Stem Cell Therapy: Traps and Tricks

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Biomedical Engineering and Materials".

Deadline for manuscript submissions: 31 March 2026 | Viewed by 4012

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Guest Editor
Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Interests: challenges in animal model research; translation; unbiased reporting of animal model characteristics and results; ethical justification
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Guest Editor
1. Department of Nephrology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
2. Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
Interests: kidney transplantation; regenerative medicine and substitutive therapies of acute and end-stage kidney failure; transplanted stem cells; nephrology

Special Issue Information

Dear Colleagues,

Over the years, stem cell therapy has garnered significant interest as a treatment for various diseases. The therapeutic potential of mesenchymal stem cells (MSCs) has been explored in numerous animal models and veterinary patients. While preclinical research has reported beneficial treatment effects, these findings have led to the initiation of several clinical trials, which have yielded inconsistent results. Additionally, recent experiences have highlighted numerous reports of adverse events and side-effects associated with MSC therapy.

This experience underscores that there are many challenges and pitfalls in regenerative medicine that are often overlooked in the literature, hindering progress in the field and leading to unnecessary financial costs and safety concerns. A comprehensive understanding of these limitations, challenges, and pitfalls is essential for fostering advancements in stem cell therapy.

Therefore, this Special Issue aims to compile articles and reviews addressing the current obstacles, limitations, and side-effects that impede progress in the field, as well as potential strategies and solutions to overcome these issues.

Dr. Martina Perše
Dr. Željka Večerić-Haler
Guest Editors

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Keywords

  • mesenchymal stem cells
  • MSC therapy
  • preclinical research
  • regenerative medicine

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Published Papers (3 papers)

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Research

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18 pages, 4023 KB  
Article
Evaluation of Platelet Lysate-Based Medium and Protein Substrate for HUVEC Culture and Expansion
by Juan Manuel Duarte Rojas, Luz Marina Restrepo Múnera and Sergio Estrada Mira
Biomedicines 2025, 13(5), 1187; https://doi.org/10.3390/biomedicines13051187 - 13 May 2025
Cited by 1 | Viewed by 1285
Abstract
Background/Objectives: Endothelial cell (EC) culture relies on specialized and commercial media with distinct growth supplement compositions. These media are expensive and must be imported, increasing the time to effective use. Human platelet lysate (PL) and platelet lysate serum (PLS) supplemented media are emerging [...] Read more.
Background/Objectives: Endothelial cell (EC) culture relies on specialized and commercial media with distinct growth supplement compositions. These media are expensive and must be imported, increasing the time to effective use. Human platelet lysate (PL) and platelet lysate serum (PLS) supplemented media are emerging alternatives to commercial media. Methods: Umbilical cords were collected, and human umbilical vein endothelial cells (HUVEC) were isolated and cultured using different media formulations, using Endothelial Cell Growth, Promocell® (ECGM-Promocell®) commercial medium, and media supplemented with PL and PLS. Results: A mixed medium combining DMEM-F12 + PLS and ECGM-Promocell® maintained EC viability, adhesion, and proliferation. Introducing a PL-derived protein substrate enhanced cell adhesion and proliferation by simulating an extracellular matrix. Flow cytometry revealed positive CD31, CD144, and CD146 markers in cells cultured with ECGM-Promocell® and the mixed medium, with or without the PL-protein substrate. Conclusions: These findings suggest that the mixed medium, especially with the PL protein substrate, offers a cost-effective and efficient approach for EC culture and proliferation, holding promise for research and therapeutic applications. Full article
(This article belongs to the Special Issue Stem Cell Therapy: Traps and Tricks)
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Review

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28 pages, 1795 KB  
Review
Transcription Factor-Based Differentiation of Pluripotent Stem Cells: Overcoming the Traps of Random Neuronal Fate
by Georgie McDaid, Jaime Vanek, Brett Cromer and Huseyin Sumer
Biomedicines 2025, 13(11), 2783; https://doi.org/10.3390/biomedicines13112783 - 14 Nov 2025
Viewed by 1353
Abstract
Developing robust methods to differentiate pluripotent stem cells (PSCs) into specific neuronal subtypes is crucial for advancing neuroscience research, including disease modelling and regenerative medicine. Research in this area has primarily focused on generating and studying excitatory neurons, often in co-culture with primary [...] Read more.
Developing robust methods to differentiate pluripotent stem cells (PSCs) into specific neuronal subtypes is crucial for advancing neuroscience research, including disease modelling and regenerative medicine. Research in this area has primarily focused on generating and studying excitatory neurons, often in co-culture with primary astrocytes to support maturation. Due to the shared ectodermal lineage of these cell types, any mesoderm derived cells, such as microglia, are absent using traditional methods of culture. To more accurately model the intricate complexity of the brain and its normal neuronal physiology, it is important to incorporate other critical neural subtypes, such as inhibitory interneurons and various glial cells. This review highlights recent progress in using transcription factor-based in vitro differentiation strategies to generate these diverse neural populations. A major advantage of this approach is the ability to rapidly produce highly specific cell types in a controlled manner, allowing for the precise seeding of cells at defined anatomical and physiological ratios. This controlled methodology enables the creation of more accurate and reproducible in vitro models, including two-dimensional (2D) and three-dimensional (3D) cultures and organoids, thereby moving beyond the limitations of random differentiation from neuronal progenitor cells. Despite these advances, key challenges remain, including reproducibility between pluripotent stem cell lines, off-target transcriptional effects of exogenous factors, and incomplete phenotypic maturation of derived cells. Addressing these constraints is essential for translating transcription factor-based approaches into robust and clinically relevant neural models. Full article
(This article belongs to the Special Issue Stem Cell Therapy: Traps and Tricks)
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Other

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51 pages, 1664 KB  
Perspective
Stem Cell and Exosome Therapy in Wound Healing: Traps, Paradoxes, and Tricks Transforming Paradigms
by Gordana Velikic, Gordana Supic, Dusica L. Maric, Miljan Puletic, Marija D. Maric, Branko Barac and Dusan M. Maric
Biomedicines 2025, 13(12), 3030; https://doi.org/10.3390/biomedicines13123030 - 10 Dec 2025
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Abstract
Cell therapies hold great promise for advancing wound healing; however, translating this promise into consistent clinical benefit has proven elusive. Numerous trials have failed to reproduce the robust outcomes suggested by preclinical studies, reflecting a landscape marked by hidden traps. These include the [...] Read more.
Cell therapies hold great promise for advancing wound healing; however, translating this promise into consistent clinical benefit has proven elusive. Numerous trials have failed to reproduce the robust outcomes suggested by preclinical studies, reflecting a landscape marked by hidden traps. These include the hostile wound microenvironment, the cytotoxicity of antimicrobial dressings, poor retention and engraftment, immune clearance, and the paradoxical risk of fibrosis and scarring. Across these challenges emerge paradoxes that redefine how traps are understood. The Scarring Paradox reveals that MSCs and EVs may either suppress or reinforce fibrosis, depending on the niche context. The Immune Double-Edged Sword captures the duality of clearance and regenerative modulation. These paradoxes illustrate that traps are not static obstacles but dynamic inflection points. Recognition of these paradoxes has inspired tricks: protective biomaterial carriers, preconditioning strategies, engineered exosomes, and combinatorial therapies with anti-fibrotic, neuromodulatory, or microbiome-targeted adjuncts. Case studies illustrate how classical traps manifest in clinical practice and how paradoxes guide innovation. Emerging adjuncts, ranging from herbal bioactives and bioelectric modulation to circadian synchronization and digital twins, point toward more unconventional but increasingly plausible frameworks for niche control. This perspective review demonstrates that the future of regenerative wound therapy depends not on avoiding traps but on reframing them through paradoxes and converting them into tricks. Stem cell and exosome therapy is thus moving beyond a linear “promise versus failure” narrative toward a systemic, context-aware, programmable approach in which paradoxes drive conceptual renewal and transformative paradigms in wound care. Full article
(This article belongs to the Special Issue Stem Cell Therapy: Traps and Tricks)
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