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Bone marrow stem cells contribute to repair of the ischemically injured renal tubule
Sujata Kale, … , Diane S. Krause, Lloyd G. Cantley
Sujata Kale, … , Diane S. Krause, Lloyd G. Cantley
Published July 1, 2003
Citation Information: J Clin Invest. 2003;112(1):42-49. https://doi.org/10.1172/JCI17856.
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Article

Bone marrow stem cells contribute to repair of the ischemically injured renal tubule

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Abstract

The paradigm for recovery of the renal tubule from acute tubular necrosis is that surviving cells from the areas bordering the injury must migrate into the regions of tubular denudation and proliferate to re-establish the normal tubular epithelium. However, therapies aimed at stimulating these events have failed to alter the course of acute renal failure in human trials. In the present study, we demonstrate that Lin–Sca-1+ cells from the adult mouse bone marrow are mobilized into the circulation by transient renal ischemia and home specifically to injured regions of the renal tubule. There they differentiate into renal tubular epithelial cells and appear to constitute the majority of the cells present in the previously necrotic tubules. Loss of stem cells following bone marrow ablation results in a greater rise in blood urea nitrogen after renal ischemia, while stem cell infusion after bone marrow ablation reverses this effect. Thus, therapies aimed at enhancing the mobilization, propagation, and/or delivery of bone marrow stem cells to the kidney hold potential as entirely new approaches for the treatment of acute tubular necrosis.

Authors

Sujata Kale, Anil Karihaloo, Paul R. Clark, Michael Kashgarian, Diane S. Krause, Lloyd G. Cantley

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Figure 6

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BMA worsens the course of ischemic ATN. (a) BUN values from mice that un...
BMA worsens the course of ischemic ATN. (a) BUN values from mice that underwent bilateral ischemia for 30 minutes followed by 7 days of recovery. Mice underwent BMA prior to I/R (BMA); underwent BMA prior to I/R and stem cell transplantation after I/R (BMA-SCT); or underwent I/R without BMA (control). (b and c) X-gal staining of kidney sections reveals multiple β-galactosidase–positive tubules in the kidneys of BMA-SCT animals 48 hours after I/R (b) and 7 days after I/R (c). Of note, the sections in b were not counterstained with neutral fast red. (d–g) H&E staining reveals tubular damage in the outer medulla of both groups, with extensive denudation of some of the tubular basement membranes in animals that underwent BMA alone (d and e, arrowheads). The majority of damaged tubules in the BMA-SCT group contain flattened cells lining the basement membrane (g, arrows), while other areas demonstrate almost complete resolution of the injury (f). ×40.

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