脂肪间质干细胞移植对大鼠肝硬化模型的治疗作用

Efficacy and safety of mesenchymal stem cell therapy in liver cirrhosis: a systematic review and meta-analysis

AIM

Although the efficacy and safety of mesenchymal stem cell therapy for liver cirrhosis have been demonstrated in several studies. Clinical cases of mesenchymal stem cell therapy for patients with liver cirrhosis are limited and these studies lack the consistency of treatment effects. This article aimed to systematically investigate the efficacy and safety of mesenchymal stem cells in the treatment of liver cirrhosis.

METHOD

The data source included PubMed/Medline, Web of Science, EMBASE, and Cochrane Library, from inception to May 2023. Literature was screened by the PICOS principle, followed by literature quality evaluation to assess the risk of bias. Finally, the data from each study's outcome indicators were extracted for a combined analysis. Outcome indicators of the assessment included liver functions and adverse events. Statistical analysis was performed using Review Manager 5.4.

RESULTS

A total of 11 clinical trials met the selection criteria. The pooled analysis' findings demonstrated that both primary and secondary indicators had improved. Compared to the control group, infusion of mesenchymal stem cells significantly increased ALB levels in 2 weeks, 1 month, 3 months, and 6 months, and significantly decreased MELD score in 1 month, 2 months, and 6 months, according to a subgroup analysis using a random-effects model. Additionally, the hepatic arterial injection favored improvements in MELD score and ALB levels. Importantly, none of the included studies indicated any severe adverse effects.

CONCLUSION

The results showed that mesenchymal stem cell was effective and safe in the treatment of liver cirrhosis, improving liver function (such as a decrease in MELD score and an increase in ALB levels) in patients with liver cirrhosis and exerting protective effects on complications of liver cirrhosis and the incidence of hepatocellular carcinoma. Although the results of the subgroup analysis were informative for the selection of mesenchymal stem cells for clinical treatment, a large number of high-quality randomized controlled trials validations are still needed.

Therapeutic effect of transplantation of human amniotic membrane- and umbilical cord-derived mesenchymal stem cells on hepatic cirrhosis in rats

AIM: To evaluate the therapeutic effect of transplantation of human amniotic membrane-derived mesenchymal stem cells (hAM-MSCs) and human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) on carbon tetrachloride (CCl₄)-induced hepatic cirrhosis in rats.

METHODS: hAM-MSCs and hUC-MSCs were isolated and analyzed by flow cytometry for detection of expression of CD44, CD29 and CD34. Hepatic cirrhosis was induced in rats with CCl₄. At week 8, five rats were killed to conduct pathological examination to confirm successful induction of hepatic cirrhosis, and 30 rats with hepatic cirrhosis were randomly and equally divided into three groups: hAM-MSCs group, hUC-MSCs group and control group. The hAM-MSCs and hUC-MSCs groups were infused wit 2×10⁶ MSCs in 2 mL of saline via the tail vein, while the control group was given equal volume of saline. Liver function was examined before cell transplantation and 4 wk after cell transplantation. HE staining and Masson dyeing were performed to observe pathological changes in the liver. The expression of alpha-smooth muscle actin (α-SMA) in the liver was determined by immunohistochemistry.

RESULTS: Both isolated hAM-MSCs and hUC-MSCs expressed CD29 and CD44, but did not express CD34. After cell transplantation, liver function parameters were markedly improved (all P < 0.05) and the expression of α-SMA was reduced in the hAM-MSCs and hUC-MSCs groups compared to the control group (130.6 ± 3.0, 127.0 ± 2.6 vs 152.2 ± 5.4, both P < 0.05). There were no statistically significant differences in liver function parameters and α-SMA expression between the hAM-MSCs and hUC-MSCs groups.

CONCLUSION: Transplantation of hAM-MSCs and hUC-MSCs could efficiently improve liver functions and inhibit liver fibrosis in rats.