Safety Assessment of Autologous Stem Cell Combination Therapy in Patients With Decompensated Liver Cirrhosis: A Pilot Study.

Autor: Sharma M; Asian Institute of Gastroenterology, Hyderabad, India., Pondugala PK; Asian Healthcare Foundation, Hyderabad, India., Jaggaihgari S; Asian Healthcare Foundation, Hyderabad, India., Mitnala S; Asian Healthcare Foundation, Hyderabad, India., Krishna VV; Asian Healthcare Foundation, Hyderabad, India., Jaishetwar G; Yashoda Hospital, Hyderabad, India., Naik P; Asian Institute of Gastroenterology, Hyderabad, India., Kumar P; Asian Institute of Gastroenterology, Hyderabad, India., Kulkarni A; Asian Institute of Gastroenterology, Hyderabad, India., Gupta R; Asian Institute of Gastroenterology, Hyderabad, India., Singh JR; Asian Institute of Gastroenterology, Hyderabad, India., Darisetty S; Asian Institute of Gastroenterology, Hyderabad, India., Sekharan A; Asian Institute of Gastroenterology, Hyderabad, India., Reddy DN; Asian Institute of Gastroenterology, Hyderabad, India., Rao GV; Asian Institute of Gastroenterology, Hyderabad, India., Syeda F; Asian Institute of Gastroenterology, Hyderabad, India., Jagtap N; Asian Institute of Gastroenterology, Hyderabad, India., Rao PN; Asian Institute of Gastroenterology, Hyderabad, India.
Jazyk: angličtina
Zdroj: Journal of clinical and experimental hepatology [J Clin Exp Hepatol] 2022 Jan-Feb; Vol. 12 (1), pp. 80-88. Date of Electronic Publication: 2021 Apr 02.
DOI: 10.1016/j.jceh.2021.03.010
Abstrakt: Background: Haematopoietic stem cell (HSC) infusion has demonstrated short-term improvement in liver functions in patients with chronic liver disease. The combination of HSC with mesenchymal stem cells (MSCs), which has an immunomodulatory effect, may augment the effects and enhance the duration of improvements on liver functions. The aim of the present study was to assess the safety of infusing the combination of autologous HSCs and MSCs in decompensated liver cirrhosis.
Methods: In phase I of the study, in vitro assessment was performed to observe the effect of coculturing MSCs with HSCs on their viability and cytokine profiles. Phase II of the study was to assess the safety of combination of stem cell infusions. Bone marrow (50 ml) was aspirated for MSC isolation and expansion using standard protocol. Patients received subcutaneous doses (n = 5) of granulocyte colony-stimulating factor (G-CSF) for stem cell mobilization followed by leukapheresis for harvesting HSCs using CliniMacs. HSCs and MSCs were infused through the hepatic artery under fluoroscopic guidance and were monitored for any adverse effects.
Results: In vitro studies revealed 94% viable HSCs in coculture similar to monoculture. HSCs released only interleukin (IL)-8, whereas MSCs secreted IL-8 and IL-6 in monocultures, and both IL-8 and IL-6 were secreted in coculture. G-CSF administration- and bone marrow aspiration-related complications were not observed. Infusion of the cells through the hepatic artery was safe, and no postprocedural complications were noted.
Conclusion: The combination of autologous HSC and MSC infusion is a safe procedure in patients with decompensated liver cirrhosis, and the outcomes needed to be assessed in larger studies.
Trial Number: NCT04243681.
(© 2021 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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