Invited comment to: Minimal modulation of the host immune response to small intestinal submucosa by mesenchymal stem cells from the amniotic fluid. F. Lesagne, S. Pranpanus, F.M. Bosisio, M. Jacobs, S. Ospitalieri, J. Toelen, J. Deprest

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Hernia surgery and research is now on the verge of integrating reconstructive medicine and tissue engineering in large scale [1]. One important aspect is the quest for implementing stem cell therapies (SCT). The main questions in this context are the complex regulatory issues, related costs and the identification of potential benefits for the patient. The market for these innovations is highly competitive and “sophisticated”. Bearing these circumstances in mind, it does not come as surprise that SCT is a seemingly everlasting promise in an apparently always deferred future. Studies like the one by Prof. Deprest et al. are, therefore, absolutely mandatory to show possible directions and indications for SCT in hernia repair [2]. It is futile at this point of time to get into a dispute whether small intestine submucosa is a feasible material for future applications or if there are pros and cons of the retrieval process of the cell lines used in this specific trial. Of course I am pleased that amniotic fluid is gaining wider attention as a source for SCT, as our team in Vienna has followed a similar approach and published on it several years ago [3]. …