Can mobilization of bone marrow stem cells be an alternative regenerative therapy to stem cell injection in a rat model of chronic kidney disease?

Chronic kidney disease (CKD) is a priority health problem affecting 36% of Egyptians. Adipose‐derived mesenchymal stem cells (ADMSCs) have multidifferentiation capacity and the ability to restore several types of cells including damaged renal cells. Granulocyte colony‐stimulating factor (G‐CSF) is known to mobilize hematopoietic stem cells from bone marrow to the peripheral circulation. The aim of this study was to compare the effect of endogenous CD34(+) cells mobilization and exogenous ADMSCs administration in the treatment of a rat model of adriamycin (ADR)‐induced CKD. A total of 48 male albino rats of the local strain (200 ± 50 g) were equally divided into four groups: control negative, ADR (control positive), ADMSCs group, and G‐CSF group. Six rats from each group were sacrificed after 4 weeks and the other 6 after 12 weeks. Renal function was assessed frequently by measuring serum creatinine, albumin, urea, 24‐h urinary protein level, and hemoglobin level throughout the study. Oxidative stress markers malondialdehyde (MDA) and total antioxidant (TAO) were measured on day 28. CD‐34(+) cell percentage was measured on day 9. After the sacrification of the rats, kidneys were removed for histopathological assessment. Results revealed that both ADMSCs and G‐CSF significantly improved serum creatinine, albumin, urea, 24‐h urinary protein level, and histopathological damage score, with the G‐CSF‐treated group showing better improvement in 24‐h urinary protein level, serum albumin, and histopathological damage score compared with ADMSCs‐treated group. The G‐CSF group also had significantly higher levels of CD34(+) cells. Oxidative stress markers (MDA and TAO) levels were significantly improved with both therapies. We conclude that mobilization of endogenous hematopoietic stem cells by G‐CSF is more effective than exogenously injected ADMSCs in protecting the kidneys against AD‐induced toxicity.