Abstract
BACKGROUND: Acute kidney injury (AKI) is a severe condition with high morbidity and mortality. Mesenchymal stem cells (MSCs) and their conditioned medium (MSCs-CM), containing extracellular vesicles (EVs), have shown therapeutic potential. This study evaluates the effects of stem cells from human exfoliated deciduous teeth (SHED) and their conditioned medium (SHED-CM) on cisplatin-induced AKI in an in vivo model. METHODS: Male Wistar rats (n = 21) were randomly divided into three groups: a control group (cisplatin-induced AKI without intervention), a SHED group (receiving intraperitoneal SHED injections), and a SHED-CM group (receiving intraperitoneal SHED-CM injections). Kidney weight, urine parameters, histopathology, and injury scores were assessed. RESULTS: SHED-CM treatment significantly improved renal function, with reduced kidney injury scores (1.42 ± 0.18 vs. 2.57 ± 0.23 in the control, p < 0.05). Kidney weight was lower in the SHED-CM group compared to the control (1.12 ± 0.05 g vs. 1.36 ± 0.07 g, p < 0.05). SHED-CM also significantly increased urine volume (2.41 ± 0.19 mL vs. 1.23 ± 0.14 mL in the control, p < 0.01) and reduced urinary protein concentration (27.3 ± 2.1 mg/dL vs. 48.5 ± 3.4 mg/dL in the control, p < 0.05). Histopathological analysis revealed reduced tubular necrosis and inflammation, with SHED-CM showing superior improvement over SHED. CONCLUSIONS: SHED-CM demonstrated superior therapeutic efficacy over SHED injection in mitigating cisplatin-induced AKI, likely due to extracellular vesicle-mediated paracrine effects. These findings support SHED-CM as a promising, non-invasive alternative for MSC-EV-based AKI therapy.