Chronic Liver Disease: Stem Cell Therapy

Gamal MA Hassan, Hamdy Sliem, Abousree T Ellethy, Mahmoud E Salama

Abstract


Chronic liver diseases (CLD) affect hundreds of millions of patients worldwide. Stem Cells (SCs) therapy to treat chronic liver diseases is resorted and is considered as the dream of the future. Although SCs are a promising means for treatment of liver diseases, studies are still at the beginning of this era. SCs are undifferentiated cells capable of renewing themselves throughout their life and of generating one or more types of differentiated cells. Different types of SCs with hepatic differentiation potential are theoretically eligible for liver cell replacement. These include Embryonic and fetal liver SCs, induced pluripotent SCs, hepatoblasts, annex SCs (pluripotent SCs obtained from umbilical cord and umbilical cord blood, placenta and amniotic fluid), and adult SCs, such hepatic progenitor cells, hematopoietic SCs, and mesenchymal stem cell. The optimal SCs delivery route should be easy to perform, less invasive and traumatic, minimum side effects, and with high cells survival rate. Liver SCs can be transplanted through several routes: Intraperitoneal and percutaneous intrahepatic artery catheterization in acute liver failure, and umbilical vein catheterization, percutaneous intrahepatic route, and portal vein or intrahepatic artery catheterization in metabolic liver diseases. Whatever the source or delivery route of SCs, how they can be manipulated for therapeutic interventions in a variety of hepatic diseases is of course of great interest in future studies. Although all clinical trials to date have shown some improvement in liver function and CD34+ cells have been used safely for bone marrow transplantation for over 20 years, only randomized controlled clinical trials will be able to fully assess the potential clinical benefit of adult SCs therapy for patients with CLD.

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