Future Directions

Transplantation of MSCs represents a new avenue for improved cellular therapy with potential clinical applications in hematopoietic engraftment, gene therapy, and regenerative strategies. Preliminary clinical observations of MSC cotransplants may accelerate hematopoietic reconstitution after cord-blood-derived and autologous stem cell transplantation. Transplants of MSCs expressing an intact or amplified gene for type I collagen may provide a therapeutic role in overcoming the genetic disorder in patients with osteogenesis imperfecta. Genetically modified MSCs may also provide an effective means to correct other inborn errors of metabolism. With respect to allografts, cotransplants of donor-derived MSCs may ameliorate graft-vs-host disease by their immunosuppres-sive effect (138). MSC therapy could also be an important bone engineering consideration for elderly patients (i.e., osteoporosis) (139). As for any clinical therapeutic with promising preliminary results, randomized trials are absolutely necessary to clearly delineate a beneficial therapeutic outcome.

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