One of the most central organs for the body’s metabolism is the liver. When the gastrointestinal tract absorbs food molecules, the first stop for most of these molecules is the liver. The liver makes many blood-specific proteins, detoxifies foreign molecules to make them more water-soluble so that the body can excrete them, and stores energy reserves in the form of glycogen. Consequently, damage to the liver from chronic liver infections (e.g., hepatitis B & C, bilharzia or schistosomiasis, illegal drug use, etc.), alcoholism, or exposure to liver-damaging chemicals (carbon tetrachloride, chloroform, etc.) seriously compromises the capacity of the body to store energy, process food molecules, make blood specific proteins (which include clotting factors), and process and synthesize metabolic wastes. Repeated damage to the liver causes extensive scarring and deposition of fatty tissues, and such a condition is called “cirrhosis.”
Cirrhosis ultimately leads to liver failure, and tough scar tissue with nodules replaces once healthy liver tissue. There are two main types of cirrhosis. Compensated cirrhosis of the liver refers to early liver damage in which the body functions well despite the damaged liver tissue. Even though liver function is decreases, the body still operates within normal parameters, and the patient often shows no symptoms of disease. Even though people with compensated liver cirrhosis are often asymptomatic, they may display symptoms of weakness, fatigue, loss of appetite, vomiting, weight loss and easy bruising. Liver function tests may reveal increased levels of certain liver enzymes. Liver damage is not reversible, but treating the underlying cause can prevent further damage. Additionally, constant monitoring is required for the early detection of loss of liver function that leads to life-threatening complications.
Decompensated liver cirrhosis is a life-threatening complication of chronic liver disease, and it is also one of the major indications for liver transplantation. The symptoms of decompensated cirrhosis are internal bleeding from the esophagus (bleeding varices), fluid in the belly (ascites), confusion (encephalopathy), yellowing of the eyes and skin (jaundice). When someone becomes this sick, there is little to be done, but receive a liver transplant.
Can stem cells help patients with decompensated liver cirrhosis? Perhaps they can. A paper from the Journal of Gastroenterology and Hepatology (2012; 27 Suppl 2:112-20) has examined the ability of human umbilical cord mesenchymal stem cells to improve symptoms in patients with decompensated liver cirrhosis (DLC). The paper’s first author is Z. Zhang and the title of the paper is “Human Umbilical Cord Mesenchymal Stem Cells Improve Liver Function and Ascites in Decompensated Liver Cirrhosis Patients.” These authors are from the Research Center for Biological Therapy at the Beijing 302 Hospital, in Beijing, China.
In this study, the safety and efficacy of umbilical cord-derived MSCs (UC-MSC) were infused into in patients with DCL. They used a total of 45 chronic hepatitis B patients, all of whom were diagnosed with DCL. 30 patients received transfusions of UC-MSCs, and another 15 patients were given saline as the control. After transfusions, all 45 patients were followed for a 1-year follow-up period.
In none of the 45 patients who were infused, were any significant side-effects observed. Also, there were no significant complications were observed in either group. As to the symptoms suffered by the patients, those who had received the UC-MSC transfusion showed a significant reduction in the volume of ascites in comparison to those patients who had received the control saline transfusions. When liver function parameters were examined, UC-MSC therapy also significantly increased of serum albumin levels (albumin is made by the liver), decreased in total serum bilirubin levels (bilirubin is a waste that is processed by the liver), and stabilized the sodium levels for patients (patients with cirrhosis have low blood sodium levels).
Further follow-up of these patients is clearly warranted, but for the year follow-up. It seems clear that UC-MSC transfusions are clinically safe. Furthermore, when compared to controls, they also seem to improve liver function and reduce the volume of belly fluid in patients with DCL. UC-MSC transfusions might represent a novel therapeutic approach for patients with DCL.