The Future of Stem Cells in Liver Diseases

Background and Aim: The liver is the main organ for multiple metabolicpathways and many metabolic and genetic diseases affect primarilyhepatocytes. On the other side, infectious diseases like hepatitis B andC can damage liver cells permanently and lead to liver cirrhosis. Livercirrhosis is a critical medical problem with high morbidity and mortalityand liver transplantation is the only acceptable treatment, which affectslife quality dramatically. We have investigated the feasibility, safety, andefficacy of using autologous mesenchymal stem cells for the treatmentof liver cirrhosis and potential usage in ex vivo therapy for metabolicdiseases.Methods: Eight patients were included in this study after they approvedinformed consent. Four have hepatitis B, one hepatitis C, one alcoholic,and two cryptogenic liver cirrhosis. All patients have a Model for End-Stage Liver Disease (MELD) score more than ten and liver cirrhosis wasconfirmed by histology. Bone marrow from each patient was taken fromhis/her iliac crest and autologous mesenchymal stem cells were isolated.Approximately, 30-50 million MSCs were proliferated and injected intoperipheral or the portal vein under ultrasound guide. Liver functiontests (e.g., ASAT, ALAT, Bilirubin, alkaline phosphatase) and other liverrelatedtests like albumin and INR were measured. Clinical symptomswere evaluated at baseline and one, two four, eight and 24 weeks afterinjection of mesenchymal stem cells.Results: All patients tolerate treatment without any side effect andhypersensitivity reaction. Liver function improved. MELD scoredecreased from 17.9+/-5.6 to 10.7+/-6.3 (P<0.05), prothrombin complexfrom international normalized ratio from 1.9+/-0.4 to 1.4+/-0.5 (P<0.05).Serum creatinine changed from 114+/-35 to 80+/-18 μmol/L (P<0.05).Serum albumin changed from 30+/-5 to 33+/-5 g/L and bilirubin from46+/-29 to 41+/-31 μmol/L. No adverse effects were noted. All patientshad very good psychological intentions.Conclusion: Our data show that autologous mesenchymal stemcells injection is a potential treatment of end-stage liver disease withsatisfactory tolerability and may improve clinical indices of liver functionin end-stage liver disease. Since mesenchymal stem cells are consideredimmunologically privileged, and they have the ability to differentiate to many cell types, they are one the best candidates for ex vivo therapy forsingle gene and metabolic disease.

کلیدواژه ها:

Stem cells ، Liver diseases