Effects of allogeneic mesenchymal stem cell transplantation in the treatment of liver cirrhosis caused by autoimmune diseases
Effects of allogeneic mesenchymal stem cell transplantation in the treatment of liver cirrhosis caused by autoimmune diseases
复制标题
异基因间充质干细胞移植治疗自身免疫性疾病肝硬化的效果
DOI：
10.1111/1756-185x.13015
复制
发表时间：
2017-09-01
影响因子：
2.5
通讯作者：
Sun, Lingyun
中科院分区：
文献类型：
--
作者：
Liang, Jun;Zhang, Huayong;Sun, Lingyun
目的 近年来，人们对利用间充质干细胞（MSC）治疗终末期肝病产生了极大的兴趣。本研究旨在评价同种异体间充质干细胞移植治疗自身免疫性疾病所致肝硬化的临床疗效。方法入选的肝硬化患者接受外周静脉同种异体间充质干细胞输注。本研究的主要目的是评估 MSCT 对自身免疫性疾病引起的肝硬化患者的安全性和有效性。次要终点是评估移植后终末期肝病模型 (MELD) 评分和肝功能的变化。 结果 共有 26 名患者入组。其中，23 名患者接受了脐带 MSCT，2 名患者接受了脐带血 MSCT，1 名患者接受了骨髓 MSCT。 3 名患者死于肝硬化并发症，2 名患者接受 MSCT 后肝移植。四名患者失访。移植后6个月、1年和2年丙氨酸转氨酶值均值下降，但无统计学意义。总胆红素的平均值在 6 个月和 1 年随访时下降。平均血清白蛋白水平在 6 个月、1 年和 2 年随访时有所改善。与基线值相比，2 年平均值显着增加。 MSCT 后 6 个月观察到凝血酶原时间降低。 MELD 评分在随访 6 个月、1 年和 2 年时有所改善。 26 名肝硬化患者在输注 MSC 期间或输注后 24 小时均未观察到严重不良事件。结论根据该临床试验，通过外周静脉进行的同种异体 MSCT 可能是安全的，并且似乎对肝硬化患者具有有益作用。因此，同种异体MSCT是治疗自身免疫性疾病引起的肝硬化的潜在选择。需要对更多患者进行进一步研究，以更好地阐明 MSCT 对肝硬化的影响和机制。
AimThere has been great interest in recent years to take advantage of mesenchymal stem cells (MSCs) to treat end-stage liver disease. This study is aimed to evaluate clinical therapeutic effects of allogeneic MSC transplantation in liver cirrhosis caused by autoimmune diseases.MethodsThe enrolled patients with liver cirrhosis were assigned to receive allogeneic MSC infusions through a peripheral vein. The primary objective of this study was to assess the safety and effectiveness of MSCT in patients with autoimmune diseases-induced cirrhosis. Secondary endpoints were to assess changes in the Models of End Stage Liver Disease (MELD) scores and liver functions after the transplantation.ResultsA total of 26 patients were enrolled. Of these, 23 patients received umbilical cord MSCT, two received cord blood MSCT and one received bone marrow MSCT. Three patents died of the complications caused by cirrhosis and two patients received liver transplantation after MSCT. Four patients were lost to follow-up. The mean of alanine transaminase values decreased 6 months, 1 and 2 years after the transplantation, but there were no statistical significance. The mean value of total bilirubin decreased at 6 months and 1 year follow-up. Average serum albumin levels improved at 6 months, 1 and 2 years follow-up. The mean value at 2 years increased significantly compared with the baseline value. A lowering of prothrombin time was seen at 6 months after MSCT. MELD score improved at 6 months, 1 and 2 years of follow-up. No serious adverse events were observed during or 24 h after infusions of MSCs in any of the 26 patients with liver cirrhosis.ConclusionBased on this clinical trial, allogeneic MSCT through the peripheral vein probably is safe and seemingly has beneficial effect in patients with liver cirrhosis. Therefore, allogeneic MSCT is a potential option for treatment of liver cirrhosis caused by autoimmune diseases. Further studies with higher numbers of patients are warranted to better clarify the impact and mechanisms of MSCT in liver cirrhosis.