A New Mesenchymal Stem Cell (MSC) Paradigm: Polarization into a Pro-Inflammatory MSC1 or an Immunosuppressive MSC2 Phenotype
Open accessAbstract
BACKGROUND: Our laboratory and others reported that the stimulation of specific Toll-like receptors (TLRs) affects the immune modulating responses of human multipotent mesenchymal stromal cells (hMSCs). Toll-like receptors recognize "danger" signals, and their activation leads to profound cellular and systemic responses that mobilize innate and adaptive host immune cells. The danger signals that trigger TLRs are released following most tissue pathologies. Since danger signals recruit immune cells to sites of injury, we reasoned that hMSCs might be recruited in a similar way. Indeed, we found that hMSCs express several TLRs (e.g., TLR3 and TLR4), and that their migration, invasion, and secretion of immune modulating factors is drastically affected by specific TLR-agonist engagement. In particular, we noted diverse consequences on the hMSCs following stimulation of TLR3 when compared to TLR4 by our low-level, short-term TLR-priming protocol. PRINCIPAL FINDINGS: Here we extend our studies on the effect on immune modulation by specific TLR-priming of hMSCs, and based on our findings, propose a new paradigm for hMSCs that takes its cue from the monocyte literature. Specifically, that hMSCs can be polarized by downstream TLR signaling into two homogenously acting phenotypes we classify here as MSC1 and MSC2. This concept came from our observations that TLR4-primed hMSCs, or MSC1, mostly elaborate pro-inflammatory mediators, while TLR3-primed hMSCs, or MSC2, express mostly immunosuppressive ones. Additionally, allogeneic co-cultures of TLR-primed MSCs with peripheral blood mononuclear cells (PBMCs) predictably lead to suppressed T-lymphocyte activation following MSC2 co-culture, and permissive T-lymphocyte activation in co-culture with MSC1. SIGNIFICANCE: Our study provides an explanation to some of the conflicting reports on the net effect of TLR stimulation and its downstream consequences on the immune modulating properties of stem cells. We further suggest that MSC polarization provides a convenient way to render these heterogeneous preparations of cells more uniform while introducing a new facet to study, as well as provides an important aspect to consider for the improvement of current stem cell-based therapies.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
TLR-priming of MSCs can lead to MSC polarization towards an anti-inflammatory immunosuppressive phenotype when primed by TLR3.
“In particular, Waterman et al. demonstrated that TLR-priming of MSCs can lead to MSCs polarization towards an anti-inflammatory immunosuppressive phenotype when primed by TLR3 [17,19].”
From Mesenchymal Stem/Stromal Cells: Immunomodulatory and Bone Regeneration Potential after Tumor Excision in Osteosarcoma Patients (2023) · cites this paper as [19]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Human mesenchymal stem cells modulate allogeneic immune cell responses
Aggarwal, S., & Pittenger, M. F. (2005) · Blood · doi:10.1182/blood-2004-04-1559 · Cited by 4,511 · see citing works
Németh, K., Leelahavanichkul, A., Yuen, P. S. T., Mayer, B., Parmelee, A., Doi, K., Robey, P. G., Leelahavanichkul, K., Koller, B. H., Brown, J. M., et al. (2009) · Nature Medicine · doi:10.1038/nm.1905 · Cited by 2,364 · see citing works
Flagged first, then by citations
Research works printed but not linked: 54
- [1]Abdi R Fiorina P Adra CN Atkinson M Sayegh MH 2008 Immunomodulation by mesenchymal stem cells: a potential therapeutic strategy for type 1 diabetes. Diabetes 57 1759 1767 18586907 PMC2453631
- [2]Prockop DJ 2009 Repair of tissues by adult stem/progenitor cells (MSCs): controversies, myths, and changing paradigms. Mol Ther 17 939 946 19337235 PMC2835176
- [4]Phinney DG Kopen G Righter W Webster S Tremain N 1999 Donor variation in the growth properties and osteogenic potential of human marrow stromal cells. J Cell Biochem 75 424 436 10536366
- [5]Ryan JM Barry FP Murphy JM Mahon BP 2005 Mesenchymal stem cells avoid allogeneic rejection. J Inflamm (Lond) 2 8 16045800 PMC1215510
- [6]Caplan AI 1995 Osteogenesis imperfecta, rehabilitation medicine, fundamental research and mesenchymal stem cells. Connect Tissue Res 31 S9 14 15612374
- [7]Nakamizo A Marini F Amano T Khan A Studeny M 2005 Human bone marrow-derived mesenchymal stem cells in the treatment of gliomas. Cancer Res 65 3307 3318 15833864
- [8]Aicher A Brenner W Zuhayra M Badorff C Massoudi S 2003 Assessment of the tissue distribution of transplanted human endothelial progenitor cells by radioactive labeling. Circulation 107 2134 2139 12695305
- [9]Picinich SC Mishra PJ Glod J Banerjee D 2007 The therapeutic potential of mesenchymal stem cells. Cell- & tissue-based therapy. Expert Opin Biol Ther 7 965 973 17665987
- [10]Ozawa K Sato K Oh I Ozaki K Uchibori R 2008 Cell and gene therapy using mesenchymal stem cells (MSCs). J Autoimmun 30 121 127 18249090
- [11]Ohtaki H Ylostalo JH Foraker JE Robinson AP Reger RL 2008 Stem/progenitor cells from bone marrow decrease neuronal death in global ischemia by modulation of inflammatory/immune responses. Proc Natl Acad Sci U S A 105 14638 14643 18794523 PMC2567180
- [12]Gao J Dennis JE Muzic RF Lundberg M Caplan AI 2001 The dynamic in vivo distribution of bone marrow-derived mesenchymal stem cells after infusion. Cells Tissues Organs 169 12 20 11340257
- [13]Hwa Cho H Bae YC Jung JS 2006 Role of toll-like receptors on human adipose-derived stromal cells. Stem Cells 24 2744 2752 16902195
- [14]Pevsner-Fischer M Morad V Cohen-Sfady M Rousso-Noori L Zanin-Zhorov A 2007 Toll-like receptors and their ligands control mesenchymal stem cell functions. Blood 109 1422 1432 17038530
- [15]Tomchuck SL Zwezdaryk KJ Coffelt SB Waterman RS Danka ES 2008 Toll-like receptors on human mesenchymal stem cells drive their migration and immunomodulating responses. Stem Cells 26 99 107 17916800 PMC2757778
- [16]Akira S Sato S 2003 Toll-like receptors and their signaling mechanisms. Scand J Infect Dis 35 555 562 14620134
- [17]Miggin SM O'Neill LA 2006 New insights into the regulation of TLR signaling. J Leukoc Biol 80 220 226 16698941
- [18]Takeda K Kaisho T Akira S 2003 Toll-like receptors. Annu Rev Immunol 21 335 376 12524386
- [19]West AP Koblansky AA Ghosh S 2006 Recognition and signaling by toll-like receptors. Annu Rev Cell Dev Biol 22 409 437 16822173
- [20]Matzinger P 2002 The danger model: a renewed sense of self. Science 296 301 305 11951032
- [21]Liotta F Angeli R Cosmi L Fili L Manuelli C 2008 Toll-like receptors 3 and 4 are expressed by human bone marrow-derived mesenchymal stem cells and can inhibit their T-cell modulatory activity by impairing Notch signaling. Stem Cells 26 279 289 17962701
- [22]Lombardo E DelaRosa O Mancheno-Corvo P Menta R Ramirez C 2009 Toll-like receptor-mediated signaling in human adipose-derived stem cells: implications for immunogenicity and immunosuppressive potential. Tissue Eng Part A 15 1579 1589 19061425
- [23]Gur-Wahnon D Borovsky Z Beyth S Liebergall M Rachmilewitz J 2007 Contact-dependent induction of regulatory antigen-presenting cells by human mesenchymal stem cells is mediated via STAT3 signaling. Exp Hematol 35 426 433 17309823
- [24]Nemeth K Mayer B Mezey E 2010 Modulation of bone marrow stromal cell functions in infectious diseases by toll-like receptor ligands. J Mol Med 88 5 10 19756450 PMC2928254
- [25]Nauta AJ Fibbe WE 2007 Immunomodulatory properties of mesenchymal stromal cells. Blood 110 3499 3506 17664353
- [26]Fibbe WE Nauta AJ Roelofs H 2007 Modulation of immune responses by mesenchymal stem cells. Ann N Y Acad Sci 1106 272 278 17442776
- [27]Di Nicola M Carlo-Stella C Magni M Milanesi M Longoni PD 2002 Human bone marrow stromal cells suppress T-lymphocyte proliferation induced by cellular or nonspecific mitogenic stimuli. Blood 99 3838 3843 11986244
- [28]Meisel R Zibert A Laryea M Gobel U Daubener W 2004 Human bone marrow stromal cells inhibit allogeneic T-cell responses by indoleamine 2,3-dioxygenase-mediated tryptophan degradation. Blood 103 4619 4621 15001472
- [29]Sotiropoulou PA Perez SA Gritzapis AD Baxevanis CN Papamichail M 2006 Interactions between human mesenchymal stem cells and natural killer cells. Stem Cells 24 74 85 16099998
- [30]Le Blanc K Tammik L Sundberg B Haynesworth SE Ringden O 2003 Mesenchymal stem cells inhibit and stimulate mixed lymphocyte cultures and mitogenic responses independently of the major histocompatibility complex. Scand J Immunol 57 11 20 12542793
- [31]Beyth S Borovsky Z Mevorach D Liebergall M Gazit Z 2005 Human mesenchymal stem cells alter antigen-presenting cell maturation and induce T-cell unresponsiveness. Blood 105 2214 2219 15514012
- [32]Krampera M Cosmi L Angeli R Pasini A Liotta F 2006 Role for interferon-gamma in the immunomodulatory activity of human bone marrow mesenchymal stem cells. Stem Cells 24 386 398 16123384
- [33]Rizzo R Campioni D Stignani M Melchiorri L Bagnara GP 2008 A functional role for soluble HLA-G antigens in immune modulation mediated by mesenchymal stromal cells. Cytotherapy 10 364 375 18574769
- [34]Heinz S Haehnel V Karaghiosoff M Schwarzfischer L Muller M 2003 Species-specific regulation of Toll-like receptor 3 genes in men and mice. J Biol Chem 278 21502 21509 12672806
- [35]Mestas J Hughes CC 2004 Of mice and not men: differences between mouse and human immunology. J Immunol 172 2731 2738 14978070
- [36]Verreck FA de Boer T Langenberg DM van der Zanden L Ottenhoff TH 2006 Phenotypic and functional profiling of human proinflammatory type-1 and anti-inflammatory type-2 macrophages in response to microbial antigens and IFN-gamma- and CD40L-mediated costimulation. J Leukoc Biol 79 285 293 16330536
- [37]Martinez FO Gordon S Locati M Mantovani A 2006 Transcriptional profiling of the human monocyte-to-macrophage differentiation and polarization: new molecules and patterns of gene expression. J Immunol 177 7303 7311 17082649
- [38]Pollard JW 2009 Trophic macrophages in development and disease. Nat Rev Immunol 9 259 270 19282852 PMC3648866
- [39]Lopez Ponte A Marais E Gallay N Langonne A Delorme B 2007 The in vitro migration capacity of human bone marrow mesenchymal stem cells: Comparison of chemokine and growth factor chemotactic activities. Stem Cells 25(7) 1737 45 Epub 2007 Mar 29 17395768
- [40]Massague J 1990 The transforming growth factor-beta family. Annu Rev Cell Biol 6 597 641 2177343
- [41]Lee BS Nowak RA 2001 Human leiomyoma smooth muscle cells show increased expression of transforming growth factor-beta 3 (TGF beta 3) and altered responses to the antiproliferative effects of TGF beta. J Clin Endocrinol Metab 86 913 920 11158066
- [42]Blokzijl A Dahlqvist C Reissmann E Falk A Moliner A 2003 Cross-talk between the Notch and TGF-beta signaling pathways mediated by interaction of the Notch intracellular domain with Smad3. J Cell Biol 163 723 728 14638857 PMC2173673
- [43]Samon JB Champhekar A Minter LM Telfer JC Miele L 2008 Notch1 and TGFbeta1 cooperatively regulate Foxp3 expression and the maintenance of peripheral regulatory T cells. Blood 112 1813 1821 18550850 PMC2518888
- [44]Uccelli A Moretta L Pistoia V 2008 Mesenchymal stem cells in health and disease. Nat Rev Immunol 8 726 736 19172693
- [45]Coffelt SB Waterman RS Florez L Honer zu Bentrup K Zwezdaryk KJ 2008 Ovarian cancers overexpress the antimicrobial protein hCAP-18 and its derivative LL-37 increases ovarian cancer cell proliferation and invasion. Int J Cancer 122 1030 1039 17960624
- [46]Coffelt SB Marini FC Watson K Zwezdaryk KJ Dembinski JL 2009 The pro-inflammatory peptide LL-37 promotes ovarian tumor progression through recruitment of multipotent mesenchymal stromal cells. Proc Natl Acad Sci U S A 106 3806 3811 19234121 PMC2656161
- [47]Romieu-Mourez R Francois M Boivin MN Bouchentouf M Spaner DE 2009 Cytokine modulation of TLR expression and activation in mesenchymal stromal cells leads to a proinflammatory phenotype. J Immunol 182 7963 7973 19494321
- [48]Wang Y Zhang Z Shen H Lu Y Li H 2008 TGF-beta1/Smad7 signaling stimulates renal tubulointerstitial fibrosis induced by AAI. J Recept Signal Transduct Res 28 413 428 18702012
- [50]Gur-Wahnon D Borovsky Z Liebergall M Rachmilewitz J 2009 The induction of APC with a distinct tolerogenic phenotype via contact-dependent STAT3 activation. PLoS One 4 e6846 19718269 PMC2731174
- [51]Town T Laouar Y Pittenger C Mori T Szekely CA T 2008 Blocking TGF-beta-Smad2/3 innate immune signaling mitigates Alzheimer-like pathology. Nat Med 14 681 687 18516051 PMC2649699
- [52]Selmani Z Naji A Zidi I Favier B Gaiffe E 2008 Human leukocyte antigen-G5 secretion by human mesenchymal stem cells is required to suppress T lymphocyte and natural killer function and to induce CD4+CD25highFOXP3+ regulatory T cells. Stem Cells 26 212 222 17932417
- [53]Di Ianni M Del Papa B De Ioanni M Moretti L Bonifacio E 2008 Mesenchymal cells recruit and regulate T regulatory cells. Exp Hematol 36 309 318 18279718
- [54]Zwezdaryk KJ Coffelt SB Figueroa YG Liu J Phinney DG 2007 Erythropoietin, a hypoxia-regulated factor, elicits a pro-angiogenic program in human mesenchymal stem cells. Exp Hematol 35 640 652 17379074
- [55]Pittenger MF Mackay AM Beck SC Jaiswal RK Douglas R 1999 Multilineage potential of adult human mesenchymal stem cells. Science 284 143 147 10102814
- [56]Coffelt SB Tomchuck SL Zwezdaryk KJ Danka ES Scandurro AB 2009 Leucine leucine-37 uses formyl peptide receptor-like 1 to activate signal transduction pathways, stimulate oncogenic gene expression, and enhance the invasiveness of ovarian cancer cells. Mol Cancer Res 7 907 915 19491199 PMC2755540
Cited by
Sorted by citations
Plasticity of mesenchymal stem cells in immunomodulation: pathological and therapeutic implications
Wang, Y., Chen, X., Cao, W., & Shi, Y. (2014) · Nature Immunology · doi:10.1038/ni.3002 · Cited by 1,452 · see citing works
Immunoregulatory mechanisms of mesenchymal stem and stromal cells in inflammatory diseases
Shi, Y., Wang, Y., Li, Q., Liu, K., Hou, J., Shao, C., & Wang, Y. (2018) · Nature Reviews Nephrology · doi:10.1038/s41581-018-0023-5 · Cited by 1,223 · see citing works
Mesenchymal stromal cells: new directions
Keating, A. (2012) · Cell Stem Cell · doi:10.1016/j.stem.2012.05.015 · Cited by 778 · see citing works
Priming approaches to improve the efficacy of mesenchymal stromal cell-based therapies
Noronha, N. D. C., Mizukami, A., Caliári-Oliveira, C., Cominal, J. G., Rocha, J. L. M., Covas, D. T., Swiech, K., & Malmegrim, K. C. R. (2019) · Stem Cell Research & Therapy · doi:10.1186/s13287-019-1224-y · Cited by 623 · see citing works
Klopp, A. H., Gupta, A., Spaeth, E., Andreeff, M., & Marini, F. (2011) · Stem Cells · doi:10.1002/stem.559 · Cited by 562 · see citing works
Mesenchymal stem cells: Amazing remedies for bone and cartilage defects
Kangari, P., Talaei-Khozani, T., Razeghian-Jahromi, I., & Razmkhah, M. (2020) · Stem Cell Research & Therapy · doi:10.1186/s13287-020-02001-1 · Cited by 286 · see citing works
Galland, S., & Stamenkovic, I. (2020) · The Journal of Pathology · doi:10.1002/path.5357 · Cited by 165 · see citing works
Mesenchymal stem cells in preclinical cancer cytotherapy: a systematic review
Christodoulou, I., Goulielmaki, M., Devetzi, M., Panagiotidis, M., Koliakos, G., & Zoumpourlis, V. (2018) · Stem Cell Research & Therapy · doi:10.1186/s13287-018-1078-8 · Cited by 122 · see citing works
Recent discoveries concerning the tumor - mesenchymal stem cell interactions
Lazennec, G., & Lam, P. Y. (2016) · Biochimica et Biophysica Acta (BBA) - Reviews on Cancer · doi:10.1016/j.bbcan.2016.10.004 · Cited by 117 · see citing works
Mesenchymal stromal cells: promising treatment for liver cirrhosis
Yao, L., Hu, X., Dai, K., Yuan, M., Liu, P., Zhang, Q., & Jiang, Y. (2022) · Stem Cell Research & Therapy · doi:10.1186/s13287-022-03001-z · Cited by 71 · see citing works
Breaking Boundaries: Chronic Diseases and the Frontiers of Immune Microenvironments
Li, G., Wan, Y., Jiao, A., Jiang, K., Cui, G., Tang, J., Yu, S., Hu, Z., Zhao, S., Yi, Z., et al. (2025) · Med Research · doi:10.1002/mdr2.70007 · Cited by 63 · see citing works
BULUT, Ö., & GÜRSEL, İ. (2020) · TURKISH JOURNAL OF BIOLOGY · doi:10.3906/biy-2002-79 · Cited by 34 · see citing works
Primed Mesenchymal Stem Cells Alter and Improve Rat Medial Collateral Ligament Healing
Saether, E. E., Chamberlain, C. S., Aktas, E., Leiferman, E. M., Brickson, S. L., & Vanderby, R. (2016) · Stem Cell Reviews and Reports · doi:10.1007/s12015-015-9633-5 · Cited by 34 · see citing works
Paladino, F. V., Sardinha, L. R., Piccinato, C. A., & Goldberg, A. C. (2017) · Stem Cells International · doi:10.1155/2017/8492797 · Cited by 23 · see citing works
New therapeutic approaches for type 1 diabetes: Disease-modifying therapies
Nagy, G., Szekely, T. E., Somogyi, A., Herold, M., & Herold, Z. (2022) · World Journal of Diabetes · doi:10.4239/wjd.v13.i10.835 · Cited by 23 · see citing works
Yarahmadi, A., Dorri Giv, M., Hosseininejad, R., Rezaie, A., Mohammadi, N., Afkhami, H., & Farokhi, A. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1472679 · Cited by 21 · see citing works
Baron, M., Drohat, P., Crawford, B., Hornicek, F. J., Best, T. M., & Kouroupis, D. (2023) · Bioengineering · doi:10.3390/bioengineering10101187 · Cited by 19 · see citing works
Mesenchymal Stem Cells and Reticulated Platelets: New Horizons in Multiple Myeloma
Mera Azaín, C. A., Vargas Pasquel, J. L., Quijano Gómez, S. M., & Rodríguez-Pardo, V. M. (2024) · Hematology Reports · doi:10.3390/hematolrep16040070 · Cited by 1 · see citing works
“ISO Standard 24651 revised their phenotypic definition [18,19].”
- Authors
- Waterman, R. S., Tomchuck, S. L., Henkle, S. L., & Betancourt, A. M.
- Affiliations
- Tulane University (US)
- Corresponding author
- Betancourt, Aline M.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2010-04-26
- Volume
- 5
- Issue
- 4
- Pages
- e10088
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC2859930
- OpenAlex
- W2073024911
- Cited by
- 1,238
- References
- 2
- Citations by year
- 2026: 42 · 2025: 44 · 2024: 60 · 2023: 82 · 2022: 95 · 2021: 138 · 2020: 106 · 2019: 91 · 2018: 80 · 2017: 86 · 2016: 107 · 2015: 90 · 2014: 66 · 2013: 64 · 2012: 49
- FWCI
- 21.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- U.S. Department of Defense (OC073102)
- National Institutes of Health (1P20RR20152-01)
- National Center for Research Resources (1P20RR20152-01, P20RR020152)
- Topics
- Health Sciences › Medicine › Genetics › Mesenchymal stem cell research
- Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- mesenchymal stem cells, Toll-like receptors, TLR3, TLR4, immunomodulation, pro-inflammatory mediators, T cell activation, peripheral blood mononuclear cells, damage-associated molecular patterns, stem cell therapy
- MeSH terms
- Cell Movement, Humans, Immune System, Immunity, Inflammation, Monocytes, Phenotype, Coculture Techniques, Toll-Like Receptors, Toll-Like Receptor 3, Toll-Like Receptor 4, Mesenchymal Stem Cells
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review