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Granulocyte-colony stimulating factor (G-CSF) to treat acute-on-chronic liver failure: A multicenter randomized trial (GRAFT study).粒细胞集落刺激因子(G-CSF)治疗慢加急性肝衰竭:一项多中心随机试验(GRAFT 研究)。
J Hepatol. 2021 Dec;75(6):1346-1354. doi: 10.1016/j.jhep.2021.07.033. Epub 2021 Aug 5.
2
Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time.肝硬化患者自体造血干细胞输注的长期结局:随着时间推移效果逐渐减弱。
J Clin Transl Hepatol. 2020 Dec 28;8(4):385-390. doi: 10.14218/JCTH.2020.00052. Epub 2020 Oct 14.
3
Controversies Surrounding the Origin of Hepatocytes in Adult Livers and the in Vitro Generation or Propagation of Hepatocytes.关于成年肝脏中肝细胞的起源以及肝细胞的体外生成或增殖的争议。
Cell Mol Gastroenterol Hepatol. 2021;11(1):273-290. doi: 10.1016/j.jcmgh.2020.09.016. Epub 2020 Sep 28.
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Granulocyte colony-stimulating factor for alcoholic hepatitis: A systematic review and meta-analysis of randomised controlled trials.粒细胞集落刺激因子治疗酒精性肝炎:随机对照试验的系统评价和荟萃分析
JHEP Rep. 2020 Jun 18;2(5):100139. doi: 10.1016/j.jhepr.2020.100139. eCollection 2020 Oct.
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Granulocyte Colony-Stimulating Factor Use in Decompensated Cirrhosis: Lack of Survival Benefit.粒细胞集落刺激因子在失代偿期肝硬化中的应用:缺乏生存获益。
J Clin Exp Hepatol. 2020 Mar-Apr;10(2):124-134. doi: 10.1016/j.jceh.2019.05.003. Epub 2019 Jun 1.
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Multiple Cycles of Granulocyte Colony-Stimulating Factor Increase Survival Times of Patients With Decompensated Cirrhosis in a Randomized Trial.随机试验表明,粒细胞集落刺激因子多次循环可延长失代偿期肝硬化患者的生存时间。
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J Clin Invest. 2020 Apr 1;130(4):2129-2145. doi: 10.1172/JCI132691.
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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.

DOI:10.1016/j.jceh.2021.08.029
PMID:35535091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9077225/
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。