Safety and efficacy of autologous bone marrow stem cell transplantation through hepatic artery for the treatment of chronic liver failure: a preliminary study

Bone marrow cells reduce fibrogenesis and enhance regeneration in fibrotic rat liver

BACKGROUND

This study aimed at investigating the cellular and molecular impacts of bone marrow-derived mononuclear cells (BMCs) on regeneration of fibrotic liver in rats.

MATERIALS AND METHODS

Thirty male adult Fisher rats were randomized into three groups: group 1 (normal controls, n = 10); group 2 (carbon tetrachloride-induced liver fibrosis, n = 10), and group 3 (liver fibrosis with portal venous infusion of autologous BMCs, 1 × 10(6), n = 10). After 7-d culturing, BMCs were characterized by flow cytometry. Groups 2 and 3 received BMC aspiration through bilateral femurs 5 d before hepatectomy. All animals received 70% hepatectomy, whereas only group 3 received a bolus of intra-portal BMC infusion 48 h after hepatectomy. Liver-to-body weight ratio, degree of fibrosis (Masson trichrome staining), oxidative stress, peroxisome proliferator activated receptor-γ coactivator-1α (PGC-1α), collagen I, tumor necrosis factor-α (TNF-α), and transforming growth factor- β (TGF-β) expressions were analyzed 14 d after hepatectomy. Immunohistochemical staining for albumin, α-smooth muscle actin, and CD31 was performed for tracing cellular differentiation.

RESULTS

Cellular phenotypes typical of hepatocyte, hepatic stellate cell (HSC), and endothelial cell were identified in the engrafted BMCs. Liver-to-body weight ratio was enhanced with PGC-1α significantly preserved, whereas oxidative index, collagen I, α-SMA, TNF-α, and TGF-β expressions were all decreased in group 3 compared with group 2 (all P < 0.05).

CONCLUSIONS

This study demonstrated a positive impact of intra-portal BMC infusion in enhancing regeneration and reducing fibrosis of the regenerating fibrotic liver in rats through suppressing HSC activation and inflammatory cytokine expressions, preserving mitochondrial function and reducing oxidative stress.

Bone marrow-derived stem cells in liver repair: 10 years down the line

Hematopoietic stem cells have potential in the field of regenerative medicine because of their capacity to form cells of different lineages. Bone marrow stem cells have been shown to contribute to parenchymal liver cell populations, and although this may not be functionally significant, it has sparked interest in the field of autologous stem cell infusion as a possible treatment for cirrhosis. In this review, we will examine the evidence for the contribution of bone marrow-derived cells to populations of liver cells and for the functional contribution of bone marrow-derived cells to both liver fibrosis and repair. The mechanisms by which cells are trafficked from the bone marrow to the liver are complex; the stromal derived factor-1/CXC receptor 4 axis is central to this process. There are limited data in liver injury, but we will examine findings from the bone marrow transplantation literature and discuss their relevance to liver disease. Stromal derived factor-1 also has a role in endogenous liver stem cell accumulation. Some groups have already started infusing autologous bone marrow cells into patients with cirrhosis. We will review these trials in the context of the basic science that we have discussed, and we will consider targets for investigation in the future.

Stem cells for liver repopulation

PURPOSE OF REVIEW

The capacity of the liver to regenerate and maintain a constant size despite injury is unique. However, the exact mechanisms are not completely clear. Cell transplantation has been proposed as an alternative treatment of liver diseases. Recent progress has been reported on the generation of stem/progenitor cells that may differentiate toward the hepatic lineage. However, it is currently difficult to determine which of the stem/progenitor cell populations are the best for therapy of a given disease.

RECENT FINDINGS

The limited access to donor human hepatocytes has led to a great interest in the generation of hepatocyte-like cells. Several potential cell sources have been identified. However, general standardization of the methods to evaluate these cells is particularly important for the promise of stem/progenitor-derived hepatocyte-based therapies. Moreover, innovations aimed at improving hepatocyte delivery, survival, and engraftment have recently opened the field of organ engineering that may improve liver repopulation.

SUMMARY

Here we review current evidence reported from the perspective of potential clinical applications of different hepatic cell sources with repopulation capacities and the future perspectives and tools that can facilitate the translation of laboratory work into clinical success.

Biological characteristics of immortalized bone marrow mesenchymal stem cells

AIM: To study biological characteristics of immortalizing bone marrow mesenchymal stem cells (BMSCs).

METHODS: Plasmid pCMVSV40T/PUR containing the simian virus 40 large T antigene gene (SV40Tag) was transfected into BMSCs. The cell shape of immortalized BMSCs was observed. Its capacity to differentiate into osteoblast cells was detected through the activity of ALP. Its tumorigenicity was examined using the nude mice experiment. Growth curve of cells in different serum concentration culture was described and its activity was measured.

RESULTS: Untreated BMSCs, after fifteenth passages, could not passage, while immortalized BMSCs of this passage preserved good activity but with contact inhibition. Immortalized BMSCs differentiated into osteoblasts. The cells, which were injected into nude mice, had no tumorigenicity. The immortalized BMSCs, cultured in 20% serum concentration, growed faster than that in other serum concentrations. The activity of immortalized BMSCs, which were frozen by 50% and 90% of serum concentration, were higher than that of 20%.

CONCLUSION: In vitro, the immortalized BMSCs, with pCMVSV40T/PUR, have good activity, but no tumorigenicity. The immortalized BMSCs can provide a large number of cells.

Feasibility investigation of allogeneic endometrial regenerative cells

Endometrial Regenerative Cells (ERC) are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with the longest follow up, of more than one year, revealed no immunological reactions or treatment associated adverse effects. These preliminary data suggest feasibility of clinical ERC administration and support further studies with this novel stem cell type.