Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
J Surg Res. 2013 Oct;184(2):1161-73. doi: 10.1016/j.jss.2013.04.054. Epub 2013 May 16.
Preexisting cirrhosis usually leads to an inadequate and delayed regeneration of the future liver remnant (FLR) after portal vein embolization (PVE). Bone marrow-derived mesenchymal stem cells (BMSC) are promising candidates for therapeutic applications in liver diseases. In this study, the efficacy of autologous BMSCs transplantation to promote FLR regeneration was investigated in a rat cirrhotic model.
Autologous BMSCs were expanded and labeled with PKH26, and then were injected immediately into nonembolized lobes after PVE through portal vein in cirrhotic rat. At 7, 14, and 28 d after this, liver weight and Ki-67 labeling index were measured, and blood analysis was performed. Cirrhotic degree of FLR was assessed by hydroxyproline content assay and histopathology. Gene expressions of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), interleukin-10 (IL-10), and matrix metalloproteinase-9 (MMP-9) were detected with real-time reverse transcriptase-polymerase chain reaction. Distribution and hepatocyte differentiation of BMSCs in FLR were determined by confocal microscopy.
Autologous BMSCs significantly increased the FLR weight ratio to the total liver and the Ki-67 labeling index, and serum albumin levels were significantly higher and total bilirubin levels were significantly lower in the BMSCs group compared with the controls without BMSCs transplantation 14 and 28 d post-PVE. BMSCs significantly decreased the hydroxyproline content and collagen accumulation, up-regulated the expressions of HGF, IL-10, VEGF, and MMP-9 28 d post-PVE, and expressed hepatocyte-specific markers, such as α-fetoprotein, cytokeratin 18, and albumin in a time-dependent manner in FLR.
Autologous BMSCs can differentiate into hepatocyte and promote FLR regeneration after PVE in cirrhotic liver, which may be through improving local microenvironment by decreasing cirrhosis, up-regulating the gene expressions of VEGF, HGF, IL-10, and MMP-9.
门静脉栓塞(PVE)后,预先存在的肝硬化通常导致未来肝残存量(FLR)的再生不足和延迟。骨髓间充质干细胞(BMSC)是治疗肝脏疾病的有前途的候选者。在这项研究中,研究了自体 BMSC 移植促进肝硬化大鼠 FLR 再生的效果。
将自体 BMSC 扩增并标记为 PKH26,然后在 PVE 后立即通过门静脉注入未栓塞的肝叶。在 PVE 后 7、14 和 28 天,测量肝重和 Ki-67 标记指数,并进行血液分析。通过羟脯氨酸含量测定和组织病理学评估 FLR 的肝硬化程度。通过实时逆转录聚合酶链反应检测血管内皮生长因子(VEGF)、肝细胞生长因子(HGF)、白细胞介素-10(IL-10)和基质金属蛋白酶-9(MMP-9)的基因表达。通过共聚焦显微镜确定 BMSC 在 FLR 中的分布和向肝细胞的分化。
与未进行 BMSC 移植的对照组相比,自体 BMSC 可显著增加 FLR 与总肝的重量比和 Ki-67 标记指数,并且在 PVE 后 14 和 28 天血清白蛋白水平显著升高,总胆红素水平显著降低。BMSC 可显著降低羟脯氨酸含量和胶原积累,在 PVE 后 28 天上调 HGF、IL-10、VEGF 和 MMP-9 的表达,并在时间依赖性方式在 FLR 中表达甲胎蛋白、细胞角蛋白 18 和白蛋白等肝细胞特异性标志物。
自体 BMSC 可在肝硬化肝 PVE 后分化为肝细胞并促进 FLR 再生,这可能是通过减轻肝硬化、上调 VEGF、HGF、IL-10 和 MMP-9 的基因表达来改善局部微环境。