People with Atherosclerotic Renovascular Disease (ARVD) often experience a reduction in blood flow to their kidneys, leading to a decline in kidney function and the development of high blood pressure. Over time, this can result in irreversible damage to the kidneys, causing them to stop functioning properly. Although restoring blood flow with a medical procedure called endovascular stenting can help, it does not always reverse the damage caused by ARVD.
Researchers have been looking for ways to repair the damage caused by ARVD and restore kidney function. One promising solution they have found is the use of mesenchymal stem cells (MSCs). MSCs are a type of cell that can produce substances that can help repair the renal microcirculation, reduce inflammation, and restore kidney function.
MSCs have been shown to be capable of repairing damaged renal microcirculation, reducing inflammation-related kidney damage and restoring normal kidney function. Through the release of soluble mediators and extracellular vesicles, MSCs can have beneficial effects on the body. Studies conducted in humans demonstrate the safety of autologous adipose tissue-derived MSC infusion into a single post-stenotic kidney, and suggest that it could improve tissue oxygenation.
Additionally, dose-related changes were studied including impacts on kidney perfusion, blood flow, cytokine signaling and glomerular filtration, which further support the potential of MSCs to restore renal function in individuals with ARVD.
A study was recently performed involving patients with ARVD in order to assess the efficacy of autologous adipose tissue-derived MSCs infusion into a single post-stenotic kidney. A clinical trial, In a Phase 1a escalating clinical trial, autologous mesenchymal stem cell infusion for renovascular disease increases blood flow and the glomerular filtration rate while reducing inflammatory biomarkers and blood pressure, looked into the potential of stem cell therapy for ARVD.
Results of the Study
Patients with ARVD were studied in two protocols conducted between 2013 and 2017. Twenty-one patients with ARVD were assigned to three different dose groups of seven subjects each. These patients visited St Mary’s Hospital in Rochester, MN for intensive research and trials.
The patients were asked to come to the hospital for three days, two times with a gap of three months between the visits. The first group of patients received the lowest dose of MSC, followed by the second group who received a higher dose and finally the third group who received the highest dose.
The patients in this study were treated using MSCs. This treatment was administered through an angiographic catheter into the single most severely stenotic renal artery. The MSCs had been suspended in 10 ml of Lactated Ringer’s solution, which was slowly infused over a period of 5 minutes.
The results of this three month study showed promising improvements in both cortical and whole kidney blood flows in patients who received the MSC therapy compared to those who received medical treatment only. Additionally, these treated patients saw partial reduction of renal vein inflammatory and angiogenic biomarkers and dose-related changes in GFR and blood pressure.
The change in renal blood flow was attributed to increased perfusion in the medullary and cortex, rather than any observed internal changes to the kidneys themselves. Moreover, even the contralateral kidneys – those not targeted by injection – experienced increases in medullary and cortical perfusion along with overall renal blood flow.
In contrast, the group of patients who only received medical treatment did not show any significant changes or even experienced a decrease in blood flow and kidney function over the same time period.
The study also revealed a reduction in markers of inflammation in the patients who received the MSC treatment, which may be due to the stem cells’ ability to regulate the immune system. The exact mechanisms behind this effect are not yet fully understood, but previous studies have shown that stem cells can reduce inflammation and oxidative stress.
These results are significant because they provide evidence that MSC treatment may offer a promising approach for improving the condition of patients with ARVD. These proven improvements give hope that further research into MSC treatments could provide significant benefits for those living with ARVD.
High doses of MSC injections were shown to be the most effective at improving overall blood pressure and GFR. This suggests that immunomodulatory and proangiogenic properties of MSCs have a positive effect on renal function. Further research into the long-term effects of this treatment could lead to better clinical care options for ARVD patients, allowing them to live healthier lives with improved kidney function.
