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Peritoneal dialysate-derived mesenchymal stem cells (PD-MSCs) are a novel, autologous, and clinically accessible cell therapy being investigated for the treatment of peritoneal fibrosis (PF), a major complication of long-term peritoneal dialysis. These mesenchymal stem cell-like cells are isolated from the dialysate samples of early-stage peritoneal dialysis patients. They exhibit characteristic MSC markers (positive for CD29, CD44, CD73, CD90, CD105, CD166; negative for CD34, CD79a, HLA-DR) and possess trilineage differentiation potential (into adipocytes, chondrocytes, and osteocytes). In preclinical studies, PD-MSCs have demonstrated anti-fibrotic potential by significantly inhibiting TGF-β-induced epithelial-to-mesenchymal transition (EMT) in human peritoneal mesothelial cells, reducing reactive oxygen species (ROS) production, and restoring the expression of anti-fibrotic proteins such as hepatocyte growth factor (HGF) and bone morphogenetic protein-7 (BMP-7). Their efficacy has been shown to be comparable or superior to tonsil-derived MSCs in mitigating EMT, reducing oxidative stress, and enhancing anti-fibrotic protein expression, suggesting their potential as a safe autologous stem cell therapy to preserve peritoneal membrane integrity.
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