Huang Wei-Chen, Li Yuan-Chi, Chen Pin-Xuan, Ma Kevin Sheng-Kai, Wang Li-Tzu
Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Laboratory of Clinical Immunology, National Defense Medical Center, Taipei, Taiwan.
Stem Cell Res Ther. 2025 Jan 6;16(1):3. doi: 10.1186/s13287-024-04127-y.
Chronic liver diseases, including cirrhosis and liver failure, remain formidable challenges due to their complex progression and limited therapeutic options. Mesenchymal stem cell (MSC) therapy has emerged as a game-changing approach, leveraging its potent immunomodulatory, anti-fibrotic, and regenerative capabilities, along with the ability to transdifferentiate into hepatocytes. This review delves into the latest advances in MSC-based treatments for chronic and end-stage liver diseases, as highlighted in current clinical trials. MSCs derived from bone marrow and umbilical cord have shown remarkable promise in reversing liver damage, improving liver function, and providing hope for patients who do not respond to conventional therapies. When administered through hepatic, portal, or peripheral veins, MSCs have significantly improved liver histology, reduced fibrosis, and restored functional capacity. Furthermore, MSC-derived materials, such as extracellular vesicles and exosomes, are emerging as cutting-edge tools for treating liver failure and mitigating post-transplant complications. While autologous MSC-derived hepatocytes hold promise for non-fatal cirrhosis, allogeneic MSCs are being applied in more severe conditions, including liver failure and transplantation cases. Despite these promising early outcomes, larger trials and long-term studies are essential to fully harness MSCs as a transformative, off-the-shelf alternative to liver transplantation, heralding a new era in regenerative liver therapies.
包括肝硬化和肝衰竭在内的慢性肝病，因其复杂的进展过程和有限的治疗选择，仍然是严峻的挑战。间充质干细胞（MSC）疗法已成为一种改变游戏规则的方法，它利用其强大的免疫调节、抗纤维化和再生能力，以及转分化为肝细胞的能力。本综述深入探讨了基于MSC的慢性和终末期肝病治疗的最新进展，正如当前临床试验所强调的那样。来自骨髓和脐带的间充质干细胞在逆转肝损伤、改善肝功能以及为对传统疗法无反应的患者带来希望方面显示出了显著的前景。通过肝静脉、门静脉或外周静脉给药时，间充质干细胞显著改善了肝脏组织学，减少了纤维化，并恢复了功能能力。此外，间充质干细胞衍生的材料，如细胞外囊泡和外泌体，正成为治疗肝衰竭和减轻移植后并发症的前沿工具。虽然自体间充质干细胞衍生的肝细胞对非致命性肝硬化有前景，但异体间充质干细胞正被应用于更严重的情况，包括肝衰竭和移植病例。尽管这些早期结果很有希望，但更大规模的试验和长期研究对于充分利用间充质干细胞作为肝移植的变革性、现成替代方案至关重要，这预示着再生肝治疗的新时代。
