Human umbilical cord mesenchymal stem cells improve liver function and ascites in decompensated liver cirrhosis patients

Abstract

Decompensated liver cirrhosis (LC), a life-threatening complication of chronic liver disease, is one of the major indications for liver transplantation. Recently, mesenchymal stem cell (MSC) transfusion has been shown to lead to the regression of liver fibrosis in mice and humans. This study examined the safety and efficacy of umbilical cord-derived MSC (UC-MSC) in patients with decompensated LC. A total of 45 chronic hepatitis B patients with decompensated LC, including 30 patients receiving UC-MSC transfusion, and 15 patients receiving saline as the control, were recruited; clinical parameters were detected during a 1-year follow-up period. No significant side-effects and complications were observed in either group. There was a significant reduction in the volume of ascites in patients treated with UC-MSC transfusion compared with controls (P < 0.05). UC-MSC therapy also significantly improved liver function, as indicated by the increase of serum albumin levels, decrease in total serum bilirubin levels, and decrease in the sodium model for end-stage liver disease scores. UC-MSC transfusion is clinically safe and could improve liver function and reduce ascites in patients with decompensated LC. UC-MSC transfusion, therefore, might present a novel therapeutic approach for patients with decompensated LC.

Cell therapy in gastroenterology

“…Efficiency of mesenchymal stem cells infusion in the treatment of liver cirrhosis was confirmed by a number of clinical studies [34,37]. The improvement of clinical indices of the functional state of the liver in patients who underwent cell therapy with mesenchymal bone marrow stem cells was marked [34].…”

“…1 year follow up in 30 patients with decompensated cirrhosis who underwent treatment with cord blood mesenchymal stem cells did not reveal any adverse effects of cell therapy and a significant improvement of the functional state of the liver was noted, increase of the content of albumin and a decrease in total bilirubin in serum compared with the control group of patients [37].…”

“…A recent study found that bone marrow cells are involved in liver regeneration [34,37]. 3 populations of bone marrow stem cells: hematopoietic and mesenchymal stem cells and endothelial progenitor cells have practical value in the context of liver regeneration [34].…”

hucMSC Exosome-Derived GPX1 Is Required for the Recovery of Hepatic Oxidant Injury

“…MSC transplantation has been investigated in clinical trials as potential treatment for liver diseases, [28][29][30] because systemic injection has been shown to be effective in experimental research. [31][32][33] This therapeutic effect may include transdifferentiation of MSCs into hepatocytelike cells, secretion of anti-inflammatory factors, and hepatocyte regeneration promotion at the site of injury.…”

Potential of Mesenchymal Stem Cells for Liver Regeneration

“…These findings led to a great deal of debate as to whether MSC can actually generate hepatocytes or if, perhaps, all the effects they produce are simply mediated through release of soluble factors. Meticulously executed in vitro studies have now provided definitive evidence that MSC can under appropriate conditions be reprogrammed into cells with all of the characteristics of functional hepatocytes that can currently be assessed in culture [37,135,[148][149][150][151]. Thus, it is now presumed that if these hepatocyte induction protocols work well in cultured MSC, in vivo organ-specific microenvironment of the recipient liver is likely to be even better suited for inducing the transplanted MSC to differentiate into hepatocytes.…”