Mesenchymal stem/stromal cells (MSCs) are the subject of numerous studies in the field of regenerative medicine. They represent a unique type of cells that can be isolated from various tissues of adult individuals, most commonly from bone marrow or adipose tissue, though there is a growing interest in using less invasive sources, such as dental pulp, umbilical cord, and others. They possess the capacity for multidirectional differentiation into a variety of tissues, a feature utilized in regenerative medicine to develop new cell-based therapies for numerous diseases. These therapies have been shown to be safe and are associated with very few adverse effects. They can act through several mechanisms, such as transdifferentiation, mitochondrial transfer, paracrine signaling, secretion of extracellular vesicles and cell fusion, which is the focus of our thesis. Cell fusion can be either a physiological or pathological process and plays a role in for example, embryonic development and the body's immune response. More recent research has also demonstrated fusion between stem cells and tissue specific cells, which offers new possibilities for therapeutic applications.
To evaluate the importance of cell fusion as one of the mechanisms of action of MSCs and to explore its potential application in regenerative medicine, we conducted a systematic literature review. The search was performed using three databases: PubMed, Web of Science and Scopus. Additionally, we included articles identified through screening of references of already included sources. A total of 46 articles were included, of which 32 were research articles that were the focus of this thesis.
The studies were categorized by organ systems, and we found that the results varied greatly. Early research focused mainly on the mechanisms underlying MSC action. Some demonstrated an absence of fusion, while others reported fusion to be a rare spontaneous event. To increase the frequency of fusion, researchers used additional techniques such as viral methods or polyethylene glycol. Such induced fusion may become an important mechanism for generating hybrid or fused cells. The concept has already been applied in the development of novel therapies targeting cardiovascular diseases, Duchenne muscular dystrophy and diabetes. Despite the proven potential of MSC fusion, this field remains under-researched and further studies, on the long-term effects of hybridoma therapies, will be needed.
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