National Key Disciplines for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
Department of Oncology, The First Affiliated Hospital, Institute for Liver Diseases of Anhui Medical University, Hefei, China.
Clin Mol Hepatol. 2020 Mar;26(2):163-179. doi: 10.3350/cmh.2019.0022n. Epub 2020 Feb 27.
End-stage liver disease is one of the leading causes of death around the world. Since insufficient sources of transplantable liver and possible immune rejection severely hinder the wide application of conventional liver transplantation therapy, artificial three-dimensional (3D) liver culture and assembly from stem cells have become a new hope for patients with end-stage liver diseases, such as cirrhosis and liver cancer. However, the induced differentiation of single-layer or 3D-structured hepatocytes from stem cells cannot physiologically support essential liver functions due to the lack of formation of blood vessels, immune regulation, storage of vitamins, and other vital hepatic activities. Thus, there is emerging evidence showing that 3D organogenesis of artificial vascularized liver tissue from combined hepatic cell types derived from differentiated stem cells is practical for the treatment of end-stage liver diseases. The optimization of novel biomaterials, such as decellularized matrices and natural macromolecules, also strongly supports the organogenesis of 3D tissue with the desired complex structure. This review summarizes new research updates on novel differentiation protocols of stem cell-derived major hepatic cell types and the application of new supportive biomaterials. Future biological and clinical challenges of this concept are also discussed.
终末期肝病是全球主要死因之一。由于可移植肝脏的来源不足和可能的免疫排斥反应严重限制了常规肝移植治疗的广泛应用,因此,人工三维(3D)肝培养和干细胞组装已成为肝硬化和肝癌等终末期肝病患者的新希望。然而,由于缺乏血管形成、免疫调节、维生素储存和其他重要的肝脏活动,单层或 3D 结构的肝细胞从干细胞的诱导分化不能在生理上支持基本的肝脏功能。因此,有新的证据表明,源自分化干细胞的组合肝细胞类型的人工血管化肝组织的 3D 器官发生对于治疗终末期肝病是实用的。新型生物材料(如脱细胞基质和天然大分子)的优化也强烈支持具有所需复杂结构的 3D 组织的器官发生。本综述总结了干细胞来源的主要肝细胞类型的新型分化方案的最新研究进展以及新型支持性生物材料的应用。还讨论了该概念的未来生物学和临床挑战。