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Mesenchymal stem cells (MSCs), more accurately called multipotent mesenchymal stromal cells, are being increasingly used in the treatment or amelioration of inflammatory and ischaemic conditions, including autoimmune diseases.1 This developed from the observation of the in vitro antiproliferative properties of MSCs, involving soluble factors and cell–cell contact-dependent events first observed in mixed lymphocyte reactions.2 Currently there are data involving nearly all known immune competent cells showing an antiproliferative and/or cell survival effect derived from MSCs,3 in some cases involving crosstalk and gene expression reprogramming.4 In addition, a plethora of animal model data have mostly been positive, but not all: notable exceptions being some rodent collagen induced arthritis models5 and murine systemic lupus erythematosus (SLE).6
The first use of MSCs in humans was as graft enhancing agents in patients with malignancies receiving haematopoietic stem cell transplants.7 An amelioration of acute graft versus host disease (GvHD) was observed, leading to successful targeted use of MSCs for acute GvHD.8 Due to their low acute toxicity and apparent immune privilege (allogeneic MSCs neither induce nor are subject to immune reaction), and relative ease of availability (eg, bone marrow, adipose tissue, placental products) and ex vivo expansion, the …
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