Title: Mesenchymal stem cells - lights and shadows

Biography:

Suad Trebinjac is a Medical Director of FIFFA Medical Center of Excellence, the Best Physiotherapy & Rehabilitation Center  in Dubai .

Abstract

Statement of the problem: Mesenchymal stem cells (MSC) are multipotent cells able to divide and differentiate into other type of cells, forming a new tissue of mesenchymal origin. With their immunomodulatory and anti-inflammatory properties, they can curb and modify the course of different chronic diseases. However, the hope that incurable conditions will be completely cured is not yet materialized in clinical practice. The main reason is still insufficient knowledge about biological properties of stem cells, their interaction with environment, and complete understanding of their Immunomodulatory effect. The other non-resolved issues are related to quantity and optimal source of cells.

Methodology and theoretical orientation: The main methodological approach was searching for the literature relevant to explanation of biological properties of stem cells, their mechanism of action, optimization of their quantity and clinical application.

Findings: Initial hypothesis that multilineage differentiation of MSC is related to their potential of replacing damaged cells and forming the new tissues is not confirmed in practice. The reason is absence of specific MSC markers that will enable the tracking of cells after their administration. Recent research indicates that production of a myriad of trophic factors, including growth factors, chemokine, cytokines and antioxidants, rather than direct differentiation and cell replacement might be the main mechanism of action. The facts that migration of MSC to the place of injury is not mandatory for their action explain their paracrine effect instead of direct cell replacement.

The optimal quantity, viability and source of cells as well as ideal scaffold are still controversial issue and need further intensive research.
Conclusion: Stem cells present the most promising scientific discovery for treatment of chronic diseases. Their clinical success will depend on further research which should bring more lights on their interaction with inflammatory environment, Immunomodulatory characteristics, and effects of different molecules released after their administration. Encouraging preclinical and limited clinical results prompt the scientists and other stakeholders to invest more in further research.