Mesenchymal Stem Cell Benefits Observed in Bone Marrow Failure and Acquired Aplastic Anemia

Figure 1

Effect of mesenchymal stem cell (MSC) transplant on bone marrow failure (BMF) etiology and progression. Acquired aplastic anemia (AA) is caused by destruction of hematopoietic stem cell (HSC) and progenitor cells associated with MSC abnormalities, caused by hematotoxic agents (drugs, chemical agents, radiation, and virus). These events lead to imbalance among CD8⁺ and CD4⁺ T cells and abnormal cytokine secretion, which correlates apoptosis of HSC and progenitor cells and consequently bone marrow (BM) aplasia and pancytopenia. Additionally, in turn of BM, imbalance aberrant alteration on MSC from BM niches arises. MSC aberrant alteration is observed by, impaired in maintaining the immune homeostasis, reduction of CD146⁺ MSC and low expression of FGF2 in MSC and its secretion, which lead to MSC inefficiency in hematopoiesis support and collaborate to progress of disease. According to the literature for AA, MSCs improve engraftment of HSC and prevent apoptosis in BM failures. BMF improvements occur as a result of MSC transplant through very similar mechanisms, such as immunomodulation, release growth factors, and osteogenic support. Although in vivo improvement on hematopoiesis was not demonstrated, several properties of MSCs, as well as its association with AA, justify the use of MSC in BM failures.