Stem Cell- and Stem Cell-Free-Based Therapies: Pros and Cons

Halimeh Mobarak, Reza Rahbarghazi, M. Mahdipour
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Abstract

The efficiency of stem cell (SC)-based therapies has been proven in numerous animal and human studies. Along with the differentiation into several lineages, it is quite evident that SCs convey significant therapeutic effects in a paracrine manner via releasing various nano-sized extracellular vesicles (EVs) containing cytokines and bioactive factors. Notably, recent trials have stated the lack of stability and durability of the transplanted SCs at the site of injury for long periods, leading to the restrictions of SC in regenerative outcomes. Thus, EVs especially exosomes (Exos) gained much attention for therapeutic purposes and delivery purposes to the injury site. In contrast to whole-SC-based therapies, Exos can be used with fewer side effects. However, it should not be forgotten that both whole-SC- and cell-free-based options possess inherent pros and cons that necessitate being carefully evaluated before application in the clinical setting. Here, the effectiveness and limitations associated with whole-SCand SC-free-based therapies in the clinical setting are briefly discussed.
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干细胞疗法和无干细胞疗法:利与弊
以干细胞(SC)为基础的疗法的有效性已在大量动物和人体研究中得到证实。干细胞在分化成多种细胞系的同时,还通过释放含有细胞因子和生物活性因子的各种纳米级细胞外囊泡(EV),以旁分泌方式传递显著的治疗效果。值得注意的是,最近的试验表明,移植的细胞外囊在损伤部位缺乏长期稳定性和持久性,导致细胞外囊在再生效果方面受到限制。因此,EVs,尤其是外泌体(Exos)因其治疗目的和向损伤部位输送的目的而备受关注。与基于全细胞的疗法相比,外泌体的副作用较小。然而,不应忘记的是,全SC 和无细胞疗法都有其固有的优缺点,因此在临床应用前必须进行仔细评估。在此,我们将简要讨论基于全SC和无SC的疗法在临床环境中的有效性和局限性。
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