MSC Therapy for Acute Pancreatitis In 16 studies, MSCs were administered for the treatment of acute pancreatitis
MSC Therapy for Acute Pancreatitis In 16 studies, MSCs were administered for the treatment of acute pancreatitis. Conclusion The available data were insufficient Rabbit polyclonal to ZNF131 for determining the best type of MSCs for the treatment of acute or chronic pancreatitis; therefore, clinical trials investigating the use of MSCs as therapy for pancreatitis are not warranted. 1. Background Pancreatitis is characterized by the release of pancreatic digestive enzymes from damaged exocrine cells and presents clinically in the following two forms: acute and chronic. Acute pancreatitis is a common cause of acute abdomen, which is self-limited in most cases; only 10C15% of patients with acute abdomen present with severe acute pancreatitis [1, 2]. Severe acute pancreatitis causes pancreatic tissue necrosis and organ failure with a mortality rate of up to 30C47% [1, 2]. KIN-1148 Acute pancreatitis is induced by the acute activation of proenzymes in the pancreatic acinar cells leading to the lysis of the pancreatic tissue . Inflammatory pancreatitis is associated with the local production of inflammatory cytokines, such as interleukin (IL)-1, IL-6, tumour necrosis factor-(TNF-(IFN-= 11 studies; 8 investigating acute pancreatitis and 2 investigating chronic pancreatitis). Only 7 studies used human MSC for pancreatitis therapy (6 studies investigating acute pancreatitis and one study investigating chronic pancreatitis) (Figure 3). Among KIN-1148 the 7 studies using human MSCs, 3 studies administered BM-MSCs to investigate acute pancreatitis, 3 other studies administered UCMSCs to investigate acute pancreatitis, and 1 study administered foetal membrane MSCs to investigate chronic pancreatitis. Open in a separate window Figure 2 Number of studies according to the type of MSCs used to treat pancreatitis. Open in a separate window Figure 3 Number of studies according to the source of MSCs used to treat pancreatitis. 3.1. MSC Therapy for Acute Pancreatitis In 16 studies, MSCs were administered for the treatment of KIN-1148 acute pancreatitis. Eleven studies used BM-MSCs [44C54], while 3 studies used UCMSCs [55C57]. Of the 11 studies, one study administered adipose-derived MSCs , and one study administered foetal membrane MSCs  (Table 1). Since acute pancreatitis is a self-limited condition and pancreatic tissue damage occurs only following severe acute pancreatitis, all included studies investigated the effect of MSC therapy in severe acute pancreatitis. Multiple methods of inducing severe acute pancreatitis were used: injection of Na-taurocholate (7 studies) [44, 46, 47, 49, 50, 52], intraperitoneal injections of caerulein (2 studies) [29, 30], L-arginine-induced acute pancreatitis (one study) , and deoxy-STC injection under the pancreatic capsule (1 KIN-1148 study) . All 16 studies showed a reduction in pancreatic tissue damage, necrosis, inflammation, and oedema compared to those of the untreated groups. In all 16 studies, the serum amylase and lipase levels were lower than those in the control groups. Fourteen of the 16 studies investigated the mechanism of action of the MSCs in alleviating the acute inflammation and tissue damage following acute pancreatitis. The studies evaluated the effect of MSC transplantation on immunomodulation, angiogenesis, and apoptosis as well as the antioxidant effect and the homing of infused cells (Figure 4). Open in a separate window Figure 4 Mechanism of action of infused MSCs in acute and chronic pancreatitis. Table 1 Summary of studies addressed MSCs in acute pancreatitis. L-arg: L-arginine; Na TCA: sodium taurocholate solution; TCA: taurocholic acid solution; LPS: lipopolysaccharide; KIN-1148 rBM-MSCs: rat bone marrow mesenchymal stromal cells; hBM-MSCs: human bone marrow mesenchymal stromal cells; UCMSCs: umbilical cord mesenchymal stromal cells; hUCMSCs: human umbilical cord mesenchymal stromal cells; rFMMSCs: rat fetal membrane mesenchymal stromal cells;.