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1 Medicine/ Division ofNephrology, University of Utah, Salt lake City, Utah, United States
2 Medicine/Nephrology, University of Utah, Salt Lake City, United States
3 Medicine/Nephrology, University of Utah, Salt Lake City, Utah, United States
4 Division of Nephrology, VA Medical Center, Univ of Utah, 500 Foothill Blvd., Salt Lake City, Utah, 84148, United States; Medicine/ Division ofNephrology, University of Utah, Salt Lake City, United States; Physiology, University of Utah, Salt Lake City, United States
* To whom correspondence should be addressed. E-mail: c.westenfelder{at}uofu.net.
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 MSCs possess vasculo-protective activity that may contribute, at least in part, to 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, 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 one week 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.
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