NDT Advance Access originally published online on December 25, 2008
Nephrology Dialysis Transplantation 2009 24(3):731-734; doi:10.1093/ndt/gfn722
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Stem cell therapy for Alport syndrome: the hope beyond the hype*
1 Department of Nephrology & Rheumatology, University of Göttingen, Göttingen, Germany 2 Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA 3 Department of Nephrology, Medical Policlinic, University of Munich, Munich, Germany 4 Division of Nephrology, The Hospital of Sick Children, University of Toronto, Toronto, Canada 5 Merheim Medical Center, University of Witten-Herdecke, Campus Cologne, Cologne, Germany 6 Clinic for Nephrology, USZ and Institute of Anatomy, University of Zurich, Switzerland 7 Nephrology Department, Fundacio Puigvert, Barcelona, Spain 8 Inserm U574, Universite Paris Descartes 9 Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA) Service de Néphrologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France 10 Boys Town National Research Hospital, Omaha, NE 11 Department of Small Animal Clinical Sciences, Texas A & M University, College Station, TX 12 Division of Pediatric Nephrology, University of Minnesota, MN 13 Nephrology and Hypertension Division, Department of Internal Medicine, The University of Utah School of Medicine, UT, USA 14 Department of Medicine, The Northern Hospital, The University of Melbourne, Epping, Australia 15 Department of Pediatrics, Peking University, First Hospital, Beijing, China 16 Department of Laboratory Medicine, Hospital for Sick Children and University of Toronto, Toronto, Canada 17 Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, USA 18 Division of Matrix Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden 19 Renal Division, Washington University School of Medicine, St Louis, MO USA
Correspondence and offprint requests to: Oliver Gross, Department of Nephrology and Rheumatology, University Hospital Gottingen, Robert-Koch Street 40, 37075 Gottingen, Germany. Tel: +49-551-396331; Fax: +49-551-398906; E-mail: gross.oliver@med.uni-goettingen.de
Keywords: alport syndrome; bone marrow transplantation; renal fibrosis; stem cell therapy
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Alport syndrome is a hereditary glomerulopathy leading to end-stage renal disease (ESRD), frequently during adolescence. It is caused by the absence or abnormal composition of the type IV collagen 
3/4/5 network normally present in the glomerular basement membrane (GBM) [1]. In the September 2008 issue of the Journal of the American Society of Nephrology, Katayama and colleagues reported that bone marrow transplantation (BMT) following lethal irradiation with either wild-type or Col4a3–/– BM prolonged the lifespan of Alport mice with similar efficiencies. Sublethal irradiation alone also provided significant benefits [2].
These results challenge reports from Cook's and Kalluri's groups suggesting that wild-type BM-derived cells ameliorate disease in Alport mice because they can differentiate into podocytes and secrete the missing collagen 3/4/5(IV) chains [3,4], which would basically constitute a curative cell-based therapeutic approach for treating Alport glomerulopathy. Their interpretation that circulating BM-derived cells are
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