Tereza Dekova, PhD, Assistant Professor, Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, 8 Dragan Tzankov Str, Sofia 1164, Bulgaria. dekova@biofac.uni-sofia.bg
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tsvetelina Velikova, Department of Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Tereza Dekova, Dimitrina Georgieva Miteva, Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, Sofia 1164, Bulgaria
Author contributions: Velikova T and Miteva DG designed the research study, analyzed the data and wrote the manuscript; Velikova T and Dekova T contributed new reagents and analytic tools; Dekova T and Miteva DG performed the research; All authors have read and approve the final manuscript.
Supported byThe National Recovery and Resilience Plan of the Republic of Bulgaria, No. BG-RRP-2.004-0008-C01.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tereza Dekova, PhD, Assistant Professor, Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, 8 Dragan Tzankov Str, Sofia 1164, Bulgaria. dekova@biofac.uni-sofia.bg
Received: December 18, 2023 Revised: February 7, 2024 Accepted: April 3, 2024 Published online: June 18, 2024 Processing time: 178 Days and 9.3 Hours
Abstract
Mesenchymal stem cells (MSCs) have tantalized regenerative medicine with their therapeutic potential, yet a cloud of controversies looms over their clinical transplantation. This comprehensive review navigates the intricate landscape of MSC controversies, drawing upon 15 years of clinical experience and research. We delve into the fundamental properties of MSCs, exploring their unique immunomodulatory capabilities and surface markers. The heart of our inquiry lies in the controversial applications of MSC transplantation, including the perennial debate between autologous and allogeneic sources, concerns about efficacy, and lingering safety apprehensions. Moreover, we unravel the enigmatic mechanisms surrounding MSC transplantation, such as homing, integration, and the delicate balance between differentiation and paracrine effects. We also assess the current status of clinical trials and the ever-evolving regulatory landscape. As we peer into the future, we examine emerging trends, envisioning personalized medicine and innovative delivery methods. Our review provides a balanced and informed perspective on the controversies, offering readers a clear understanding of the complexities, challenges, and potential solutions in MSC transplantation.
Core Tip: Controversies surrounding mesenchymal stem cell (MSC) transplantation demand nuanced evaluation. Autologous vs allogeneic choices, long-term efficacy, and safety remain hot topics. Understanding the mechanisms of homing, integration, and paracrine signaling is vital for predictable outcomes. Standardization, regulatory clarity, and cost considerations require urgent attention. Combining MSCs with other therapies offers a promising horizon. Ethical, legal, and publication quality concerns persist. Rigorous research, informed patient selection and personalized strategies are paramount. In this dynamic field, our review underscores the need for clarity, transparency, and evidence-based practice to harness the transformative potential of MSCs effectively.
