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Am J Physiol Renal Physiol 292: F1626-F1635, 2007. First published January 9, 2007; doi:10.1152/ajprenal.00339.2006
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Vasculotropic, paracrine actions of infused mesenchymal stem cells are important to the recovery from acute kidney injury

Florian Tögel,1,2,3 Kathleen Weiss,1 Ying Yang,1 Zhuma Hu,1 Ping Zhang,1 and Christof Westenfelder1,2,3

1Division of Nephrology, Department of Medicine, University of Utah, 2Section of Nephrology, Veterans Affairs Medical Center, and 3Department of Physiology, University of Utah, Salt Lake City, Utah

Submitted 29 August 2006 ; accepted in final form 2 January 2007

Acute kidney injury (AKI) is a major clinical problem in which a critical vascular, pathophysiological component is recognized. We demonstrated previously that mesenchymal stem cells (MSC), unlike fibroblasts, are significantly renoprotective after ischemia-reperfusion injury and concluded that this renoprotection is mediated primarily by paracrine mechanisms. In this study, we investigated whether MSC possess vasculoprotective activity that may contribute, at least in part, to an improved outcome after ischemia-reperfusion AKI. MSC-conditioned medium contains VEGF, HGF, and IGF-1 and augments aortic endothelial cell (EC) growth and survival, a response not observed with fibroblast-conditioned medium. MSC and EC share vasculotropic gene expression profiles, as both form capillary tubes in vitro on Matrigel alone or in cooperation without fusion. MSC undergo differentiation into an endothelial-like cell phenotype in culture and develop into vascular structures in vivo. Infused MSC were readily detected in the kidney early after reflow but were only rarely engrafted at 1 wk post-AKI. MSC attached in the renal microvascular circulation significantly decreased apoptosis of adjacent cells. Infusion of MSC immediately after reflow in severe ischemia-reperfusion AKI did not improve renal blood flow, renovascular resistance, or outer cortical blood flow. These data demonstrate that the unique vasculotropic, paracrine actions elicited by MSC play a significant renoprotective role after AKI, further demonstrating that cell therapy has promise as a novel intervention in AKI.

endothelial cells; angiogenesis; conditioned media; VEGF; renal blood flow; differentiation; apoptosis


Address for reprint requests and other correspondence: C. Westenfelder, Section of Nephrology (111N), VA Medical Center, 500 Foothill Blvd., Salt Lake City, UT 84148 (e-mail: Christof.Westenfelder{at}hsc.utah.edu)




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