scholarly journals Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Chen-Hui Zhu ◽  
Dian-Han Zhang ◽  
Chen-Wei Zhu ◽  
Jing Xu ◽  
Chuan-Long Guo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Stem Cell ◽  
Liver Disease ◽  
Liver Function ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Adult Stem Cell ◽  
End Stage Liver Disease ◽  
End Stage

AbstractEnd-stage liver disease (ESLD) is characterized by the deterioration of liver function and a subsequent high mortality rate. Studies have investigated the use of adult stem cells to treat ESLD. Here, a systematic review and meta-analysis was conducted to determine the efficacy of a combination therapy with adult stem cell transplantation and traditional medicine for treating ESLD. Four databases—including PubMed, Web of Science, Embase, and Cochrane Library—were investigated for studies published before January 31, 2021. The main outcome indicators were liver function index, model for end-stage liver disease (MELD) scores, and Child‒Turcotte‒Pugh (CTP) scores. Altogether, 1604 articles were retrieved, of which eight met the eligibility criteria; these studies included data for 579 patients with ESLD. Combination of adult stem cell transplantation with conventional medicine significantly improved its efficacy with respect to liver function index, CTP and MELD scores, but this effect gradually decreased over time. Moreover, a single injection of stem cells was more effective than two injections with respect to MELD and CTP scores and total bilirubin (TBIL) and albumin (ALB) levels, with no significant difference in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. With respect to the TBIL levels, patients receiving mononuclear cells (MNCs) experienced a significantly greater therapeutic effect—starting from twenty-four weeks after the treatment—whereas with respect to ALB levels, CD34+ autologous peripheral blood stem cells (CD34+ APBSCs) and MNCs had similar therapeutic effects. Severe complications associated with adult stem cell treatment were not observed. Although the benefits of combination therapy with respect to improving liver function were slightly better than those of the traditional treatment alone, they gradually decreased over time.Systematic review registration: PROSPERO registration number: CRD42021238576.

In Vitro Hepatic Differentiation of Adult, Embryonic, Induced Pluripotent and Perinatal Stem-Cells

2020 ◽  
Keyword(s):  
Stem Cells ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Organ Transplantation ◽  
Cell Transplantation ◽  
Hepatic Differentiation ◽  
End Stage Liver Disease ◽  
Induced Pluripotent ◽  
End Stage

Globally regenerative medicine is considered as one of the rapidly growing biomedical industry have objective to substitute damaged cells. Cell transplantation is less intrusive than whole-organ transplantation, and has been used to provide an alternative for patients to whole-organ transplantation. The End-stage liver disease comprises a subgroup of patients with cirrhosis who have signs of decompensation that is irreversible with medical treatment. The only restorative therapy for severe end-stage liver disease is orthotropic liver transplantation. However, liver transplantation has several limitations such as scarcity of organ donors, immunosuppressive drugs, and several postoperative complications. Thus, cell transplantation can be used for the treatment of end stage liver disorders to decrease the mortality in acute liver failure. Therefore, stem cells can be used for cellular therapy, development of liver disease models, and tissue-engineering applications. This review involved the studies conducted on the stem cells potential of hepatic differentiation, isolated from different sources. The PubMed and Google Scholar were searched for scientific studies reported the sources of stem cells based on their origin and their potential of hepatic differentiation in-vitro by using different tools of differentiation. All the research articles were selected in which solely hepatic differentiation in combination with different tools is reported. Keywords: Adult Stem Cells, Embryonic Stem Cells, Induced Pluripotent Stem Cells, In-vitro, Mesenchymal Stem Cells.

scholarly journals Efficacy and Safety of Mesenchymal Stem Cells Co-Infusion in Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Teng li ◽  
Chengxin Luo ◽  
Jiasi Zhang ◽  
Ling Wei ◽  
Wei Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Lower Risk ◽  
Meta Analysis ◽  
Current Evidence ◽  
Efficacy And Safety

Abstract BackgroundHematopoietic stem cell transplantation (HSCT) is a life-saving strategy for severe hematological conditions, but its efficacy and safety need further improvement. Co-infusion of mesenchymal stem cells (MSCs) may bring promise for the overall efficacy in HSCT setting. About that there are increasing studies, while the results from different trials are conflicting. A systematic review and meta-analysis are needed to appraise the real efficacy of MSCs co-infusion in HSCT. MethodsFive medical databases were searched to identify related controlled studies, which included individuals with hematological diseases receiving allogeneic HSCT (allo-HSCT), and with MSCs co-infusion as intervention arm versus no MSCs as comparison arm. Meta-analysis was performed using RevMan 5.4.ResultsUltimately, 19 trials met the inclusion criteria. MSCs co-infusion was associated with shorter time both to ANC engraftment (4RCTs: SMD -1.20, p = 0.04; 10nRCTs: SMD -0.54, p = 0.04) and PLT engraftment (4RCTs: SMD -0.60, p = 0.04; 10nRCTs: SMD -0.70, p = 0.01), lower risk of cGVHD incidence (4RCTs: RR 0.53, p = 0.01; 10nRCTs: RR 0.50, p < 0.01), and slightly positive trend towards the risk of aGVHD incidence (3RCTs: RR 0.84, p = 0.33; 9nRCTs: RR 0.74, p < 0.01) and NRM(3RCTs: OR 0.59, p = 0.34; 3nRCTs: OR 0.18, p < 0.01); didn’t affect relapse (5RCTs: RR 1.34, p = 0.34; 4nRCTs: RR 0.74, p = 0.24) and overall survival (4RCTs: HR 1.54, p = 0.18; 6nRCTs: HR 0.60, p = 0.06). Subgroup analyses revealed that, when co-transplanted with MSCs, patients younger than 18 or those received HLA-haploidentical grafts had improved engraftment (ANC and PLT）and lower risk of NRM and GVHD (acute and chronic forms) incidence. For adults or those received HLA-identical grafts, the risk of cGVHD incidence were reduced. Patients with hematologic malignancies had lower risk of developing GVHD and NRM, patients with non-malignancies showed faster engraftment.ConclusionWithout increasing the risk of mortality or relapse, MSCs co-infusion in allo-HSCT improved engraftment of platelet and neutrophil, reduced the risk of developing cGVHD. In terms of aGVHD and NRM, the effect of MSCs co-infusion was not quite significant with current evidence.

Human Fetal Liver-Derived Stem Cell Transplantation as Supportive Modality in the Management of End-Stage Decompensated Liver Cirrhosis

2010 ◽  
Vol 19 (4) ◽  
pp. 409-418 ◽  
Author(s):  
Aleem A. Khan ◽  
Mahaboob V. Shaik ◽  
N. Parveen ◽  
A. Rajendraprasad ◽  
Mohammed A. Aleem ◽  
...  
Keyword(s):  
Stem Cells ◽  
Liver Cirrhosis ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Liver Diseases ◽  
Fetal Liver ◽  
Decompensated Liver Cirrhosis ◽  
Human Fetal Liver ◽  
End Stage

Liver transplantation is the only existing modality for treating decompensated liver cirrhosis. Several factors, such as nonavailability of donors, combined with operative risks, complications associated with rejection, usage of immunosuppressive agents, and cost intensiveness, make this strategy available to only a few people. With a tremendous upsurge in the mortality rate of patients with liver disorders worldwide, there is a need to search for an alternative therapeutic tool that can combat the above limitations and serve as a supportive therapy in the management of liver diseases. Cell therapy using human fetal liver-derived stem cells can provide great potential to conservatively manage end-stage liver diseases. Therefore, the present investigation aimed to study and prove the safety and efficacy of human fetal liver-derived stem cell transplantation in patients with end-stage liver cirrhosis. Twenty-five patients with liver cirrhosis of different etiologies were infused with human fetal liver-derived stem cells (EpCAM+ve) labeled with Tc-HMPAO through hepatic artery. Our high throughput analysis using flow cytometry, RT-PCR, and cellular characterization exemplifies fetal liver cells with their high proliferation rate could be the best source for rejuvenating the diseased liver. Further, no episodes related to hepatic encephalopathy recurred in any of the subjects following hepatic stem cell transplantation. There was marked clinical improvement observed in terms of all clinical and biochemical parameters. Further, there was decrease in mean MELD score ( p < 0.01) observed in 6 months follow-up in all patients. Therapy using human fetal liver stem/progenitor cells offers a potentially supportive modality to organ transplantation in the management of liver diseases.

Bone marrow stem cell transplantation for cardiac repair

2005 ◽  
Vol 288 (6) ◽  
pp. H2557-H2567 ◽  
Author(s):  
Husnain Kh Haider ◽  
Muhammad Ashraf
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Adult Stem Cell ◽  
Cell Types ◽  
Repair Process ◽  
Cardiac Repair ◽  
Adult Cardiomyocytes

Cardiomyocytes respond to physiological or pathological stress only by hypertrophy and not by an increase in the number of functioning cardiomyocytes. However, recent evidence suggests that adult cardiomyocytes have the ability, albeit limited, to divide to compensate for the cardiomyocyte loss in the event of myocardial injury. Similarly, the presence of stem cells in the myocardium is a good omen. Their activation to participate in the repair process is, however, hindered by some as-yet-undetermined biological impediments. The rationale behind the use of adult stem cell transplantation is to supplement the inadequacies of the intrinsic repair mechanism of the heart and compensate for the cardiomyocyte loss in the event of injury. Various cell types including embryonic, fetal, and adult cardiomyocytes, smooth muscle cells, and stable cell lines have been used to augment the declining cardiomyocyte number and cardiac function. More recently, the focus has been shifted to the use of autologous skeletal myoblasts and bone marrow-derived stem cells. This review is a synopsis of some interesting aspects of the fast-emerging field of bone marrow-derived stem cell therapy for cardiac repair.

Stem Cell Transplantation: A Promising Therapy for Spinal Cord Injury

2020 ◽  
Vol 15 (4) ◽  
pp. 321-331 ◽  
Author(s):  
Zhe Gong ◽  
Kaishun Xia ◽  
Ankai Xu ◽  
Chao Yu ◽  
Chenggui Wang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Stem Cells ◽  
Spinal Cord Injury ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Therapeutic Potential ◽  
Embryonic Stem ◽  
Current Status ◽  
Cord Injury

Spinal Cord Injury (SCI) causes irreversible functional loss of the affected population. The incidence of SCI keeps increasing, resulting in huge burden on the society. The pathogenesis of SCI involves neuron death and exotic reaction, which could impede neuron regeneration. In clinic, the limited regenerative capacity of endogenous cells after SCI is a major problem. Recent studies have demonstrated that a variety of stem cells such as induced Pluripotent Stem Cells (iPSCs), Embryonic Stem Cells (ESCs), Mesenchymal Stem Cells (MSCs) and Neural Progenitor Cells (NPCs) /Neural Stem Cells (NSCs) have therapeutic potential for SCI. However, the efficacy and safety of these stem cellbased therapy for SCI remain controversial. In this review, we introduce the pathogenesis of SCI, summarize the current status of the application of these stem cells in SCI repair, and discuss possible mechanisms responsible for functional recovery of SCI after stem cell transplantation. Finally, we highlight several areas for further exploitation of stem cells as a promising regenerative therapy of SCI.

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