Published online Sep 26, 2019. doi: 10.4252/wjsc.v11.i9.618
Peer-review started: March 4, 2019
First decision: April 11, 2019
Revised: March 23, 2019
Accepted: July 16, 2019
Article in press: July 16, 2019
Published online: September 26, 2019
Processing time: 205 Days and 8 Hours
Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract associated with multifactorial conditions such as ulcerative colitis and Crohn’s disease. Although the underlying mechanisms of IBD remain unclear, growing evidence has shown that dysregulated immune system reactions in genetically susceptible individuals contribute to mucosal inflammation. However, conventional treatments have been effective in inducing remission of IBD but not in preventing the relapse of them. In this way, mesenchymal stromal cells (MSC) therapy has been recognized as a promising treatment for IBD due to their immunomodulatory properties, ability to differentiate into several tissues, and homing to inflammatory sites. Even so, literature is conflicted regarding the location and persistence of MSC in the body after transplantation. For this reason, recent studies have focused on the paracrine effect of the biofactors secreted by MSC, especially in relation to the immunomodulatory potential of soluble factors (cytokines, chemokines, and growth factors) and extracellular vehicles that are involved in cell communication and in the transfer of cellular material, such as proteins, lipids, and nucleic acids. Moreover, treatment with interferon-γ, tumor necrosis factor-α, and interleukin-1β causes MSC to express immunomodulatory molecules that mediate the suppression via cell-contact dependent mechanisms. Taken together, we present an overview of the role of bioactive factors and cell membrane proteins derived from MSC as a cell-free therapy that can improve IBD treatment.
Core tip: Recent experimental studies have suggested that both bioactive factors and surface proteins of mesenchymal stem cells demonstrate great therapeutic potential for overcoming the deficiencies of current therapies for inflammatory bowel diseases. Our goal in this review is to describe cell-free therapy based upon the therapeutic potential of mesenchymal stem cells, while avoiding the practical issues associated with the use of living cells.