Mesenchymal stem cells in myelodysplastic syndromes, contributions to disease pathogenesis and biomarker discovery

It is widely accepted that alterations in both haematopoietic stem cell compartment and the bone marrow microenvironment contribute to the pathogenesis of myelodysplastic syndromes. In order to gain insights into disease pathogenesis, a main cell type in the bone marrow microenvironment, mesenchymal stem cells, have been studied with great interest in the recent past. These cells are multipotent stem cells having the ability to differentiate in to other main resident cell types of the bone marrow such as chondrocytes, adipocytes and osteogenic cells. Their properties of plastic adherence in cell culture and characteristic cell marker expression have enabled easy isolation, characterization and used in research studies. These cells are known to interact closely with the haematopoietic stem and progenitor cells to maintain normal haematopoiesis. Their interactions are tightly regulated via many mechanisms including immunomodulation. Research studies have been done on marrow derived mesenchymal stem cells by many groups. Conflicting results regarding cell morphology, cell culture characteristics, cell proliferation and karyotype have been found. Altered haematopoietic support, immunomodulation, increased cellular senescence and genomic changes indicate that deranged mesenchymal stem cells as playing a definitive role in disease pathogenesis while providing leads to biomarker discovery in myelodysplastic syndromes. Preliminary studies on intercellular communications between mesenchymal stem cells and haematopoietic cells via extracellular vesicles have shown how mesenchymal stem cells could bring about myelodysplastic changes in the marrow. Current hypomethylating and immunomodulatory therapy were shown to have effects on stromal cells. Further studies on mesenchymal stem cells are warranted.