Publications by authors named "M Todeschini"

BACKGROUNDSevere forms of idiopathic nephrotic syndrome (INS) require prolonged immunosuppressive therapies and repeated courses of high-dose glucocorticoids. Mesenchymal stromal cells (MSCs) have promising immunomodulatory properties that may be employed therapeutically to reduce patient exposure to medications and their side effects.METHODSWe performed a phase I open-label trial assessing safety and feasibility of autologous bone marrow-derived MSCs (BM-MSCs) in children and young adults with severe forms of steroid-dependent nephrotic syndrome.

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Article Synopsis
  • Mesenchymal stromal cells (MSCs) show potential as a new therapy for diabetic kidney disease (DKD), but clinical trials have faced challenges.
  • In a phase 1b/2a trial involving 16 adults with type 2 diabetes, a low dose of MSCs (ORBCEL-M) was found to be safe and well-tolerated, with no serious adverse events linked to the treatment.
  • Compared to a placebo group, those receiving ORBCEL-M experienced a significantly slower decline in kidney function, suggesting the need for further studies on this therapy.
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Induced pluripotent stem cells (iPSC) have huge potential as cell therapy for various diseases, given their potential for unlimited self-renewal and capability to differentiate into a wide range of cell types. Although autologous iPSCs represents the ideal source for patient-tailored regenerative medicine, the high costs of the extensive and time-consuming production process and the impracticability for treating acute conditions hinder their use for broad applications. An allogeneic iPSC-based strategy may overcome these issues, but it carries the risk of triggering an immune response.

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Immune dysregulation plays a key role in the pathogenesis of steroid-dependent/frequently relapsing nephrotic syndrome (SDNS/FRNS). However, in contrast with evidence from the pediatric series, no major B- or T-cell alterations have been described for adults. In these patients, treatment with rituximab allows safe discontinuation of steroids, but long-term efficacy is variable, and some patients experience NS relapses after B cell reconstitution.

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