Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Hepatology. 2013 Mar;57(3):1017-23. doi: 10.1002/hep.26150. Epub 2013 Feb 15.
There is improved survival and partial metabolic correction of a mouse intermediate maple syrup urine disease (iMSUD) model after allogenic hepatocyte transplantation, confirming that a small number of enzyme-proficient liver-engrafted cells can improve phenotype. However, clinical shortages of suitable livers for hepatocyte isolation indicate a need for alternative cell sources. Human amnion epithelial cells (hAECs) share stem cell characteristics without the latter's safety and ethical concerns and differentiate to hepatocyte-like cells. Eight direct hepatic hAEC transplantations were performed in iMSUD mice over the first 35 days beginning at birth; animals were provided a normal protein diet and sacrificed at 35 and 100 days. Treatment at the neonatal stage is clinically relevant for MSUD and may offer a donor cell engraftment advantage. Survival was significantly extended and body weight was normalized in iMSUD mice receiving hAEC transplantations compared with untreated iMSUD mice, which were severely cachectic and died ≤28 days after birth. Branched chain α-keto acid dehydrogenase enzyme activity was significantly increased in transplanted livers. The branched chain amino acids leucine, isoleucine, valine, and alloisoleucine were significantly improved in serum and brain, as were other large neutral amino acids.
Placental-derived stem cell transplantation lengthened survival and corrected many amino acid imbalances in a mouse model of iMSUD. This highlights the potential for their use as a viable alternative clinical therapy for MSUD and other liver-based metabolic diseases.
异体肝细胞移植可提高小鼠中间型枫糖尿症(iMSUD)模型的存活率并部分纠正其代谢异常,证实少量酶活性正常的肝移植细胞可改善表型。然而,适合分离肝细胞的临床供肝短缺表明需要替代细胞来源。人羊膜上皮细胞(hAECs)具有干细胞特征而无后者的安全性和伦理学问题,并可分化为肝样细胞。在出生后的前 35 天内,对 iMSUD 小鼠进行了 8 次直接肝 hAEC 移植,动物给予正常蛋白饮食,并于 35 天和 100 天处死。MSUD 的新生儿期治疗具有临床相关性,可能为供体细胞移植提供优势。与未治疗的 iMSUD 小鼠相比,接受 hAEC 移植的 iMSUD 小鼠的存活率显著延长,体重正常,而未治疗的 iMSUD 小鼠严重消瘦,出生后≤28 天死亡。移植肝脏中的支链 α-酮酸脱氢酶活性显著增加。血清和脑内的支链氨基酸亮氨酸、异亮氨酸、缬氨酸和别异亮氨酸显著改善,其他大中性氨基酸也得到改善。
胎盘源性干细胞移植可延长 iMSUD 小鼠的存活时间并纠正多种氨基酸失衡,这突出了其作为 MSUD 和其他基于肝脏的代谢疾病可行的临床治疗替代方法的潜力。