Over the past decade, significant efforts have been made to
develop stem cell-based therapies for difficult to treat diseases.
Multipotent mesenchymal stromal cells, also referred to as
mesenchymal stem cells (MSCs), appear to hold great promise in
regards to a regenerative cell-based therapy for the treatment of
these diseases. Currently, more than 200 clinical trials are
underway worldwide exploring the use of MSCs for the treatment of a
wide range of disorders including bone, cartilage and tendon
damage, myocardial infarction, graft-versus-host disease, Crohn s
disease, diabetes, multiple sclerosis, critical limb ischemia and
many others.
MSCs were first identified by Friendenstein and colleagues as an
adherent stromal cell population within the bone marrow with the
ability to form clonogenic colonies "in vitro. "In regards to the
basic biology associated with MSCs, there has been tremendous
progress towards understanding this cell population s phenotype and
function from a range of tissue sources. Despite enormous progress
and an overall increased understanding of MSCs at the molecular and
cellular level, several critical questions remain to be answered in
regards to the use of these cells in therapeutic applications.
Clinically, both autologous and allogenic approaches for the
transplantation of MSCs are being explored. Several of the
processing steps needed for the clinical application of MSCs,
including isolation from various tissues, scalable "in vitro
"expansion, cell banking, dose preparation, quality control
parameters, delivery methods and numerous others are being
extensively studied. Despite a significant number of ongoing
clinical trials, none of the current therapeutic approaches have,
at this point, become a standard of care treatment. Although
exceptionally promising, the clinical translation of MSC-based
therapies is still a work in progress.
The extensive number of ongoing clinical trials is expected to
provide a clearer path forward for the realization and
implementation of MSCs in regenerative medicine. Towards this end,
reviews of current clinical trial results and discussions of
relevant topics association with the clinical application of MSCs
are compiled in this book from some of the leading researchers in
this exciting and rapidly advancing field. Although not absolutely
all-inclusive, we hope the chapters within this book can promote
and enable a better understanding of the translation of MSCs from
bench-to-bedside and inspire researchers to further explore this
promising and quickly evolving field.
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