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Stromal cells in tissue homeostasis: balancing regeneration and fibrosis

Nature Reviews Nephrology volume 9, pages 747–753 (2013)Cite this article

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Abstract

The ageing population and the increasing prevalence of noncommunicable diseases such as diabetes and hypertension have led to an increased prevalence of chronic kidney disease. The generation of de novo kidney tissue from embryonic tissue and stem cells using tissue engineering approaches is being explored as an alternative to renal replacement therapy for treating the disease. It is, however, becoming clear that resident cells can not only induce fibrotic repair, but can also restore damaged kidney tissue. Mobilizing this innate capacity of the kidney to regenerate is of particular interest in the prevention of irreversible kidney failure. A novel concept is that the interaction of interstitial stromal cells with the local immune system may regulate tissue homeostasis and the balance between tissue repair and fibrosis. Mesenchymal stromal cells (MSCs), in particular, may enhance the intrinsic reparative capabilities of the kidney. This Perspectives article considers the innate regenerative potential of the kidney in the context of ongoing studies of MSC therapy.

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Figure 1: Models of tubular repair in the kidney.
Figure 2: The cellular components of the renal interstitium.

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Acknowledgements

We thank Kylie Georgas, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia for assistance with illustrations. Our research has received funding from the European Community's Seventh Framework Program (FP7/2007–2013) under grant agreement number 305436. M. H. Little is a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellow and her work in this area is supported by the NHMRC (APP1054985).

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  1. Division of Nephrology, Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Centre, Postbus 96002300, RC Leiden, Netherlands

    Ton J. Rabelink

  2. Institute for Molecular Bioscience, The University of Queensland, Carmody Road, St Lucia, Brisbane, 4072, Qld, Australia

    Melissa H. Little

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T. J. Rabelink and M. H. Little contributed equally to discussion of content for the article, researching data to include in the manuscript, and writing, reviewing and editing of the manuscript before submission.

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Correspondence to Ton J. Rabelink.

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Rabelink, T., Little, M. Stromal cells in tissue homeostasis: balancing regeneration and fibrosis. Nat Rev Nephrol 9, 747–753 (2013). https://doi.org/10.1038/nrneph.2013.152

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