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Review
. 2021 Mar 16:9:650664.
doi: 10.3389/fcell.2021.650664. eCollection 2021.

The Current Status of Mesenchymal Stromal Cells: Controversies, Unresolved Issues and Some Promising Solutions to Improve Their Therapeutic Efficacy

David García-Bernal  1   2 , Mariano García-Arranz  2   3 , Rosa M Yáñez  2   4   5 , Rosario Hervás-Salcedo  2   4   5 , Alfonso Cortés  2   6 , María Fernández-García  2   4   5 , Miriam Hernando-Rodríguez  2   4   5 , Óscar Quintana-Bustamante  2   4   5 , Juan A Bueren  2   4   5 , Damián García-Olmo  2   3 , Jose M Moraleda  1   2 , José C Segovia  2   4   5 , Agustín G Zapata  2   7
Affiliations
Review

The Current Status of Mesenchymal Stromal Cells: Controversies, Unresolved Issues and Some Promising Solutions to Improve Their Therapeutic Efficacy

David García-Bernal et al. Front Cell Dev Biol. .

Abstract

Mesenchymal stromal cells (MSCs) currently constitute the most frequently used cell type in advanced therapies with different purposes, most of which are related with inflammatory processes. Although the therapeutic efficacy of these cells has been clearly demonstrated in different disease animal models and in numerous human phase I/II clinical trials, only very few phase III trials using MSCs have demonstrated the expected potential therapeutic benefit. On the other hand, diverse controversial issues on the biology and clinical applications of MSCs, including their specific phenotype, the requirement of an inflammatory environment to induce immunosuppression, the relevance of the cell dose and their administration schedule, the cell delivery route (intravascular/systemic vs. local cell delivery), and the selected cell product (i.e., use of autologous vs. allogeneic MSCs, freshly cultured vs. frozen and thawed MSCs, MSCs vs. MSC-derived extracellular vesicles, etc.) persist. In the current review article, we have addressed these issues with special emphasis in the new approaches to improve the properties and functional capabilities of MSCs after distinct cell bioengineering strategies.

Keywords: MSC bioengineering; MSC homing; MSC immunomodulation; MSC preconditioning; MSC therapeutic efficacy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Next steps to improve the immunomodulatory properties of MSCs to treat patients efficiently.
See this image and copyright information in PMC

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