Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)

Mesenchymal stromal cells (MSCs) have enormous intrinsic clinical value due to their multi-lineage differentiation capacity, support of hemopoiesis, immunoregulation and growth factors/cytokines secretion. MSCs have thus been the object of extensive research for decades. After completion of many pre...

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Main Author: Simone ePacini
Format: Article
Language:English
Published: Frontiers Media S.A. 2014-09-01
Series:Frontiers in Cell and Developmental Biology
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fcell.2014.00050/full
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author Simone ePacini
author_facet Simone ePacini
author_sort Simone ePacini
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description Mesenchymal stromal cells (MSCs) have enormous intrinsic clinical value due to their multi-lineage differentiation capacity, support of hemopoiesis, immunoregulation and growth factors/cytokines secretion. MSCs have thus been the object of extensive research for decades. After completion of many pre-clinical and clinical trials, MSC-based therapy is now facing a challenging phase. Several clinical trials have reported moderate, non-durable benefits, which caused initial enthusiasm to wane, and indicated an urgent need to optimize the efficacy of therapeutic, platform-enhancing MSC-based treatment. Recent investigations suggest the presence of multiple in vivo MSC ancestors in a wide range of tissues, which contribute to the heterogeneity of the starting material for the expansion of MSCs. This variability in the MSC culture-initiating cell population, together with the different types of enrichment/isolation and cultivation protocols applied, are hampering progress in the definition of MSC-based therapies. International regulatory statements require a precise risk/benefit analysis, ensuring the safety and efficacy of treatments. GMP validation allows for quality certification, but the prediction of a clinical outcome after MSC-based therapy is correlated not only to the possible morbidity derived by cell production process, but also to the biology of the MSCs themselves, which is highly sensible to unpredictable fluctuation of isolating and culture conditions.Risk exposure and efficacy of MSC-based therapies should be evaluated by pre-clinical studies, but the batch-to-batch variability of the final medicinal product could significantly limit the predictability of these studies. The future success of MSC-based therapies could lie not only in rational optimization of therapeutic strategies, but also in a stochastic approach during the assessment of benefit and risk factors.
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spelling doaj.art-ce3ccbd5a0d94784a24d8a4f112ba1dc2022-12-22T03:22:17ZengFrontiers Media S.A.Frontiers in Cell and Developmental Biology2296-634X2014-09-01210.3389/fcell.2014.00050112071Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)Simone ePacini0University of PisaMesenchymal stromal cells (MSCs) have enormous intrinsic clinical value due to their multi-lineage differentiation capacity, support of hemopoiesis, immunoregulation and growth factors/cytokines secretion. MSCs have thus been the object of extensive research for decades. After completion of many pre-clinical and clinical trials, MSC-based therapy is now facing a challenging phase. Several clinical trials have reported moderate, non-durable benefits, which caused initial enthusiasm to wane, and indicated an urgent need to optimize the efficacy of therapeutic, platform-enhancing MSC-based treatment. Recent investigations suggest the presence of multiple in vivo MSC ancestors in a wide range of tissues, which contribute to the heterogeneity of the starting material for the expansion of MSCs. This variability in the MSC culture-initiating cell population, together with the different types of enrichment/isolation and cultivation protocols applied, are hampering progress in the definition of MSC-based therapies. International regulatory statements require a precise risk/benefit analysis, ensuring the safety and efficacy of treatments. GMP validation allows for quality certification, but the prediction of a clinical outcome after MSC-based therapy is correlated not only to the possible morbidity derived by cell production process, but also to the biology of the MSCs themselves, which is highly sensible to unpredictable fluctuation of isolating and culture conditions.Risk exposure and efficacy of MSC-based therapies should be evaluated by pre-clinical studies, but the batch-to-batch variability of the final medicinal product could significantly limit the predictability of these studies. The future success of MSC-based therapies could lie not only in rational optimization of therapeutic strategies, but also in a stochastic approach during the assessment of benefit and risk factors.http://journal.frontiersin.org/Journal/10.3389/fcell.2014.00050/fullBioreactorsCell Culture TechniquesMesenchymal Stem Cell TransplantationMesenchymal Stromal CellsRisk Assessmentcell isolation
spellingShingle Simone ePacini
Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
Frontiers in Cell and Developmental Biology
Bioreactors
Cell Culture Techniques
Mesenchymal Stem Cell Transplantation
Mesenchymal Stromal Cells
Risk Assessment
cell isolation
title Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
title_full Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
title_fullStr Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
title_full_unstemmed Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
title_short Deterministic and Stochastic Approaches in the Clinical Application of Mesenchymal Stromal Cells (MSCs)
title_sort deterministic and stochastic approaches in the clinical application of mesenchymal stromal cells mscs
topic Bioreactors
Cell Culture Techniques
Mesenchymal Stem Cell Transplantation
Mesenchymal Stromal Cells
Risk Assessment
cell isolation
url http://journal.frontiersin.org/Journal/10.3389/fcell.2014.00050/full
work_keys_str_mv AT simoneepacini deterministicandstochasticapproachesintheclinicalapplicationofmesenchymalstromalcellsmscs