Mesenchymal stem cell therapy (MSCT) for immune and inflammatory diseases continues to be popular based on progressive accumulation of preclinical mechanistic evidence. This has led to further expansion in clinical indications from graft rejection, autoimmune diseases, and osteoarthritis, to inflammatory liver and pulmonary diseases including COVID-19. A clear trend is the shift from using autologous to allogeneic MSCs, which can be immediately available as off-the-shelf products. In addition, new products such as cell-free exosomes and human pluripotent stem cell (hPSC)-derived MSCs are exciting developments to further prevalent use. Increasing numbers of trials have now published results in which safety of MSCT has been largely demonstrated. While reports of therapeutic endpoints are still emerging, efficacy can be seen for specific indications—including graft-vs-host-disease, strongly Th17-mediated autoimmune diseases, and osteoarthritis—which are more robustly supported by mechanistic preclinical evidence. In this review, we update and discuss outcomes in current MSCT clinical trials for immune and inflammatory disease, as well as new innovation and emerging trends in the field.

中文翻译：

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免疫和炎症疾病间充质干细胞治疗的进展：无细胞产品和人多能干细胞衍生的间充质干细胞的使用

基于临床前机制证据的逐步积累，用于免疫和炎症疾病的间充质干细胞疗法 (MSCT) 继续流行。这导致临床适应症进一步扩大，从移植排斥、自身免疫性疾病和骨关节炎，到炎症性肝病和肺病，包括 COVID-19。一个明显的趋势是从使用自体到异体 MSC 的转变，后者可以立即作为现成产品提供。此外，无细胞外泌体和人类多能干细胞 (hPSC) 衍生的 MSC 等新产品是进一步普及使用的令人兴奋的发展。越来越多的试验现已发表结果，其中已在很大程度上证明了 MSCT 的安全性。虽然关于治疗终点的报道仍在不断出现，可以看到特定适应症的疗效——包括移植物抗宿主病、强 Th17 介导的自身免疫性疾病和骨关节炎——这些都得到了机械临床前证据的有力支持。在这篇综述中，我们更新和讨论了当前针对免疫和炎症疾病的 MSCT 临床试验的结果，以及该领域的新创新和新兴趋势。