Adult bone marrow-derived mesenchymal stem cells (MSCs) exist in all living species and are capable of differentiating into different types of specific cells. In this study, we demonstrate the therapeutic effectiveness of rat MSC transplantation in D-galactosamine (GalN)-induced acute liver injury and identified the novel pathways which are involved in hepatic differentiation of MSCs. In vivo, intraportal transplantation with 5 Â 10 6 MSCs at 24 hours after GalN administration resulted in significant reduction in serum levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin compared to the control group. Engrafted MSCs actively proliferated, differentiated, and further enhanced hepatocyte proliferation activity. In vitro, coculture of MSCs with GalN-induced injured hepatocytes showed efficient differentiation and was evidenced by progressive increase in messenger RNA levels of hepatic markers, including albumin, a-fetoprotein, CCAAT-enhancer binding protein a, a-1-antitryspin, and hepatocyte nuclear factor-3b. Immunofluorescent staining revealed that these cells were positive for albumin, a-fetoprotein, and cytokeratin 18, but not clusters of differentiation 34, cytokeratin 19, or OV6. During hepatic differentiation, signal transducer and activator of transcription 3 (STAT3) and mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) signaling were constantly activated, and a gradual down-regulation of b-catenin expression in messenger RNA and protein levels was detected. Hyper-interleukin-6 fusion protein but not interleukin-6 (IL-6) alone caused reduction in b-catenin expression associated with the up-regulation of Wnt-5a in MSCs via activating the glycoprotein 130 (gp130)-mediated STAT3 signaling pathway, which indicates the operation of the trans-signaling mechanism. Activation of IL-6/gp130-mediated STAT3 signaling pathway in MSCs triggered wound healing, cell migration, and proliferation. In conclusion, transplantation of MSCs promotes cell proliferation and organ repair, and activation of IL-6/gp130-mediated STAT3 signaling pathway via soluble IL-6 receptor is crucial in hepatic differentiation of MSCs. Liver Transpl 16:1195-1206. V C 2010 AASLD. Received February 19, 2010 accepted July 7, 2010. Additional Supporting Information may be found in the online version of this article.Abbreviations: AFP, a-fetoprotein; ALT, alanine aminotransferase; APC, adenomatous polyposis coli; AR, androgen receptor; AST, aspartate aminotransferase; CEBP, CCAAT/enhancer binding protein; CK, cytokeratin; CTNN b 1, b-catenin; DAPI, 4 0 ,6-diamidino-2-phenylindole; DVL1, dishevelled; ERK, extracellular signal-regulated kinase; FISH, fluorescent in situ hybridization; FITC, fluorescein isothiocyanate; DMEM, Dulbecco's modified Eagle medium; FBS, fetal bovine serum; GalN, D-galactosamine; GFP, green fluorescent protein; GSK3bglycoprotein synthase kinase 3b; IL, interleukin; IP, immunoprecipitation; MAPK, mitogenactivated protein kinase; mRNA, messenger RNA; MSC, mesenchy...