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World J Stem Cells. Dec 31, 2009; 1(1): 3-7
Published online Dec 31, 2009. doi: 10.4252/wjsc.v1.i1.3
Microenvironment at tissue injury, a key focus for efficient stem cell therapy: A discussion of mesenchymal stem cells
Pranela Rameshwar
Pranela Rameshwar, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, MSB E-585, Newark, NJ 07103, United States
Author contributions: Rameshwar P solely contributed to this Editorial.
Supported by F. M. Kirby Foundation
Correspondence to: Pranela Rameshwar, PhD, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, MSB E-585, Newark, NJ 07103, United States. rameshwa@umdnj.edu
Telephone: +1-973-9720625 Fax: +1-973-9728854
Received: May 26, 2009
Revised: July 31, 2009
Accepted: August 7, 2009
Published online: December 31, 2009

Stem cell therapy is not a new field, as indicated by the success of hematopoietic stem cell reconstitution for various hematological malignancies and immune-mediated disorders. In the case of tissue repair, the major issue is whether stem cells should be implanted, regardless of the type and degree of injury. Mesenchymal stem cells have thus far shown evidence of safety, based on numerous clinical trials, particularly for immune-mediated disorders. The premise behind these trials is to regulate the stimulatory immune responses negatively. To apply stem cells for other disorders, such as acute injuries caused by insults from surgical trauma and myocardial infarction, would require other scientific considerations. This does not imply that such injuries are not accompanied by immune responses. Indeed, acute injuries could accompany infiltration of immune cells to the sites of injuries. The implantation of stem cells within a milieu of inflammation will establish an immediate crosstalk among the stem cells, microenvironmental molecules, and resident and infiltrating immune cells. The responses at the microenvironment of tissue injury could affect distant and nearby organs. This editorial argues that the microenvironment of any tissue injury is a key consideration for effective stem cell therapy.

Keywords: Stem cell therapy, Microenvironment, Mesenchymal stem cells, Immune responses