Department of Infectious Diseases, Tongling People's Hospital, Tongling City, Anhui Province, China.
Cellular Central Laboratory, 105th Hospital of PLA, Hefei, Anhui Province, China.
J Gastroenterol Hepatol. 2018 Apr;33(4):774-780. doi: 10.1111/jgh.14081.
The aim of our study was to investigate the immunomodulatory effect and short-term efficacy and long-term prognosis of decompensated liver cirrhosis patients caused by hepatitis B after a double transplantation with human umbilical cord mesenchymal stem cells (hUCMSCs).
Fifty inpatients were recruited and given the same medical treatments, receiving hUCMSCs injection intravenously. Fifty-three patients (Group B) matched for age, sex, and baseline alanine aminotransferase, aspartate aminotransferase, albumin, total bilirubin, prothrombin time, and model for end-stage liver disease score and Child-Pugh classification, acted as the control group.
Interleukin-6 and tumor necrosis factor alpha levels markedly decreased, and interleukin-10 level apparently increased in Group A at 2 and 4 weeks after treatment. Transforming growth factor beta in Group A increased more remarkably at 2 weeks after treatment. T4 cells and Treg cells in Group A were apparently higher than those in Group B at 2 and 4 weeks after treatment, and T8 cells and B cells were significantly lower than those in Group B. Aspartate aminotransferase levels in Group A were dramatically declining at 8 and 12 weeks after treatment. Levels of albumin, total bilirubin, and prothrombin time in Group A were apparently improved from 4 to 12 weeks after treatment. The improvements in model for end-stage liver disease and Child-Pugh scores in Group A were notably superior to those in Group B from 4 to 36 weeks after treatment. There were no remarkable differences in the incidence of developing liver failure throughout the follow-up period, but the mortality rate of Group A was lower than that of Group B.
This therapeutic method may be an appropriate choice for patients with decompensated liver cirrhosis.
本研究旨在探讨双次人脐带间充质干细胞（hUCMSCs）移植治疗乙型肝炎所致失代偿期肝硬化患者的免疫调节作用及短期疗效和长期预后。
共纳入 50 例住院患者，均给予相同的内科治疗，并接受静脉注射 hUCMSCs。53 例年龄、性别、基线丙氨酸氨基转移酶、天冬氨酸氨基转移酶、白蛋白、总胆红素、凝血酶原时间、终末期肝病模型评分和 Child-Pugh 分级相匹配的患者（B 组）作为对照组。
治疗后 2 周和 4 周，A 组白细胞介素-6 和肿瘤坏死因子-α水平明显下降，白细胞介素-10 水平明显升高；治疗后 2 周，A 组转化生长因子-β升高更为显著。治疗后 2 周和 4 周，A 组 T4 细胞和 Treg 细胞明显高于 B 组，T8 细胞和 B 细胞明显低于 B 组。治疗后 8 周和 12 周，A 组天门冬氨酸氨基转移酶水平明显下降。治疗后 4 周至 12 周，A 组白蛋白、总胆红素和凝血酶原时间明显改善。治疗后 4 周至 36 周，A 组终末期肝病模型和 Child-Pugh 评分的改善明显优于 B 组。随访期间两组肝衰竭发生率无显著差异，但 A 组死亡率低于 B 组。
该治疗方法可能是治疗失代偿期肝硬化患者的一种合适选择。
