Hematopoietic cells as hepatocyte stem cells: a critical review of the evidence

Hematopoietic stem cells mobilized by granulocyte colony-stimulating factor partly contribute to liver graft regeneration after partial orthotopic liver transplantation

On the basis of the recently recognized potential of hematopoietic stem cells (HSCs) to give rise to hepatocytes, we investigated whether HSCs mobilized by granulocyte colony-stimulating factor (G-CSF) or G-CSF per se could contribute to faster recovery and promote tissue reparation after rats' (cross-sex) partial orthotopic liver transplantation (PLTx). Sex-mismatched (female to male) syngeneic rat PLTx was established. The recipients were repeatedly administrated recombinant G-CSF for 5 consecutive days before (G-CSF + PLTx group) and after PLTx (PLTx + G-CSF group). Compared with those in PLTx group, CD34+ cells in peripheral blood and portal tract region increased from day 1 to 7 after transplantation in G-CSF + PLTx group and from day 3 to 14 after transplantation in PLTx + G-CSF group, respectively, which suggested that CD34+ HSCs were mobilized and migrated into liver graft. Compared with that in G-CSF + PLTx and PLTx groups, there was a higher survival rate in the PLTx + G-CSF group. On day 3 after surgery, the level of aspartate aminotransferase and alanine aminotransferase were lower, whereas the mitosis index, proliferating cell nuclear antigen-positive nuclei, bromodeoxyuridine (BrdU) incorporation, and graft-to-recipient weight ratio were higher in the PLTx + G-CSF group. In contrast, these parameters had no significant difference between G-CSF + PLTx and PLTx groups. To define the origin of proliferating cells reconstituting liver after injury, sry+ (sex-determining region for Y chromosome) and sry+/cytokeratin 19+ (CK19) cells were quantitated. Higher percentage of sry+ and sry+/CK19+ cells in PLTx + G-CSF was detected than in G-CSF + PLTx groups on day 14 after surgery, although the liver engraftment rate still remained rather low. Some of the sry+/CK19+ cells in the portal tract areas were similar to hepatic oval cells/cholangiocytes. In conclusion, G-CSF administration after PLTx greatly improved survival rate and liver regeneration of partial graft, partly by its mobilizing HSCs into the injured liver to differentiate into hepatocytes through hepatic oval cells'/cholangiocytes' engraftment.

Properties of cryopreserved fetal liver stem/progenitor cells that exhibit long-term repopulation of the normal rat liver

We have previously achieved a high level of long-term liver replacement by transplanting freshly isolated embryonic day (ED) 14 rat fetal liver stem/progenitor cells (FLSPCs). However, for most clinical applications, it will be necessary to use cryopreserved cells that can effectively repopulate the host organ. In the present study, we report the growth and gene expression properties in culture of rat FLSPCs cryopreserved for up to 20 months and the ability of cryopreserved FLSPCs to repopulate the normal adult rat liver. After thawing and placement in culture, cryopreserved FLSPCs exhibited a high proliferation rate: 49.7% Ki-67-positive on day 1 and 34.7% Ki-67-positive on day 5. The majority of cells were also positive for both alpha-fetoprotein and cytokeratin-19 (potentially bipotent) on day 5. More than 80% of cultured cells expressed albumin, the asialoglycoprotein receptor, and UDP-glucuronosyltransferase (unique hepatocyte-specific functions). Expression of glucose-6-phosphatase, carbamyl phosphate synthetase 1, hepatocyte nuclear factor 4alpha, tyrosine aminotransferase, and oncostatin M receptor mRNAs was initially negative, but all were expressed on day 5 in culture. After transplantation into the normal adult rat liver, cryopreserved FLSPCs proliferated continuously, regenerated both hepatocytes and bile ducts, and produced up to 15.1% (mean, 12.0% +/- 2.0%) replacement of total liver mass at 6 months after cell transplantation. These results were obtained in a normal liver background under nonselective conditions. This study is the first to show a high level of long-term liver replacement with cryopreserved fetal liver cells, an essential requirement for future clinical applications.

Implications of 'postmodern biology' for pathology: the Cell Doctrine

Recent insights regarding stem cells, repression and de-repression of gene expression, and the application of Complexity Theory to cell and molecular biology require a re-evaluation of many long-held dogmas regarding the nature of the human body in health and disease. Greater than expected cell plasticity, trafficking of cells between organs, 'cellular uncertainty', stochasticity of cell origins and fates, and a reconsideration of Cell Doctrine itself all logically follow from these observations and conceptual approaches. In this paper, these themes will be considered and some implications for the investigative pathologist will be explored.

Liver stem cells and prospects for liver reconstitution by transplanted cells

Although it was proposed almost 60 years ago that the adult mammalian liver contains hepatic stem cells, this issue remains controversial. Part of the problem is that no specific marker gene unique to the adult hepatic stem cell has yet been identified, and regeneration of the liver after acute injury is achieved through proliferation of adult hepatocytes and does not require activation or proliferation of stem cells. Also, there are differences in the expected properties of stem versus progenitor cells, and we attempt to use specific criteria to distinguish between these cell types. We review the evidence for each of these cell types in the adult versus embryonic/fetal liver, where tissue-specific stem cells are known to exist and to be involved in organ development. This review is limited to studies directed toward identification of hepatic epithelial stem cells and does not address the controversial issue of whether stem cells derived from the bone marrow have hepatocytic potential, a topic that has been covered extensively in other recent reviews.