Avital Itzhak, Feraresso Chiara, Aoki Takeshi, Hui Thomas, Rozga Jacek, Demetriou Achilles, Muraca Maurizio
Department Of Surgery, Liver Support Research Laboratory, Cedars-Sinai Medical Center, UCLA School Of Medicine, 90048, USA.
Surgery. 2002 Aug;132(2):384-90. doi: 10.1067/msy.2002.125785.
The definitive therapy for end-stage liver disease is orthotopic liver transplantation (OLT). However, rejection is still a major cause of mortality and morbidity following OLT. Hepatocyte transplantation has been used experimentally to treat liver diseases. The aim of this study was to investigate whether bone marrow-derived liver stem cells (BDLSC) and mature hepatocytes could repopulate transplanted livers undergoing rejection.
OLT was carried out from D'Agouti (C3-positive female) into Lewis (C3-negative female) rats. BDLSC were transplanted from Lewis (male) into livers of D'Agouti (female) rats. Group A (n = 9) received intraportal normal saline. Groups B (n = 9) and C (n = 9) underwent intraportal transplantation of mature hepatocytes (Lewis female, 0.75 x 10(7)) and DBLSC (Lewis male, 5 x 10(4)) respectively. All groups received subtherapeutic immunosuppression (Cyclosporin 0.25 mg/kg/d) for 13 days. Liver repopulation was assessed using immunohistochemistry (C3 antigen-negative cells), in-situ hybridization, (Y-chromosome-positive BDLSC) and histologic assessment (hematoxylin and eosin) for rejection.
BDLSC and mature hepatocytes repopulated 62 +/- 12.3% and 2.5 +/- 1.7% of rejecting livers, respectively. BDLSC demonstrated formation of hepatic lobules and portal triads with little evidence of rejection 36 days after discontinuation of immunosuppression.
BDLSC can repopulate livers undergoing severe rejection. Moreover, BDLSC can differentiate into hepatocytes and cholangiocytes. This finding may have important clinical implications.
终末期肝病的确定性治疗方法是原位肝移植(OLT)。然而,排斥反应仍是OLT后死亡和发病的主要原因。肝细胞移植已被用于实验性治疗肝脏疾病。本研究的目的是调查骨髓源性肝干细胞(BDLSC)和成熟肝细胞是否能在发生排斥反应的移植肝脏中重新增殖。
将D'Agouti(C3阳性雌性)大鼠的肝脏移植到Lewis(C3阴性雌性)大鼠体内。将Lewis(雄性)大鼠的BDLSC移植到D'Agouti(雌性)大鼠的肝脏中。A组(n = 9)接受门静脉内注射生理盐水。B组(n = 9)和C组(n = 9)分别接受门静脉内移植成熟肝细胞(Lewis雌性,0.75×10⁷)和DBLSC(Lewis雄性,5×10⁴)。所有组均接受亚治疗剂量的免疫抑制(环孢素0.25 mg/kg/d),持续13天。使用免疫组织化学(C3抗原阴性细胞)、原位杂交(Y染色体阳性BDLSC)和组织学评估(苏木精和伊红染色)来评估肝脏重新增殖情况及排斥反应。
BDLSC和成熟肝细胞分别在62±12.3%和2.5±1.7%的发生排斥反应的肝脏中重新增殖。在停用免疫抑制36天后,BDLSC显示出肝小叶和门三联的形成,几乎没有排斥反应的迹象。
BDLSC可以在严重排斥反应的肝脏中重新增殖。此外,BDLSC可以分化为肝细胞和胆管细胞。这一发现可能具有重要的临床意义。