Liver progenitor cells have the potential to repair and regenerate a diseased liver. The success of any translational efforts, however, hinges on thorough understanding of the fate of these cells after transplant, especially in terms of long-term safety and efficacy. Here, we report transplantation of a liver progenitor population isolated from human fetal livers into immunepermissive mice with follow-up up to 36 weeks after transplant. We found that human progenitor cells engraft and differentiate into functional human hepatocytes in the mouse, producing albumin, alpha-1-antitrypsin, and glycogen. They create tight junctions with mouse hepatocytes, with no evidence of cell fusion. Interestingly, they also differentiate into functional endothelial cell and bile duct cells. Transplantation of progenitor cells abrogated carbon tetrachlorideinduced fibrosis in recipient mice, with downregulation of procollagen and anti-smooth muscle actin. Paradoxically, the degree of engraftment of human hepatocytes correlated negatively with the anti-fibrotic effect. Progenitor cell expansion was most prominent in cirrhotic animals, and correlated with transcript levels of pro-fibrotic genes. Animals that had resolution of fibrosis had quiescent native progenitor cells in their livers. No evidence of neoplasia was observed, even up to 9 months after transplantation. Human fetal liver progenitor cells successfully attenuate liver fibrosis in mice. They are activated in the setting of liver injury, but become quiescent when injury resolves, mimicking the behavior of de novo progenitor cells. Our data suggest that liver progenitor cells transplanted into injured livers maintain a functional role in the repair and regeneration of the liver. STEM CELLS 2018;36:103-113
SIGNIFICANCE STATEMENTLiver stem cells hold tremendous potential as cell therapy for liver injury. However, engraftment efficiency, efficacy, long-term cell fate, and safety issues remain unresolved. Transplantation of human fetal liver stem cells in a mouse liver injury model shows low engraftment efficiency. Under injury stimulus, they can integrate, proliferate, differentiate, and repair the injured liver, returning to a quiescent state as injury abates. They can differentiate into a variety of cell types, including hepatocyte, cholangiocyte, and endothelial-like cells. Metaplasia occurs in an extreme fibrotic milieu and underscores the need to test candidate stem cells for prolonged period in a cirrhotic environment.