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系统评价:自体干细胞疗法对肝病患者的疗效

Systematic review: the effects of autologous stem cell therapy for patients with liver disease.

作者信息

Moore J K, Stutchfield B M, Forbes S J

机构信息

MRC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK.

出版信息

Aliment Pharmacol Ther. 2014 Apr;39(7):673-85. doi: 10.1111/apt.12645. Epub 2014 Feb 13.

Abstract

BACKGROUND

As morbidity and mortality from liver disease continues to rise, new strategies are necessary. Liver transplantation is not only an expensive resource committing the patient to lifelong immunosuppression but also suitable donor organs are in short supply. Against this background, autologous stem cell therapy has emerged as a potential treatment option.

AIM

To evaluate if it is possible to make a judgement on the safety, feasibility and effect of autologous stem cell therapy for patients with liver disease.

METHODS

MEDLINE and EMBASE were searched up until July 2013 to identify studies where autologous stem cell therapy was administered to patients with liver disease.

RESULTS

Of 1668 studies identified, 33 were eligible for inclusion evaluating a median sample size of 10 patients for a median follow-up of 6 months. Although there was marked heterogeneity between studies with regards to type, dose and route of delivery of stem cell, the treatment was shown to be safe and feasible largely when a peripheral route of administration was used. Of the studies which also looked at biochemical outcome, statistically significant improvement in liver function tests was seen in 16 studies post-treatment.

CONCLUSION

Although autologous stem cell therapy is a much needed possibility in the treatment of liver disease, further robust clinical trials and collaborative protocols are required.

摘要

背景

随着肝病发病率和死亡率持续上升,新策略势在必行。肝移植不仅是一种昂贵的治疗手段,使患者终身接受免疫抑制,而且合适的供体器官短缺。在此背景下,自体干细胞疗法已成为一种潜在的治疗选择。

目的

评估是否有可能对自体干细胞疗法治疗肝病患者的安全性、可行性和疗效做出判断。

方法

检索截至2013年7月的MEDLINE和EMBASE数据库,以确定对肝病患者进行自体干细胞治疗的研究。

结果

在检索到的1668项研究中,33项符合纳入标准,评估的样本量中位数为10例患者,随访时间中位数为6个月。尽管各研究在干细胞类型、剂量和给药途径方面存在显著异质性,但当采用外周给药途径时,该治疗在很大程度上被证明是安全可行的。在那些还观察生化结果的研究中,16项研究显示治疗后肝功能检查有统计学意义的改善。

结论

尽管自体干细胞疗法是肝病治疗中急需的一种可能性,但仍需要进一步开展有力的临床试验和协作方案。

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