Human
MSCs are the single most used cell source for tissue engineering and
regenerative medicine applications, and clinical trials involving hMSCs have
outpaced all other cell types in recent years (see here
and here). However, despite indications of clinical effectiveness
(see here and here),
there is repeated news of the failure of high-profile MSC trials to demonstrate
efficacy in a number of therapeutic applications (see here, here, here,
here and here). It has been suggested that the large amount
of intra- and inter-donor variability in the MSC populations used in these
trials may be responsible for their falling short of expectations despite highly
encouraging in vitro and in vivo pre-clinical data.
A
team led by Steve Bauer at the US FDA has reported that large variations in proliferation,
morphology, differentiation capacity, and cell surface marker expression
profiles exist within any population of MSCs and that these intra-population
heterogeneities may arise as a result of long-term in vitro culture and the in
vivo microenvironment (Free article available here.) In addition, their work has demonstrated that
there are inherent differences in MSCs from donors of similar age, and they
have noted the “potential for other donor-related factors in MSC biological
variability, which may play a role in their clinical usefulness or performance
in various model systems.” Other research groups have also corroborated
donor-related differences in MSC function, including in response to stimuli,
such as challenge with inflammatory cytokines (see here and here). A review article on developing
cell therapy manufacturing processes reinforces that several donors should
be tested prior to implementing; 1) changes in media composition (such as serum
reduction/elimination or addition of growth supplements), 2) extensions of the
product dose population
doubling level (PDL), or 3) changes
in lot size during scale-up.