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Autologous Cell-based Treatment for Severe Acute Kidney Injury in a Human Patient

Review of “Acute kidney injury successfully treated with autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation: A first-in-human report” from STEM CELLS Translational Medicine by Stuart P. Atkinson

Researchers led by Hiroyuki Suzuki (Shonan Kamakura General Hospital, Kamakura, Japan) recently established the therapeutic potential of CD34-positive cell-enriched human peripheral blood mononuclear cell transplantation as a treatment for acute kidney injury in an animal model [1]. This research, and others using mesenchymal stem cells derived from bone marrow [2], umbilical cord [3] (See the STEM CELLSarticle here!), and adipose tissue [4] have provided evidence for the utility of cell-based therapies for acute kidney injury; however, heir application in human patients for this indication remains undescribed.

In a recent STEM CELLS Translational Medicine article [5], the Suzuki team describes the first case of granulocyte colony-stimulating factor (G-CSF)-mobilized autologous CD34-positive cell transplantation as a treatment for acute kidney injury in a single human patient.

The details of this article from Suzuki et al. include:

  • This first case involved a male patient diagnosed with acute kidney injury with chronic ischemic renal damage due to refractory hypertension with microangiopathic hemolysis
    • Intermittent hemodialysis improved some hypertension-related symptoms, although acute kidney injury persisted
  • The authors collected G-CSF-mobilized CD34-positive cells from the patient and infused them directly into both renal arteries
    • This represents the first case in a phase I/II clinical trial of autologous G-CSF-mobilized peripheral blood CD34-positive cell transplantation for severe acute kidney injury with a cell dose-escalating protocol to evaluate the safety and efficacy as primary and secondary endpoints, respectively
    • Cell transplantation associated with transient fever and thrombocytosis but failed to prompt any major adverse events
    • Cell transplantation led to improved kidney function in the long term (as evidenced by improved serum creatinine levels) 

While this new study describes a single patient, the authors hope that the accumulation of data will provide further support for G-CSF-mobilized autologous peripheral blood CD34-positive cell transplantation as a safe and effective treatment for human patients with acute kidney injury.

For more on the therapeutic potential of this cell-based strategy for the treatment of severe acute kidney injury, stay tuned to the Stem Cells Portal!

References

  1. Ohtake T, Kobayashi S, Slavin S, et al., Human Peripheral Blood Mononuclear Cells Incubated in Vasculogenic Conditioning Medium Dramatically Improve Ischemia/Reperfusion Acute Kidney Injury in Mice. Cell Transplantation 2018;27:520-530.
  2. La Manna G, Bianchi F, Cappuccilli M, et al., Mesenchymal Stem Cells in Renal Function Recovery after Acute Kidney Injury: Use of a Differentiating Agent in a Rat Model. Cell Transplantation 2011;20:1193-1208.
  3. Morigi M, Rota C, Montemurro T, et al., Life-Sparing Effect of Human Cord Blood-Mesenchymal Stem Cells in Experimental Acute Kidney Injury. STEM CELLS 2010;28:513-522.
  4. Burgos-Silva M, Semedo-Kuriki P, Donizetti-Oliveira C, et al., Adipose Tissue-Derived Stem Cells Reduce Acute and Chronic Kidney Damage in Mice. PLOS ONE 2015;10:e0142183.
  5. Suzuki H, Ohtake T, Tsukiyama T, et al., Acute kidney injury successfully treated with autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation: A first-in-human report. STEM CELLS Translational Medicine 2021;10:1253-1257.