Effects of allogeneic mesenchymal stem cell transplantation in the treatment of liver cirrhosis caused by autoimmune diseases

Int J Rheum Dis. 2017 Sep;20(9):1219-1226. doi: 10.1111/1756-185X.13015. Epub 2017 Feb 20.

Abstract

Aim: There has been great interest in recent years to take advantage of mesenchymal stem cells (MSCs) to treat end-stage liver disease. This study is aimed to evaluate clinical therapeutic effects of allogeneic MSC transplantation in liver cirrhosis caused by autoimmune diseases.

Methods: The enrolled patients with liver cirrhosis were assigned to receive allogeneic MSC infusions through a peripheral vein. The primary objective of this study was to assess the safety and effectiveness of MSCT in patients with autoimmune diseases-induced cirrhosis. Secondary endpoints were to assess changes in the Models of End Stage Liver Disease (MELD) scores and liver functions after the transplantation.

Results: A total of 26 patients were enrolled. Of these, 23 patients received umbilical cord MSCT, two received cord blood MSCT and one received bone marrow MSCT. Three patents died of the complications caused by cirrhosis and two patients received liver transplantation after MSCT. Four patients were lost to follow-up. The mean of alanine transaminase values decreased 6 months, 1 and 2 years after the transplantation, but there were no statistical significance. The mean value of total bilirubin decreased at 6 months and 1 year follow-up. Average serum albumin levels improved at 6 months, 1 and 2 years follow-up. The mean value at 2 years increased significantly compared with the baseline value. A lowering of prothrombin time was seen at 6 months after MSCT. MELD score improved at 6 months, 1 and 2 years of follow-up. No serious adverse events were observed during or 24 h after infusions of MSCs in any of the 26 patients with liver cirrhosis.

Conclusion: Based on this clinical trial, allogeneic MSCT through the peripheral vein probably is safe and seemingly has beneficial effect in patients with liver cirrhosis. Therefore, allogeneic MSCT is a potential option for treatment of liver cirrhosis caused by autoimmune diseases. Further studies with higher numbers of patients are warranted to better clarify the impact and mechanisms of MSCT in liver cirrhosis.

Keywords: allogeneic mesenchymal stem cells transplantation; autoimmune disease; liver cirrhosis.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / mortality
  • Autoimmunity*
  • Biomarkers / blood
  • Bone Marrow Transplantation* / adverse effects
  • Bone Marrow Transplantation* / mortality
  • Cord Blood Stem Cell Transplantation* / adverse effects
  • Cord Blood Stem Cell Transplantation* / mortality
  • Feasibility Studies
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / immunology
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / surgery*
  • Liver Function Tests
  • Liver Transplantation
  • Male
  • Mesenchymal Stem Cell Transplantation* / adverse effects
  • Mesenchymal Stem Cell Transplantation* / mortality
  • Middle Aged
  • Prothrombin Time
  • Time Factors
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Immunosuppressive Agents

Associated data

  • GENBANK/ZKX15018