4. Adipose-Derived MSCs for Chronic Kidney Disease | Sit. Stay. Learn. with Dr. Adrienne Wright скачать в хорошем качестве

4. Adipose-Derived MSCs for Chronic Kidney Disease | Sit. Stay. Learn. with Dr. Adrienne Wright

Today’s Paper: Adipose-Derived MSCs for Chronic Kidney Disease This week, I’m switching gears. Most of the studies I cover are animal-focused, but this time we’re looking at a human pilot study that gives us insights we can bring right back into veterinary medicine. The paper examined autologous adipose-derived mesenchymal stem cells (MSCs) for chronic kidney disease (CKD) in adults. It comes from researchers in Chile and was published in Kidney Research and Clinical Practice in 2019. Why This Matters CKD is a relentless disease—progressive, permanent, and costly. It’s a major issue in both human and veterinary medicine. • In dogs, about 1% overall are affected, climbing to 10% of older dogs. • In cats, around 3% overall, but up to 50% of cats over 15 years old. Certain breeds are predisposed, and dogs generally face a worse prognosis than cats. Current therapies can slow disease but don’t stop it, and often come with significant risks. MSCs bring hope here. Their anti-inflammatory, trophic, and immune-modulating effects may help preserve kidney function. At Ardent, we’ve seen cats treated with MSCs show quality-of-life improvements—better appetite, weight stability, and energy—even when bloodwork doesn’t tell the whole story. Study Design Seven adults were initially enrolled, but one was removed due to poor cell proliferation in culture. That left six patients, three men and three women, with an average age of 42 years. Four had hypertension. Their average serum creatinine was 2.22 mg/dL, much higher than normal. The treatment involved a single intravenous infusion of autologous adipose-derived MSCs. Each patient received one million cells per kilogram of body weight, delivered in 120 mL of LRS over 30–40 minutes. Most patients received the full dose, though one only received about 59% of target. Instead of a separate placebo group, the researchers compared each patient’s results from the 12 months before treatment (control period) to the 12 months after treatment (intervention period). Patients were followed for a full year post-infusion, while maintaining pharmacologic therapy, blood pressure control, and dietary protein restriction. Results The infusion was well tolerated, with no treatment-related adverse events reported. Safety labs stayed stable across the board. Proteinuria, which had worsened in most patients during the control period, decreased in nearly everyone after MSC therapy. Even the patient with renal dysplasia, who didn’t improve as much as the others, showed a major slowdown in progression compared to the year prior. Renal function results were mixed. Overall eGFR decline wasn’t statistically significant, but five of the six patients saw plasma creatinine reductions of 7.5%–49%. Patients with less inflammatory forms of CKD appeared to stabilize more effectively. Why It’s Exciting What stands out to me most is the safety and feasibility. Every patient tolerated the infusion well, and the process was straightforward. The proteinuria reductions are also encouraging. Even though eGFR results weren’t dramatic, stabilization and creatinine improvements are important—especially when paired with quality-of-life gains, which we also see in veterinary patients. It’s also notable that the study used adipose-derived MSCs rather than bone marrow-derived MSCs. Adipose yields more cells and avoids the invasive harvest procedure, making it practical in both people and animals. • Safe, simple, single dose • Proteinuria improvement in nearly every case • Promising parallels for cats and dogs with CKD Final Thoughts This pilot study suggests that a single IV infusion of autologous adipose-derived MSCs is safe, feasible, and potentially effective for CKD. While larger trials are needed, the consistent improvements in proteinuria and creatinine trends are worth attention. For veterinary medicine, it reinforces what we’ve seen in practice: stem cell therapy won’t always transform lab values, but it can deliver meaningful improvements in how pets feel and live. What do you think—are MSCs ready to change the way we treat CKD in pets? You can email me at [email protected].