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肝硬化中的肝再生

Hepatic Regeneration in Cirrhosis.

作者信息

Jindal Ankur, Jagdish Rakesh K, Kumar Anupam

机构信息

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi 110070, India.

Consultant Hepatologist, Fortis Hospital, Noida, India.

出版信息

J Clin Exp Hepatol. 2022 Mar-Apr;12(2):603-616. doi: 10.1016/j.jceh.2021.08.029. Epub 2021 Sep 4.

Abstract

End-stage liver disease is characterized by massive hepatocyte death resulting in clinical decompensation and organ failures. Clinical consequences in cirrhosis are the results of the loss of functional hepatocytes and excessive scarring. The only curative therapy in advanced cirrhosis is orthotropic liver transplantation, but the clinical demand outweighs the availability of acceptable donor organs. Moreover, this also necessitates lifelong immunosuppression and carries associated risks. The liver has a huge capability for regeneration. Self-replication of quiescent differentiated hepatocytes and cholangiocytes occurs in patients with acute liver injury. Due to limited hepatocyte self-renewal capacity in advanced cirrhosis, great interest has therefore been shown in characterizing the possible role of hepatic progenitor cells and bone marrow-derived stem cells to therapeutically aid this process. Transplantation of cells from various sources that can be properly differentiated into functional liver cells or use of growth factors for ex-vivo expansion of progenitor cells is needed at utmost priority. Multiple researches over the last two decades have aided researchers in refining proliferation, differentiation, and storage techniques and understand the functionality of these cells for use in clinical practice. However, these cell-based therapies are still experimental and have to be used in trial settings.

摘要

终末期肝病的特征是大量肝细胞死亡,导致临床失代偿和器官衰竭。肝硬化的临床后果是功能性肝细胞丧失和过度瘢痕形成的结果。晚期肝硬化唯一的治愈性疗法是原位肝移植,但临床需求超过了可接受供体器官的供应。此外,这还需要终身免疫抑制并伴有相关风险。肝脏具有巨大的再生能力。急性肝损伤患者的静止分化肝细胞和胆管细胞会发生自我复制。由于晚期肝硬化中肝细胞自我更新能力有限,因此人们对确定肝祖细胞和骨髓来源干细胞在治疗上辅助这一过程的可能作用表现出极大兴趣。最优先需要的是移植能够正确分化为功能性肝细胞的各种来源的细胞,或使用生长因子对祖细胞进行体外扩增。过去二十年的多项研究帮助研究人员完善了增殖、分化和储存技术,并了解了这些细胞在临床实践中的功能。然而,这些基于细胞的疗法仍处于实验阶段,必须在试验环境中使用。

相似文献

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Hepatic Regeneration in Cirrhosis.肝硬化中的肝再生
J Clin Exp Hepatol. 2022 Mar-Apr;12(2):603-616. doi: 10.1016/j.jceh.2021.08.029. Epub 2021 Sep 4.
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Role of liver progenitors in liver regeneration.肝脏祖细胞在肝再生中的作用。
Hepatobiliary Surg Nutr. 2015 Feb;4(1):48-58. doi: 10.3978/j.issn.2304-3881.2015.01.16.

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