Read this (https://stemcellsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/stem.3380) and tell me that we're not right on the cusp of MSC's being approved for all sorts of indications. It's a paper from a guy who knows a thing or two about stem cells, in fact he's the President elect of the International Society for Cell and Gene Therapy.
Warning, there's a lot of scientific jargon in there so I'll summarise it for you in my own words - "we didn't really know exactly how MSC's worked or if they were really working other than some theories on inflammation and evidence showing that they worked in clinical trials and the FDA wasn't happy with that because they have trouble approving things when they don't understand how they work, now we do know how they work and we'll have a way of showing it before and/or after they've been deployed and that should keep the FDA happy"
or in scientist speak
"Biological insights on MSC mechanism of action in human clinical studies is typically limited to in vitro correlative studies attempting to plot a direct relationship between MSC cellular attributes and human subject clinical and biological predictive markers of objective response[5]. This missing link between MSC functional attributes [eg:“potency”] and clinical outcomes remains the Achilles heel of marketing approval in international regulatory jurisdictions [6,7]. A remedy to this shortcoming is to eek insights from a comparative biology perspective examining pre-clinical models of disease especially the study of MSC attributes that are shared between human and animal systems as well as the host response [8]. The scope of this concise review is to provide such an analysis interrogating murine systems that provide insight in the mechanism of action of MSC and the emerging role of MSC-borne chemokines in host macrophage response for clinical effect in acute inflammatory tissue injury syndromes."
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