Intravascular Mesenchymal Stromal/Stem Cell Therapy Product Diversification: Time for New Clinical Guidelines

Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived fr...

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Published in:Trends in molecular medicine Vol. 25; no. 2; pp. 149 - 163
Main Authors: Moll, Guido, Ankrum, James A., Kamhieh-Milz, Julian, Bieback, Karen, Ringdén, Olle, Volk, Hans-Dieter, Geissler, Sven, Reinke, Petra
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.02.2019
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ISSN:1471-4914, 1471-499X, 1471-499X
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Abstract Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived from other sources, such as adipose and perinatal tissues. Different MSC products display varying levels of highly procoagulant tissue factor (TF) and may adversely trigger the instant blood-mediated inflammatory reaction (IBMIR). Suitable strategies for assessing and controlling hemocompatibility and optimized cell delivery are crucial for the development of safer and more effective MSC therapies. MSC products have largely diversified during the past decade, making extrapolation about safety and efficacy from first-generation products inappropriate. MSCs and other blood non-resident cellular therapeutics display different degrees of incompatibility with human blood, which compromises their safety and efficacy. TF is the major determinant of cell product hemocompatibility, and this should be routinely monitored in all therapeutics intended for intravascular delivery. MSC products from different tissue sources display high variability in TF expression, with potential lethal consequences for patients when infused systemically. Once aware of the problem, a large array of product and process innovations became available to improve the clinical delivery of systemically infused cellular therapeutics.
AbstractList Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived from other sources, such as adipose and perinatal tissues. Different MSC products display varying levels of highly procoagulant tissue factor (TF) and may adversely trigger the instant blood-mediated inflammatory reaction (IBMIR). Suitable strategies for assessing and controlling hemocompatibility and optimized cell delivery are crucial for the development of safer and more effective MSC therapies. MSC products have largely diversified during the past decade, making extrapolation about safety and efficacy from first-generation products inappropriate. MSCs and other blood non-resident cellular therapeutics display different degrees of incompatibility with human blood, which compromises their safety and efficacy. TF is the major determinant of cell product hemocompatibility, and this should be routinely monitored in all therapeutics intended for intravascular delivery. MSC products from different tissue sources display high variability in TF expression, with potential lethal consequences for patients when infused systemically. Once aware of the problem, a large array of product and process innovations became available to improve the clinical delivery of systemically infused cellular therapeutics.
Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived from other sources, such as adipose and perinatal tissues. Different MSC products display varying levels of highly procoagulant tissue factor (TF) and may adversely trigger the instant blood-mediated inflammatory reaction (IBMIR). Suitable strategies for assessing and controlling hemocompatibility and optimized cell delivery are crucial for the development of safer and more effective MSC therapies.
Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived from other sources, such as adipose and perinatal tissues. Different MSC products display varying levels of highly procoagulant tissue factor (TF) and may adversely trigger the instant blood-mediated inflammatory reaction (IBMIR). Suitable strategies for assessing and controlling hemocompatibility and optimized cell delivery are crucial for the development of safer and more effective MSC therapies.Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials. Meta-analysis has demonstrated that bone marrow MSC infusion is safe. It is not clear if this also applies to diverse new cell products derived from other sources, such as adipose and perinatal tissues. Different MSC products display varying levels of highly procoagulant tissue factor (TF) and may adversely trigger the instant blood-mediated inflammatory reaction (IBMIR). Suitable strategies for assessing and controlling hemocompatibility and optimized cell delivery are crucial for the development of safer and more effective MSC therapies.
Author Reinke, Petra
Geissler, Sven
Ankrum, James A.
Moll, Guido
Kamhieh-Milz, Julian
Ringdén, Olle
Bieback, Karen
Volk, Hans-Dieter
Author_xml – sequence: 1
  givenname: Guido
  orcidid: 0000-0001-6173-5957
  surname: Moll
  fullname: Moll, Guido
  email: guido.moll@charite.de
  organization: Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin (FUB), Humboldt-Universität zu Berlin (HUB), and Berlin Institute of Health (BIH), Berlin, Germany
– sequence: 2
  givenname: James A.
  surname: Ankrum
  fullname: Ankrum, James A.
  organization: Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
– sequence: 3
  givenname: Julian
  surname: Kamhieh-Milz
  fullname: Kamhieh-Milz, Julian
  organization: Department of Transfusion Medicine, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin (FUB), Humboldt-Universität zu Berlin (HUB), and Berlin Institute of Health (BIH), Berlin, Germany
– sequence: 4
  givenname: Karen
  surname: Bieback
  fullname: Bieback, Karen
  organization: Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
– sequence: 5
  givenname: Olle
  surname: Ringdén
  fullname: Ringdén, Olle
  organization: Translational Cell Therapy Research (TCR), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
– sequence: 6
  givenname: Hans-Dieter
  surname: Volk
  fullname: Volk, Hans-Dieter
  organization: Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin (FUB), Humboldt-Universität zu Berlin (HUB), and Berlin Institute of Health (BIH), Berlin, Germany
– sequence: 7
  givenname: Sven
  surname: Geissler
  fullname: Geissler, Sven
  organization: Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin (FUB), Humboldt-Universität zu Berlin (HUB), and Berlin Institute of Health (BIH), Berlin, Germany
– sequence: 8
  givenname: Petra
  surname: Reinke
  fullname: Reinke, Petra
  organization: Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin (FUB), Humboldt-Universität zu Berlin (HUB), and Berlin Institute of Health (BIH), Berlin, Germany
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30711482$$D View this record in MEDLINE/PubMed
http://kipublications.ki.se/Default.aspx?queryparsed=id:140276056$$DView record from Swedish Publication Index (Karolinska Institutet)
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Issue 2
Keywords CD142
hemocompatibility
tissue factor
safety and efficacy
cellular therapy
mesenchymal stromal/stem cell
tissue source
Language English
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Snippet Intravascular infusion is the most popular route for therapeutic multipotent mesenchymal stromal/stem cell (MSC) delivery in hundreds of clinical trials....
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SubjectTerms Animals
CD142
cellular therapy
Clinical Trials as Topic
hemocompatibility
Humans
Inflammation - etiology
Inflammation - immunology
Mesenchymal Stem Cell Transplantation - adverse effects
Mesenchymal Stem Cell Transplantation - methods
Mesenchymal Stem Cells - cytology
Mesenchymal Stem Cells - immunology
mesenchymal stromal/stem cell
safety and efficacy
Thromboplastin - analysis
Thromboplastin - immunology
tissue factor
tissue source
Title Intravascular Mesenchymal Stromal/Stem Cell Therapy Product Diversification: Time for New Clinical Guidelines
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https://dx.doi.org/10.1016/j.molmed.2018.12.006
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