Since their initial identification as cells contributing to the hematopoietic niche within the BM, MSCs have received an ever-increasing amount of attention, mainly for reasons completely independent of their hematopoiesis-supporting properties. There are currently more than 800 human trials listed on ClinicalTrials.gov that employ MSCs for regenerative medicine and as modulators of the immune system.77,441 By virtue of the fact that their surrounding milieu can “license” MSCs, it is possible to tailor these cells to either inhibit or to stimulate an immune response, making them a unique and valuable tool in the immunotherapy arsenal. This remarkable immunological plasticity enables MSCs to be used to dampen aberrant immune responses in autoimmune disease, help to prevent rejection following solid organ or hematopoietic cell transplantation, deliver highly immunogenic therapeutic transgene products such as FVIII for treating genetic diseases, and to selectively target tumor cells for immune elimination. It is truly an exciting time in the MSC field, with each month seeing new and highly promising therapeutic uses for these versatile cells. We envision that the coming years will see the immunomodulatory properties of MSCs forming the basis for mainline therapy for a wide range of inherited and acquired disorders, enabling the successful treatment, and perhaps cure, of many diseases and forms of cancer for which current therapeutic strategies are ineffective.
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