Combined Effect of Granulocyte-Colony-Stimulating Factor-Induced Bone Marrow-Derived Stem Cells and Red Ginseng in Patients with Decompensated Liver Cirrhosis (Combined Effect of G-CSF and Red Ginseng in Liver Cirrhosis)

Abstract

Objectives: Granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow (BM)-derived hematopoietic stem cells could contribute to improvement of liver function. In addition, liver fibrosis can reportedly be prevented by the Rg 1 component of red ginseng. This study investigated the combined effect of G-CSF and red ginseng on decompensated liver cirrhosis. Methods: Four patients with decompensated liver cirrhosis were injected with G-CSF to proliferate BM stem cells for 4 days (5 μg/kg bid subcutaneously) and followed-up for 3 months. The patients also received red ginseng for 4 days (2 tablets tid per os). We analyzed Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores and cirrhotic complications. Results: All patients showed marked increases in White blood cell (WBC) and CD34+ cells in the peripheral blood, with a peak time of 4 days after G-CSF injection. Spleen size also increased after G-CSF injection, but not severely. At end of the study, 2 patients showed improvement in Child-Pugh scores, hepatic encephalopathy, and refractory ascites. During the clinical trial period, none of the 4 patients showed any other adverse events or deterioration of liver function. Conclusions:We conclude that G-CSF/red ginseng combination therapy is relatively effective in improving liver function and major complications of decompensated liver cirrhosis without adverse effects. Further clinical trials are warranted to assess the clinical effects of G-CSF for decompensated liver cirrhosis.

The effect of medicinal plants on cirrhosis: A systematic review of clinical trials

“…According to Table 2, six of the 11 studies included in this review had good quality (Fathalah et al, 2017; Ferenci et al, 1989; Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020; Parés et al, 1998; Velussi et al, 1997), and five studies had relatively good quality (Angulo et al, 2000; Fallah Huseini et al, 2005; Kim, Kim, et al, 2016; Lucena et al, 2002; Velussi et al, 1993).…”

“…Included trials (Angulo et al, 2000; Fallah Huseini et al, 2005; Fathalah et al, 2017; Ferenci et al, 1989; Kim, Kim, et al, 2016; Lucena et al, 2002; Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020; Parés et al, 1998; Velussi et al, 1993; Velussi et al, 1997) were conducted from 1989 to 2020. Ten studies were in English (Angulo et al, 2000; Fathalah et al, 2017; Ferenci et al, 1989; Kim, Kim, et al, 2016; Lucena et al, 2002; Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020; Parés et al, 1998; Velussi et al, 1993; Velussi et al, 1997) and one was in Persian language (Fallah Huseini et al, 2005). Among these studies, Kim et al's study had the smallest sample size ( n = 4) (Kim, Kim, et al, 2016) and Parés et al's study (Parés et al, 1998) had the largest sample size ( n = 200); the total sample size of the 11 articles combined was 735 patients.…”

“…Ten studies were in English (Angulo et al, 2000; Fathalah et al, 2017; Ferenci et al, 1989; Kim, Kim, et al, 2016; Lucena et al, 2002; Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020; Parés et al, 1998; Velussi et al, 1993; Velussi et al, 1997) and one was in Persian language (Fallah Huseini et al, 2005). Among these studies, Kim et al's study had the smallest sample size ( n = 4) (Kim, Kim, et al, 2016) and Parés et al's study (Parés et al, 1998) had the largest sample size ( n = 200); the total sample size of the 11 articles combined was 735 patients. All subjects studied were adults (over 18 years old) with cirrhosis.…”

“…All subjects studied were adults (over 18 years old) with cirrhosis. The following interventions were used: silymarin in eight studies (Angulo et al, 2000; Fallah Huseini et al, 2005; Fathalah et al, 2017; Ferenci et al, 1989; Lucena et al, 2002; Parés et al, 1998; Velussi et al, 1993; Velussi et al, 1997), curcumin in two studies (Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020) and ginseng in one study (Kim, Kim, et al, 2016). The duration of the intervention varied from 4 consecutive days to 2 years.…”

“…The duration of the intervention varied from 4 consecutive days to 2 years. The study locations are as follows: Iran ( n = 3) (Fallah Huseini et al, 2005; Nouri‐Vaskeh, Afshan, et al, 2020; Nouri‐Vaskeh, Malek Mahdavi, et al, 2020), Spain ( n = 2) (Lucena et al, 2002; Parés et al, 1998), Italy ( n = 2) (Velussi et al, 1993; Velussi et al, 1997), Australia ( n = 1) (Ferenci et al, 1989), USA ( n = 1) (Angulo et al, 2000), Korea ( n = 1) (Kim, Kim, et al, 2016) and Egypt ( n = 1) (Fathalah et al, 2017) (Table 1).…”