Dr Teoh – Family Medicine Specialist, Stem Cell & Immune Therapy

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Exploring Mesenchymal Stem Cell Therapy in End-Stage Renal Failure Due to Goodpasture Syndrome: A Case Study

3–4 minutes

Case Overview

Today, we share the compelling story of a 45-year-old woman who was diagnosed with Goodpasture Syndrome two years ago. Goodpasture Syndrome is an autoimmune disease where the body’s immune system mistakenly attacks the kidneys and lungs. Despite her anti-GBM (anti-glomerular basement membrane) antibody becoming negative six months ago, her renal function has not returned to normal. She continues to require hemodialysis twice a week. Recent investigations revealed high creatinine levels and a GFR (glomerular filtration rate) of 10, along with heavy proteinuria.

In an effort to explore new treatment avenues, she received a 100 million Mesenchymal Stem Cell (MSC) therapy today. Let’s delve into the potential benefits of MSC therapy and the supporting evidence behind it.

Potential Benefits of MSC Therapy in End-Stage Renal Failure

  1. Anti-inflammatory Effects:
    MSCs can significantly reduce inflammation in the kidneys. This anti-inflammatory effect can potentially alleviate some of the kidney damage caused by the autoimmune responses in Goodpasture Syndrome.
  2. Tissue Repair and Regeneration:
    One of the remarkable properties of MSCs is their ability to promote the repair and regeneration of damaged tissues. In the context of kidney disease, MSCs can help repair the damaged kidney tissues, potentially improving renal function over time.
  3. Immunomodulation:
    MSCs have the capability to modulate the immune system. This means they can help prevent further autoimmune attacks on the kidneys, preserving the remaining kidney function and possibly enhancing the patient’s overall health.
  4. Reduction of Proteinuria:
    Proteinuria, the presence of excess proteins in the urine, is a significant marker of kidney damage. Studies have shown that MSC therapy can help reduce proteinuria, indicating a potential improvement in kidney function.

What is GFR?

GFR, or glomerular filtration rate, is a critical indicator of kidney function. It measures how much blood the kidneys filter each minute to remove waste and excess fluids. Here are some key points about GFR:

  • Normal GFR: Typically above 90. A normal GFR indicates healthy kidney function.
  • Moderate to Severe Kidney Damage: GFR values between 15 and 59 indicate moderate to severe kidney damage.
  • End-Stage Renal Disease: When GFR drops below 15, it indicates severe kidney damage. At this stage, dialysis or a kidney transplant may be necessary to sustain life.

Supporting Evidence for MSC Therapy in ESRF

Clinical Study:

    • Title: Mesenchymal Stem Cells for the Treatment of End-Stage Renal Disease
    • Authors: Kim, Y. J., Park, H. J., Lee, G., Bang, O. Y., & Ahn, Y. H.
    • Journal: Journal of Translational Medicine
    • Year: 2015
    • Summary: This study explored the effects of MSCs in patients with ESRF. The results showed significant improvements in kidney function and reduction in inflammation markers after MSC therapy.

    Clinical Trial:

      • Title: Allogeneic Mesenchymal Stem Cells in Severe Chronic Kidney Disease
      • Authors: Perico, N., Casiraghi, F., Introna, M., Gotti, E., Todeschini, M., Cavinato, R. A., … & Remuzzi, G.
      • Journal: Stem Cells Translational Medicine
      • Year: 2017
      • Summary: This clinical trial demonstrated that MSC infusion was safe and resulted in improved renal function and reduced proteinuria in patients with severe chronic kidney disease, including those in the end-stage.

      Preclinical Study:

        • Title: Mesenchymal Stem Cells Ameliorate Experimental Chronic Kidney Disease
        • Authors: Tögel, F., Hu, Z., Weiss, K., Isaac, J., Lange, C., & Westenfelder, C.
        • Journal: Journal of the American Society of Nephrology
        • Year: 2012
        • Summary: This preclinical study showed that MSCs could significantly improve kidney function and reduce fibrosis in animal models of chronic kidney disease, providing a strong basis for their use in human ESRF.

        While more extensive clinical trials are needed, MSC therapy offers a promising avenue for patients with end-stage renal failure. We will closely monitor our patient’s progress and hope to see positive outcomes.

        Stay tuned for updates on her journey and further insights into the advancements in stem cell therapy for kidney diseases.