitro experiments and preclinical animal studies, and also summarize the effects of using these cells in clinical trial settings. Since the obtained therapeutic benefits are not always satisfactory, approaches aimed at enhancing the effect of MSCs in regenerative therapies are presented at the end.

Keywords: Clinical applications; Ischemia; Mesenchymal stem cells; Regenerative medicine; Stem cell therapy.

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Conflict of interest statement

Conflict-of-interest statement: The author reports having no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Mesenchymal stem cell therapy in ischemic diseases. The mesenchymal stem cells can be use as biological drugs in the treatment of ischemic disorders of various organs, including brain ischemia in ischemic stroke, heart ischemia in acute myocardial infraction, Chronic ischemic cardiomyopathy, ischemic heart failure, and chronic lower extremity ischemia. MSC: Mesenchymal stem cell.
Figure 2
Figure 2
Proposed therapeutic mechanisms of mesenchymal stem cells, including differentiation, immunomodulation, secretion of paracrine factors, and secretion of microvesicles. Mesenchymal stem cells (MSCs) can repair and/or rescue injured cells via differentiation into replacement cell types including endothelial cells, and cardiomyocytes. The immunomodulatory activity of MSCs includes the suppression of macrophage polarization to M1, though favors M2 polarization. MSCs can secrete a number of factors that stimulate the regeneration of damaged cells and tissues [e.g., vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), hepatocyte growth factor (HGF), stromal cell-derived factor-1] and having a beneficial effect for neovascularization processes (e.g., VEGF, IGF-1, HGF, fibroblast growth factor-2, platelet-derived growth factor-BB, placental growth factor), inhibiting the pathological remodeling of ischemic tissues [e.g., matrix metalloproteinase 2 (MMP-2), MMP-9]. The exosomes secreted by MSCs contain cytokines and growth factors, signaling lipids, mRNAs, and regulatory microRNAs which can be responsible for the therapeutic effects. MSC: Mesenchymal stem cell.
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