Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University & Hebei Key Laboratory of Mechanism of Liver Fibrosis in Chronic Liver Disease, Shijiazhuang 050051, Hebei Province, China.
World J Gastroenterol. 2020 Dec 21;26(47):7444-7469. doi: 10.3748/wjg.v26.i47.7444.
Although multiple drugs are accessible for recovering liver function in patients, none are considered efficient. Liver transplantation is the mainstay therapy for end-stage liver fibrosis. However, the worldwide shortage of healthy liver donors, organ rejection, complex surgery, and high costs are prompting researchers to develop novel approaches to deal with the overwhelming liver fibrosis cases. Mesenchymal stem cell (MSC) therapy is an emerging alternative method for treating patients with liver fibrosis. However, many aspects of this therapy remain unclear, such as the efficiency compared to conventional treatment, the ideal MSC sources, and the most effective way to use it. Because bone marrow (BM) is the largest source for MSCs, this paper used a systematic review approach to study the therapeutic efficiency of MSCs against liver fibrosis and related factors. We systematically searched multiple published articles to identify studies involving liver fibrosis and BM-MSC-based therapy. Analyzing the selected studies showed that compared with conventional treatment BM-MSC therapy may be more efficient for liver fibrosis in some cases. In contrast, the cotreatment presented a more efficient way. Nevertheless, BM-MSCs are lacking as a therapy for liver fibrosis; thus, this paper also reviews factors that affect BM-MSC efficiency, such as the implementation routes and strategies employed to enhance the potential in alleviating liver fibrosis. Ultimately, our review summarizes the recent advances in the BM-MSC therapy for liver fibrosis. It is grounded in recent developments underlying the efficiency of BM-MSCs as therapy, focusing on the preclinical experiments, and comparing to other treatments or sources and the strategies used to enhance its potential while mentioning the research gaps.
虽然有多种药物可用于恢复肝功能，但没有一种被认为是有效的。肝移植是治疗终末期肝纤维化的主要方法。然而，全球健康肝脏供体短缺、器官排斥、复杂的手术和高昂的成本促使研究人员开发新的方法来应对大量的肝纤维化病例。间充质干细胞（MSC）治疗是治疗肝纤维化患者的一种新兴替代方法。然而，这种治疗方法的许多方面仍然不清楚，例如与传统治疗相比的效率、理想的 MSC 来源以及最有效的使用方法。由于骨髓（BM）是 MSC 的最大来源，本文采用系统评价方法研究了 MSC 治疗肝纤维化的疗效及其相关因素。我们系统地搜索了多篇已发表的文章，以确定涉及肝纤维化和基于 BM-MSC 治疗的研究。对选定研究的分析表明，与传统治疗相比，BM-MSC 治疗在某些情况下可能对肝纤维化更有效。相比之下，联合治疗是一种更有效的方法。然而，BM-MSCs 缺乏治疗肝纤维化的能力；因此，本文还综述了影响 BM-MSC 效率的因素，例如实施途径和策略，以增强其缓解肝纤维化的潜力。最终，我们的综述总结了 BM-MSC 治疗肝纤维化的最新进展。它基于 BM-MSCs 作为治疗方法的效率的最新发展，重点介绍了临床前实验，并与其他治疗方法或来源及其增强其潜力的策略进行了比较，同时提到了研究空白。
