Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Reply to MSCs: science and trials

Nature Medicine volume 19, pages 813–814 (2013)Cite this article

Subjects

Bianco et al. reply:

A fil rouge unites the three Correspondences that distinguished colleagues1,2,3 have offered on our Perspective4 on mesenchymal stem cells (MSCs) in medicine. That is, the idea that their clinical promise does not come from a proven biology as established experimentally. MSCs are not pluripotent cells, and they cannot regenerate heart or brain; this is accepted and not disputed by the Correspondences. Therefore, the promise of MSCs as a therapy for the heart, brain or other organs comes not from their nature as stem cells, progenitors of skeletal tissues or key cells in the hematopoietic microenvironment but rather from their nonprogenitor functions. These functions have not been identified, are not proven and are incompletely understood; however, they are nonetheless the mainstay of the commercial development of MSCs. These nonprogenitor functions (trophic, immune modulatory and anti-inflammatory) have been proposed—but not proven—to enable MSCs to improve a broad range of unrelated diseases in multiple organs beyond the skeleton, regardless of their etiology or mechanism or the type and extent of organ damage. On the basis of this assumption, their potential benefit is then amenable to exploration, either directly in clinical trials—regardless of a rationale or mechanism—or empirically, in view of the historical virtues of empiricism in medicine.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Fibbe, W.E., Dazzi, F. & LeBlanc, K. Nat. Med. 19, 812–813 (2013).

    Article  CAS  Google Scholar 

  2. Pittenger, M.F. Nat. Med. 19, 811 (2013).

    Article  CAS  Google Scholar 

  3. Phinney, D.G. et al. Nat. Med. 19, 812 (2013).

    Article  CAS  Google Scholar 

  4. Bianco, P. et al. Nat. Med. 19, 35–42 (2013).

    Article  CAS  Google Scholar 

  5. Moll, G. et al. Stem Cells 30, 1565–1574 (2012).

    Article  CAS  Google Scholar 

  6. Thomas, E.D., Lochte, H.L. Jr., Lu, W.C. & Ferrebee, J.W. N. Engl. J. Med. 1957, 257491–257496 (1957).

    Google Scholar 

  7. Appelbaum, F.R. N. Engl. J. Med. 357, 1472–1475 (2007).

    Article  CAS  Google Scholar 

  8. Caplan, A.I. & Correa, D. Cell Stem Cell 9, 11–15 (2011).

    Article  CAS  Google Scholar 

  9. Bianco, P. et al. EMBO J. 32, 1489–1495 (2013).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Molecular Medicine, La Sapienza Universita' di Roma, Rome, Italy

    Paolo Bianco

Authors
  1. Paolo Bianco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Bianco.

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bianco, P. Reply to MSCs: science and trials. Nat Med 19, 813–814 (2013). https://doi.org/10.1038/nm.3255

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nm.3255

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing