1. Critical Need for Regenerative Approaches
1.4 million patients die from chronic kidney disease and kidney failure globally. Current approaches to manage the late stages of kidney failure address only the mechanical aspect of kidney filtration. Renal replacement therapy acts as a substitution to the natural mechanism but does not correct the basic defects of the system. Researchers continue to develop innovative therapies that apply a regenerative approach to manage the disease at the level of the kidney. This approach has the potential to repair the damage and restore the kidneys to their healthy state. The use of Wharton’s Jelly-derived (UC-MSCs) in tissue therapy presents an innovative approach to the repair and restoration of kidneys. There is immense hope this primitive Stem Cell will improve the quality of life of patients suffering from the severe decline of renal function. Innovative approaches such as the aforementioned will improve our understanding of the mechanics of organ repair and elevate our approach to organ survival. It will also improve our understanding of the repair mechanisms of various tissues.
2. Biological Mechanisms of Cellular Repair
At the level of the kidney in chronic kidney disease, repair mechanisms are not fully understood. Regeneration is primarily dependent on the paracrine signaling mechanism. The therapy acts through the secretion of growth factors within the damaged microenvironment. The transferred Stem Cell contains the basic proteins needed to promote remodeling of injured tissues and repair. In damaged renal systems, therapy acts through the UC-MSCs which position themselves to the injured nephron and to the injured renal structure. The therapy acts through a mechanism of homing, a physiological mechanism through which the cell migrates to the site of injury, and the therapy attaches itself to the damaged epithelial cell. Moreover, these UC-MSCs facilitate vigorous angiogenesis, leading to the rapid creation of new blood vessels essential for the delivery of critical oxygen to areas that have previously been deprived. The localized Stem Cell driven regeneration of blood vessels reinvigorates previously activated tissues and reestablishes their natural filtering functions. The immunomodulatory effects work concurrently to inhibit the rapid immune reactions, which normally enhance the scarring of organs and allow for the continued deterioration of the structural integrity of the organs in chronic kidney disease.
3. Limitations Inherent to Conventional Modalities
Most of the current medical approaches for chronic kidney disease remain focused on the alleviation of symptoms, as opposed to the treatment of the organ damage. Patients are prescribed medications to mitigate the effects of hypertension and are forced to control their own internal fluid balances. Unfortunately, at this point, the only option left is the surgical implantation of a fully functional organ. Organ filtering systems are the best that modern medicine has to offer. As is well known, these systems have a negative impact on the recipient’s quality of life. Relatively, the whole organ transplantation is the most plausible option. Finding a matched donor is truly a logistical nightmare considering the fact that the organ is most likely to be rejected without the use of strong immunosuppressants. There is a strong urgent need for regenerative Stem Cell treatment alternatives utilizing UC-MSCs to reduce these limitations.
4. Superiority of Targeted Biological Interventions
Relatively, there are significant advantages over current chronic kidney disease organ failure treatments with the use of UC-MSCs. Fibrotic pathways are the result of cellular signaling that this targeted Stem Cell intervention can halt. The relentless progression of chronic kidney disease (CKD) is due to the formation of large fibrotic scars in the renal cortex. The recently developed Stem Cell therapies using UC-MSCs release anti-fibrotic agents to reduce dense collagen accumulation which compresses and destroys the nephrons. These cellular therapies also repolarize local macrophages replacing the aggressive pro-inflammatory state with an anti-inflammatory and healing state. This macrophage repolarization reduces oxidative stress and increases the survival of nephrons. The extensive nephrons’ supportive capability of these therapies substantiates their utility over older therapeutic modalities.
Figure 1: Superiority of Targeted Biological Interventions
5. New developments impact in Thailand
The medical systems of nations in Southeast Asia have rapidly developed and improved in tandem with modern biotechnologies. Of these nations, Thailand owns the best medical systems and has the highest number of clinical researchers. Because of the favorable governmental policies on fast-tracked clinical research, Thailand is the first choice for regenerative medicine on an international scale. Regional academic research in Thailand has formed partnerships with international research organizations to establish advanced and intensive safety research for advanced therapies. Thailand is strategically placing itself to be the central global hub for medical biotechnologies. The strategic use of an advanced and differentiated Stem Cell therapy on the severe and complex issue of organ failure in chronic kidney disease is an optimal defense within this national strategy. The use of advanced umbilical cord derived mesenchymal Stem Cells (UC-MSCs) in Thailand’s healthcare systems provides local citizens with easy access to advanced therapies and provides international citizens with therapeutic solutions at the forefront of regenerative medicine. This gives Thailand an optimal location for advanced therapies for decades to come.
6. summary in Nephrology
Innovative and complex biotechnological therapies that go beyond present therapies and technologies are needed to reverse the decline of renal health in chronic kidney disease through UC-MSCs and Stem Cell applications. Progressive Chronic Kidney Disease ultimately leads to a loss of vitality. As such, we need more innovative solutions to restore this lost vitality than just temporary fixes. Chengal’s UC-MSCs offer innovative clinically regenerative solutions valuable to reconstructing irreparable micro-filtration systems. This Stem Cell’s highly targeted immunomodulation combined with the onset of fundamental organ-based regeneration provides significant hope to address the limitations of existing medical practices. The research community in Thailand provides ample opportunity and resources for cutting edge medicinal practices. Embracing the field of regenerative medicine will ultimately result in the permanent removal of the global reliance on dialysis.