Mesenchymal stem cells: Immunomodulatory capability and clinical potential in immune diseases

Mesenchymal stem cells (MSCs) represent a heterogenous population of adult, fibroblast-like multi-potent cells. MSCs have drawn much attention during the last decade in the field of regenerative medicine, mainly due to their capacity to differentiate into specific cell types, abundant production of soluble growth factors and cytokines, and hematopoiesis supporting properties. In addition, MSCs can migrate to the sites of inflammation and hold potent of immunomodulatory and anti-inflammatory effects through cell and cell interactions between MSCs and lymphocytes or production of soluble factors. Therefore, the application of MSCs in many disease situations is full of possibilities for future clinical treatment. Phase III clinical trials have been run using MSCs for treatment of Graft versus Host Disease (GVHD), and MSCs product approval has been achieved for pediatric GVHD treatment in Canada and New Zealand (Prochymal®; Osiris Therapeutics). In addition, hundreds of clinical trials are being run using MSCs for treatment of several immune mediated diseases, including GVHD, aplastic anemia (AA), Crohn's disease (CD), rheumatoid arthritis (RA), and multiple sclerosis (MS). In this review we mainly focus on immunomodulation potential of MSCs and promising therapeutic application of MSCs in immune mediated diseases. Furthermore, we emphasize that biological effectiveness of MSCs will be one of most important standards to determine the dose of MSCs infusion.