Mesenchymal Stromal Cell Therapies – The Next Frontiers

The emerging field of cell therapy has been considered by many to be the next revolution in medicine, promising unprecedented and previously unimaginable treatments for major life-altering conditions and degenerative diseases. However, there are legitimate questions about the slow pace of comprehension of the biological activity of the cells versus the fast pace of patient testing. There are concerns that the biology of the in vivo mesenchymal stromal cell (MSC), the consistency and quality of culture expanded preparations, the nature of lineage commitment and the therapeutic mechanism of action have not been adequately addressed. For these reasons, MSCs may be regarded as a cellular ‘poultice’, used because we did not know any better and to be replaced by more refined therapies when these become available. Therefore, MSCs may be primarily a means to an end, that end becoming apparent with greater scientific comprehension. This chapter discusses the nature of the next generation of therapies, taking us beyond MSCs.