Mesenchymal stem cell (MSC) therapy is being explored as a potential new approach for IgA nephropathy (IgAN), particularly because of its immunomodulatory, anti-inflammatory, antifibrotic, and tissue-repair effects. Rather than working mainly through direct differentiation into kidney cells, MSCs appear to act largely through paracrine signaling, releasing cytokines, growth factors, and extracellular vesicles that may help regulate immune responses, reduce oxidative stress and apoptosis, and suppress profibrotic pathways. Preclinical IgAN studies have reported reductions in proteinuria, IgA deposition, mesangial proliferation, glomerulosclerosis, and fibrosis with several MSC types, including bone marrow-, adipose-, and umbilical cord–derived cells.
The key takeaway is that MSC therapy remains investigational. Clinical evidence in IgAN is limited primarily to case reports and one small phase 1 trial of allogeneic adipose-derived MSCs in nine patients with refractory disease. The trial suggested acceptable short-term safety and reductions in proteinuria and kidney-injury markers but did not demonstrate a clear effect on eGFR. Important challenges remain, including limited cell survival, inconsistent homing, manufacturing variability, cost, and uncertainty about long-term safety and efficacy. Larger, well-controlled clinical trials and standardized cell-preparation and delivery methods will be needed before MSC therapy can be incorporated into routine IgAN care.
Reference: Liu Y, Zhao Y, Xie J, et al. The role of mesenchymal stem cells in IgA nephropathy: current evidence and future directions. Stem Cell Res Ther. 2026 Apr 11;17(1):186. doi: 10.1186/s13287-026-05012-6.
