Mesenchymal stem cells (MSCs) therapy is showing potential therapeutic effects on liver function improvement in patients with chronic liver disease and acute chronic liver disease (ACLD). These diseases are mainly caused by alcoholic cirrhosis , high fat blood levels, autoimmune disease or a viral infection, among others.
Clinical studies have found that allogeneic BM-MSCs are safe and feasible for treatment of patients with liver cirrhosis and acute on chronic liver failure (ACLF) . Recently, accumulated research has indicated that umbilical cord-derived MSCs (UC-MSCs) transplantation is an ideal therapy alternative in different liver diseases, even if several complications are present, such as encephalopathy , and increase the survival rates of patients with ACLF.
What results have the studies shown recently?
The MELD score is designed to predict survival in end-stage liver disease using serum bilirubin, INR and creatinine. Other indicators of how your liver functions are Albumina, total bilirubin, AST , ALT, and coagulation factor as TP and PTA. ALB and coagulation factors are mainly synthesized in the liver. They can appropriately reflect the liver reserve function in patients with cirrhosis and liver failure.
Several studies found an improvement on all of these indicators. Albumin and coagulation function given for PTA and INR, increased after the therapy, that could indicate that de MSCs contribute to liver regeneration. Total Bilirubin levels and Transaminases (ASt,ALT) are parameters to show the severity of the liver injury; several results showed that those levels decreased after the therapy, especially when Bone Marrow MSCs were used.
Which delivery route is better to obtain good outcomes?
Whether hepatic arterial injection is feasible has been controversial. For one thing, it is an invasive procedure with potential risks of portal hypertensive bleeding and thrombosis. However, some studies suggested that hepatic arterial injection was more effective than the peripheral vein because of less loss and higher homing ability of MSCs during the treatment.
Nonetheless, as a systemic administration, whatever the delivery route, side effects of therapy such as immune reaction and bleeding should be closely observed. There is no consensus on the times of MSCs treatment for chronic liver disease. Some study results showed that multiple injections exerted greater benefit on the MELD score, while a single administration had more favorable effects on ALB levels.
BM-MSCs and UC-MSCs treatment had similar efficacy to improve liver function. The effectiveness varied slightly between the peripheral intravenous injection and hepatic arterial injection.
At our clinic we used an intravenous route to deliver the Mesenchymal stem cells, to help you with many diseases, including liver diseases. Additionally we use exosomes and multivitamins that can improve the outcomes of the therapy.
Yuwei Liu, Yutong Dong, Xiaojing Wu, Xiaotong Xu, and Junqi Niu. (May 16, 2022). The assessment of mesenchymal stem cells therapy in acute on chronic liver failure and chronic liver disease: a systematic review and meta-analysis of randomized controlled clinical trials. Stem cell research and therapy. retrieved from: https://stemcellres.biomedcentral.com/articles/10.1186/s13287-022-02882-4