Cell Therapy in Hematopoietic Stem Cell Transplantation / 대한이식학회지

ABSTRACT

Mesenchymal stem cells (MSCs) are attractive not only in regenerative medicine but also for the treatment of graft- versus-host disease (GVHD). During stem cell transplantation, the damaged marrow stroma induced by conditioning regimen can be regained their function with cotransplantation of culture-expanded MSCs. So, MSCs are capable of enhancing hematopoietic cell engraftment owing to providing optimal environment for hematopoietic regeneration. MSCs have been shown to exert immunoregulatory activity in various studies. In vitro data suggested that they inhibit T-cell proliferation to alloantigens and mitogens and their effect is directed mainly at the level of cell proliferation. MSCs have started to be used in clinical trials for the prevention and treatment of GVHD after allogeneic stem cell transplantation. Some data suggested that cotransplantation of MSCs with hematopoietic stem cells reduced the incidence and severity of GVHD and the remission of grade III-IV acute GVHD can be achieved after infusion of donor-derived MSCs. However, several problems need to be addressed before the therapeutical potential of MSCs can be realized, including the investigation to characterize their phenotype, their mechanisms of action, and optimize their in vitro expansion for clinical use. Conclusively, MSCs may be used for hematopoiesis enhancement, as GVHD prophylaxis, and for the treatment of severe acute GVHD. And further studies are required to evaluate their therapeutic potentials.