1. Institute for Regenerative Medicine, Ji’an Hospital, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai 200123, China 2. Shanghai Engineering Research Center of Stem Cells Translational Medicine, Shanghai 200335, China 3. Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai 200120, China 4. Postgraduate Training Base of Shanghai East Hospital, Jinzhou Medical University, Jinzhou 121001, China 5. The First Affiliated Hospital of Nanchang University, Nanchang 330006, China 6. Graduate School of Frontier Biosciences, Osaka University, Suita, Osaka, 565-0871, Japan 7. Department of General Surgery, Ji’an Hospital, Shanghai East Hospital, School of Medicine, Tongji University, Ji’an 343006, China 8. Department of Cell Biology and Physiology and Program in Molecular Biology and Biotechnology; UNC School of Medicine, Chapel Hill, NC 27599, USA
The liver has a complex cellular composition and a remarkable regenerative capacity. The primary cell types in the liver are two parenchymal cell populations, hepatocytes and cholangiocytes, that perform most of the functions of the liver and that are helped through interactions with non-parenchymal cell types comprising stellate cells, endothelia and various hemopoietic cell populations. The regulation of the cells in the liver is mediated by an insoluble complex of proteins and carbohydrates, the extracellular matrix, working synergistically with soluble paracrine and systemic signals. In recent years, with the rapid development of genetic sequencing technologies, research on the liver’s cellular composition and its regulatory mechanisms during various conditions has been extensively explored. Meanwhile breakthroughs in strategies for cell transplantation are enabling a future in which there can be a rescue of patients with end-stage liver diseases, offering potential solutions to the chronic shortage of livers and alternatives to liver transplantation. This review will focus on the cellular mechanisms of liver homeostasis and how to select ideal sources of cells to be transplanted to achieve liver regeneration and repair. Recent advances are summarized for promoting the treatment of end-stage liver diseases by forms of cell transplantation that now include grafting strategies.
Patients with end-stage liver diseases with at least 6 months living
220 participants
Long-term rescue of patients; 5-year-survival rates > 80%
[82,87,90,91]
EpCAM+ fetal biliary tree stem cells
Chronic liver disease
2 participants
Improvement in biochemical indices; continuous decline MELD score; no immune suppression needed
[92]
Human fetal liver cell transplantation
Cirrhotic patients
25 participants
5 of the 9 treated patients survived to a 1-year follow-up, while 6 of the 16 control patients with standard therapies survived to a 1-year follow-up
NCT01013194
Autologous CD34+ haemopoietic cells
Liver disease
5 participants; complete
Patients receiving 5×1010 cells; revealed to be safe within 12 months with mild side effects
NCT00655707
PSiPS generated from skin fiboblasts with 4 Yamanaka factors
Hepatic disorders; eye disorders
15 participants
No results revealed for further indication
NCT00953693
Tab.1
Fig.6
Fig.7
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