Regulatory cell therapy for kidney transplantation and autoimmune kidney diseases

Pediatr Nephrol. 2025 Jan;40(1):39-52. doi: 10.1007/s00467-024-06514-2. Epub 2024 Sep 16.

Abstract

Regulatory cell therapies, including regulatory T cells and mesenchymal stromal cells, have shown promise in early clinical trials for reducing immunosuppression burden in transplantation. While regulatory cell therapies may also offer potential for treating autoimmune kidney diseases, data remains sparse, limited mainly to preclinical studies. This review synthesises current literature on the application of regulatory cell therapies in these fields, highlighting the safety and efficacy shown in existing clinical trials. We discuss the need for further clinical validation, optimisation of clinical and immune monitoring protocols, and the challenges of manufacturing and quality control under Good Manufacturing Practice conditions, particularly for investigator-led trials. Additionally, we explore the potential for expanding clinical indications and the unique challenges posed in paediatric applications. Future directions include scaling up production, refining protocols to ensure consistent quality across manufacturing sites, and extending applications to other immune-mediated diseases.

Keywords: Cell therapy; Glomerulonephritis; Kidney transplantation; Tolerance.

Publication types

  • Review

MeSH terms

  • Animals
  • Autoimmune Diseases* / immunology
  • Autoimmune Diseases* / therapy
  • Cell- and Tissue-Based Therapy* / methods
  • Cell- and Tissue-Based Therapy* / standards
  • Child
  • Humans
  • Kidney Diseases* / immunology
  • Kidney Diseases* / therapy
  • Kidney Transplantation* / adverse effects
  • Mesenchymal Stem Cell Transplantation / methods
  • T-Lymphocytes, Regulatory* / immunology