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间充质干/基质细胞是治疗非酒精性脂肪性肝病的新途径吗?

Are mesenchymal stem/stromal cells a novel avenue for the treatment of non-alcoholic fatty liver disease?

作者信息

Ruiz Milton Artur, Kaiser Junior Roberto Luiz R, Piron-Ruiz Gabriel, de Quadros Luiz Gustavo

机构信息

Department of Bone Marrow Transplantation, Associação Portuguesa de Beneficência, São José do Rio Preto 15090 470, São Paulo, Brazil.

Department of Bone Marrow Transplantation, Beneficência Portuguesa Hospital, São José do Rio Preto 15090 470, São Paulo, Brazil.

出版信息

World J Stem Cells. 2025 May 26;17(5):99638. doi: 10.4252/wjsc.v17.i5.99638.

Abstract

In this editorial, we comment on the article by Jiang . Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by the accumulation of fat in the liver without evidence of significant alcohol consumption. NAFLD can progress to more serious conditions such as non-alcoholic steatohepatitis, fibrosis, cirrhosis and hepatocellular carcinoma. This disease is considered an emerging public health problem in several countries as it has increased in recent decades, currently affecting around 30% of the world's population. The fatty diet and the current lifestyle of the Western population are identified as the main culprits of the disease. Drug treatment aims to reduce the weight of patients and treat metabolic alterations and diseases, including type 2 diabetes mellitus and other comorbidities that coexist with NAFLD. In this scenario, cell therapy with mesenchymal stem/stromal cells (MSCs) has been proposed as a perspective treatment of numerous diseases that do not have definitive curative treatment, such as Crohn's disease and coronavirus disease 2019. This is due to the versatile, immunomodulatory and regenerative properties of MSCs. The possibility of MSCs being used in patients with severe liver disease progressing to non-alcoholic steatohepatitis or cirrhosis is summarized, because of the therapeutic benefits in reducing fibrosis of affected livers. It remains to be seen when MSC transplantation should be indicated for NAFLD, that is, at what stage of the disease and which phenotype, as well as deciding on the best source of MSCs, the dose, and the administration route. We conclude that well-designed clinical trials are essential in order to obtain robust results for the implementation of this modality in the medical practice.

摘要

在这篇社论中,我们对蒋的文章发表评论。非酒精性脂肪性肝病(NAFLD)是一种慢性肝病,其特征是肝脏中脂肪堆积,且无大量饮酒证据。NAFLD可进展为更严重的疾病,如非酒精性脂肪性肝炎、纤维化、肝硬化和肝细胞癌。由于近几十年来这种疾病有所增加,目前影响着全球约30%的人口,因此在一些国家被视为一个新出现的公共卫生问题。高脂肪饮食和西方人群当前的生活方式被认为是该疾病的主要罪魁祸首。药物治疗旨在减轻患者体重,并治疗代谢改变和疾病,包括2型糖尿病以及与NAFLD共存的其他合并症。在这种情况下,间充质干/基质细胞(MSCs)的细胞治疗已被提议作为多种尚无明确治愈性治疗方法的疾病的一种潜在治疗手段,如克罗恩病和2019冠状病毒病。这是由于MSCs具有多能性、免疫调节和再生特性。鉴于MSCs在减轻受影响肝脏纤维化方面的治疗益处,总结了其用于进展为非酒精性脂肪性肝炎或肝硬化的严重肝病患者的可能性。对于NAFLD而言,何时应进行MSC移植仍有待观察,即疾病处于何种阶段以及何种表型,同时还需确定MSCs的最佳来源、剂量和给药途径。我们得出结论,精心设计的临床试验对于在医疗实践中实施这种治疗方式以获得可靠结果至关重要。

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