Prospects for stem cell application in cirrhosis treatment?

In the cirrhosis stage, liver disease is considered irreversible and the optimal treatment is a liver transplant.

In the cirrhosis stage, liver disease is considered irreversible and the optimal treatment is a complete liver transplantation. However, the increasing shortage of healthy livers for transplantation is one of the main reasons limiting the advantage of this method, requiring new treatment strategies, in which stem cells are a promising method.

Commonly used stem cell types

Autologous bone marrow stem cells

The study using autologous bone marrow cell infusion (ABMi) was applied since 2003. About 400 ml of autologous bone marrow cells were collected using general anesthesia, then concentrated and washed to obtain bone marrow cells, purified to get mononuclear cells in the cell suspension, then infused into the peripheral vein in the same patient. The results showed a very significant improvement in serum albumin concentration, total protein and Child-Pugh score after 6 months of treatment.

Another study using bone marrow stem cells by Lyra (Brazil) et al showed that the use of ABMi therapy via the hepatic artery was more effective than via the peripheral vein in patients waiting for liver transplantation.

Autologous bone marrow stem cell transplantation procedure for cirrhosis treatment.

Cultured autologous bone marrow cells

Bone marrow cells have two main types of stem cells: hematopoietic stem cells and mesenchymal stem cells. Previous basic studies have demonstrated the effectiveness of these cells in treating advanced liver disease in experimental animals. After the stem cells are isolated, cultured and re-implanted into the host, they have the effect of regenerating liver cells and improving liver function. If the culture and application in treatment are successful, the use of these cells will be more widely applied and there will be no need to collect bone marrow fluid or perform under anesthesia.

The role of CD34+ cells in the treatment of cirrhosis

In the following years, many studies continued to demonstrate the role and potential of bone marrow stem cells in the treatment of cirrhosis or chronic liver disease. In 2011, Li Nan (China) and colleagues reported clinical results of a study on autologous CD34+ stem cell transplantation in the treatment of patients with liver failure due to hepatitis. 27 Child-C patients participated in the study, including 22 HBV-infected patients and 5 HCV-infected patients. The study results showed that all patients improved liver function after one week of treatment. The most significant recovery was achieved after 3 months of stem cell transplantation when total bilirubin and albumin levels were at their highest. Overall, clinical results improved in most patients, with jaundice disappearing and ascites decreasing.

Most recently, a research group in Japan reported the results of treating 10 patients with decompensated cirrhosis with CD34+ stem cells. After 24 weeks of treatment, serum albumin levels increased significantly in the group treated with CD34+ stem cells at medium and high doses. The research group concluded that the treatment regimen with CD34+ cells is feasible, safe and effective in slowing down the decline in liver recovery function.

Stem cell research in Vietnam

The use of stem cells in disease treatment has been applied quite early in our country since 1995 and is mainly applied in the treatment of blood and hematopoietic organ diseases (autologous peripheral hematopoietic stem cell transplantation), some malignant diseases (autologous peripheral stem cells for the treatment of non-hodgkin's disease), CD34+ stem cells isolated from the pelvis in the treatment of osteoarthritis and achieved positive results.

Thus, studies in the world and in Vietnam have shown that the use of stem cells in the treatment of diseases in general and chronic liver disease in particular has a lot of promise. However, the type of cells used, the route of use, the process of purification and preservation/cultivation of stem cells before transplantation to achieve the highest efficiency is still a long way off, requiring the continuous efforts of scientists at home and abroad.

According to Health and Life