Figure 2.

Mechanism of action of MSC-based therapy in kidney diseases. Graphic representation depicting the mechanism of action of MSC-based therapy in (A) acute kidney injury and (B) chronic kidney disease. (A) Following injection, MSCs engraft the damaged kidney and have a protective effect on proximal tubular cells through the local release of growth factors and extracellular vesicles (EVs) with mitogenic, anti-inflammatory and anti-apoptotic effects. Moreover, MSC bioproducts also reduce oxidative stress, sustaining energy supply and mitochondrial exchange among adjacent tubular cells, thus inducing regenerative processes. (B) In CKD, upon infusion, MSCs localise in the damaged kidney and limit podocyte migration and loss, glomerular endothelial cell damage and parietal epithelial cell (PEC) activation through the release of growth factors and EVs. MSC therapy by limiting glomerular cell dysfunction also reduces the formation of glomerular fibrotic and sclerotic lesions.