Infection Control Office, Weifang People's Hospital, Weifang, 261041, Shandong Province, China.
Dispensing room for intravenous transfusion, Weifang People's Hospital, Weifang, 261041, Shandong Province, China.
Stem Cell Res Ther. 2020 Mar 5;11(1):104. doi: 10.1186/s13287-020-01627-5.
Autologous bone marrow stem cell (ABMSC) transplantation has been considered a promising option for hepatitis B virus-related cirrhosis (HBV-C). Although an analysis of the published literature has been performed, the exact effects and safety have yet to be systematically investigated.
We conducted a wide-ranging online search of electronic databases (Web of Science, PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang database) to reach systematic conclusions. Outcome measurements, including therapeutic efficacy, clinical symptoms, and adverse events, were extracted and analyzed statistically.
Ultimately, a total of 10 articles including 662 HBV-C patients were included in this analysis, which indicated that ABMSC therapy could significantly improve liver function in patients with HBV-C in terms of the MELD and Child-Pugh scores, total bilirubin, serum albumin, alanine aminotransferase, aspartate aminotransferase, and coagulation function. Compared with patients receiving routine therapy (RT), those treated with ABMSC and RT combined therapy showed improved clinical symptoms, as represented by increased appetite and reduced fatigue and ascitic fluid and abdominal distension. Moreover, the fibrosis indexes indicated a reduction in liver fibrosis in patients treated with combined therapy according to the improved levels of hyaluronic acid (MD = - 70.47, CI = - 103.72-37.21, P < 0.0001), laminin (MD = - 25.11, CI = - 37.73-12.49, P < 0.0001), type III procollagen (MD = - 22.42, CI = - 34.49-10.34, P = 0.0003), and type IV collagen (MD = - 22.50, CI = - 39.92-5.08, P = 0.01). No obvious adverse events occurred during ABMSC treatment.
ABMSC transplantation via the hepatic artery was safe and effective in treating HBV-C without causing severe adverse events.
自体骨髓干细胞（ABMSC）移植已被认为是治疗乙型肝炎病毒相关肝硬化（HBV-C）的一种有前途的选择。尽管已经对已发表的文献进行了分析，但确切的疗效和安全性尚未得到系统研究。
我们进行了广泛的在线电子数据库搜索（Web of Science、PubMed、Cochrane Library、Embase、CNKI、VIP 和万方数据库），以得出系统结论。提取并统计分析了包括治疗效果、临床症状和不良事件在内的结局测量。
最终，共有 10 篇文章（包括 662 例 HBV-C 患者）被纳入本分析，结果表明，ABMSC 治疗可显著改善 HBV-C 患者的肝功能，表现在 MELD 和 Child-Pugh 评分、总胆红素、血清白蛋白、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和凝血功能方面。与接受常规治疗（RT）的患者相比，接受 ABMSC 和 RT 联合治疗的患者临床症状改善更为明显，表现为食欲增加，疲劳、腹水和腹胀减轻。此外，根据透明质酸（MD=-70.47，CI=-103.72-37.21，P<0.0001）、层粘连蛋白（MD=-25.11，CI=-37.73-12.49，P<0.0001）、III 型前胶原（MD=-22.42，CI=-34.49-10.34，P=0.0003）和 IV 型胶原（MD=-22.50，CI=-39.92-5.08，P=0.01）等纤维化指标的改善，提示联合治疗组的肝纤维化减轻。
经肝动脉输注 ABMSC 治疗 HBV-C 安全有效，无严重不良事件发生。
