Cell-based therapy shows promise in ameliorating renal anemia

Researchers in Japan have developed a cell-based therapy for renal anemia, a common complication of chronic kidney disease. The cell-based therapy worked well in mice.

The paper, "Human pluripotent stem cell-derived erythropoietin-producing cells ameliorate renal anemia in mice," is published in the 27 Sep 2017 issue of the journal Science Translational Medicine. Hirofumi Hitomi is the first author.

The kidneys perform essential functions in the body, such as removing waste products from the blood, regulating the water fluid levels, and producing certain hormones like erythropoietin (EPO). Chronic kidney disease refers to a progressive loss of kidney function, which can be caused by a variety of factors, such as diseases (particularly diabetes), high blood pressure, drug toxicity, heavy metal poisoning, and an infection. Over time, the disease may get worse and progress to kidney failure that requires dialysis or kidney transplant.

When kidney disease develops to an advanced stage, renal anemia usually occurs. This is because diseased kidneys fail to make enough EPO. The hormone EPO stimulates the production of red blood cells in bone marrow. EPO deficiency causes the bone marrow to make fewer red blood cells, triggering anemia.

An important treatment option for patients with renal anemia is regular injection of recombinant human EPO. However, regular EPO injection is expensive and may cause side effects. Therefore, novel therapies are needed.

In the present study, a team of researchers from Kyoto University and Kagawa University investigated another treatment strategy -- cell-based therapy. They generated EPO-producing cells from human induced pluripotent stem cells (hiPSCs), which they named hiPSC-EPO cells. In vitro experiments showed that EPO secreted from hiPSC-EPO cells is able to induce differentiation of human umbilical cord blood progenitor cells toward red blood cells.

Further, the researchers transplanted hiPSC-EPO cells into mice with renal anemia and found that it improved the disease. The EPO levels in the animals returned to normal and were maintained for a lifetime.

Collectively, the data demonstrate that hiPSC-EPO cells help restore the production of EPO. The study provides a new treatment strategy for renal anemia.
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