Professor Mark Slevin: This review provides a thorough investigation of the literature surrounding the potential utilization of mesenchymal stem cells (MSCs) for therapeutic application for cell and tissue repair, replacement and regeneration. In particular, it describes and compares the sources of these MSCS i.e. derivation from adipose tissue (ADSCs), bone marrow (BM-MSCs) and umbilical cord (UC-MSCs). The authors summarized that all sources of MSCs possessed similar anti-inflammatory properties through secretion of proteins such as IL-1R-alpha antagonist, although ADSCs had the greatest level of secretion of these factors and secreted more proteins with higher gene activity than MSCs from other sources.
The harvesting of these cells ranges from the most simple-UC-MSCs at birth through liposucted ADSCs to the most invasive and painful procedure for the removal of BM-MSCs. BM-MSCs constitute only around 0.002% of the total cell population, their isolation is variable and the maximum number of divisions (for expansion and storage or use) is limited to around 12 passages. All sources of MSCs are multi-potent, that is that they can differentiate into adipogenic, chondrogenic or osteogenic precursors, however, the potential of BM-MSCs to differentiate decreases with age as does their number and life span. UC-MSCs generally maintain there multipotency for longer, have higher potency of osteogenic differentiation and also express embryonic stem cell markers-that have translated into their experimental use for treatment of neurological disease following differentiation into spinal cord tissue etc. ADSCs present at around 2% of the stromal cell fraction (making it much easier to culture up required numbers for treatment or strorage) maintaining their differentiation capacity in aged subjects and with almost zero expression of HLADR, are suitable for allogeneic transplantation. In addition, they also possess multi-potency giving them the potential to be used beyond mesodermal regenerative and reparative applications.
In a summary of current use, the authors indicate the advantages in safety and efficacy of ADSCs when compared to other sources of MSCs, in regard to clinical studies involving wound healing, stroke, brain and spinal cord injury, autoimmune disorders such as Lupus, osteoarthritis
concerning bone and cartilage repair and regeneration, and cardiovascular disease such as myocardial tissue repair.