Considerations for Clinical Use of Mesenchymal Stromal Cells

The clinical application of stem cells continues to fascinate the scientific and clinical communities. Despite the controversies surrounding this field, it is clear that stem cells have revolutionized regenerative medicine. Cell therapy is a progressively growing field that is moving fast from preclinical model development to clinical application. In this regard, outcomes obtained from clinical trials reveal the therapeutic potential of stem cell-based therapy that deals with unmet medical treatment for several disorders with no therapeutic alternatives. The application of stem cells in regenerative medicine is addressing a wide range of clinical conditions using various types of stem cells. Mesenchymal stromal cells (MSCs) have been established as promising candidate sources of universal donor cells for cell therapy due to their contributions to tissue and organ homeostasis, repair, and support by self-renewal and multi-differentiation, as well as by their anti-inflammatory, anti-proliferative, immunomodulatory, trophic, and pro-angiogenic properties. Various diseases have been successfully treated by MSCs in animal models. Additionally, hundreds of clinical trials related to the potential benefits of MSCs are in progress or have concluded satisfactorily. However, although all MSCs are considered suitable to exert these functions, dissimilarities have been found among MSCs derived from different tissues. The same levels of efficacy and desired outcomes have not always been achieved in the diverse studies that have been performed thus far. Therefore, collecting information regarding the characteristics of MSCs obtained from different sources and the influence of other medical and physiological conditions on MSCs is important for assuring the feasibility, safety, and efficacy of cell-based therapies. This chapter will update and discuss the state of the art in MSCs’ cell-based therapies and provide relevant information regarding factors to consider for the clinical application of MSCs.