Di Campli C, Piscaglia A C, Giuliante F, Rutella S, Bonanno G, Zocco M A, Ardito F, Nuzzo G, Mancuso S, Leone G, Gasbarrini G, Pola P, Gasbarrini A
Department of Medical Pathology, Hepato-Biliary Surgery Unit, Catholic University of Rome, Rome, Italy.
Transplant Proc. 2005 Jul-Aug;37(6):2563-6. doi: 10.1016/j.transproceed.2005.06.072.
Liver regeneration is a heterogeneous phenomenon involving the proliferation of different cell lineages in response to injury. Under a strong positive selection pressure bone marrow derived stem cells may be involved in this process, by making a contribution to both parenchymal restoration and endothelial cell replacement. We investigate bone marrow stem cell migration to the liver in patients undergoing hepatectomy or with acute on chronic liver failure.
We enrolled 6 patients submitted to hepatectomy, 6 patients to cholecystectomy and 8 patients with acute decompensation of liver cirrhosis. Mobilization of CD34+ cells was evaluated by cytofluorimetry on peripheral blood samples at different time points; baseline, 1, 3, 7, 15 and 30 days after surgery and at admission, 1, 7 and discharge among patients with acute on chronic liver failure. 10 healthy subjects undergoing blood donation were also enrolled to evaluated the basal value of CD34+ cells.
White blood cell counts remained in the normal range (4.1-9.8 x 10(9)/L) in all groups throughout the follow-up. In all patients of Groups 1, 2 and 3, circulating CD34+ failed to show statistically significant differences both as the absolute number and as the percentage at any time point compared to healthy controls.
Bone marrow derived cell mobilization can not be detected after hepatectomy or during an acute decompensation on a cirrhotic liver. Under these circumstances liver regeneration can probably call upon mature hepatocytes and endogenous progenitor cells. The involvement of extrahepatic progenitors if any, is a rare and limited phenomenon.
肝再生是一种异质性现象，涉及不同细胞谱系对损伤的增殖反应。在强大的正选择压力下，骨髓来源的干细胞可能参与这一过程，对实质修复和内皮细胞替代均有贡献。我们研究了肝切除患者或急性慢性肝衰竭患者中骨髓干细胞向肝脏的迁移情况。
我们纳入了6例行肝切除术的患者、6例行胆囊切除术的患者以及8例肝硬化急性失代偿患者。通过细胞荧光分析法在不同时间点对外周血样本中的CD34+细胞动员情况进行评估；肝切除患者在基线、术后1、3、7、15和30天，急性慢性肝衰竭患者在入院时、1、7天及出院时。还纳入了10名健康献血者以评估CD34+细胞的基础值。
在整个随访期间，所有组的白细胞计数均保持在正常范围内（4.1 - 9.8×10⁹/L）。在第1、2和3组的所有患者中，与健康对照组相比，循环CD34+细胞的绝对数量和百分比在任何时间点均未显示出统计学上的显著差异。
肝切除术后或肝硬化急性失代偿期间未检测到骨髓来源细胞的动员。在这些情况下，肝再生可能依赖于成熟肝细胞和内源性祖细胞。肝外祖细胞的参与（如果有的话）是一种罕见且有限的现象。
