Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 4 Issue 11

Evaluation of Route of Administration (Via Portal Vein) for Assessing the Role of Stem Cell Therapy in Cirrhosis of Liver

Mamun Al Mahtab1, Ahmed Lutful Moben2, Md Abdur Rahim3, Md Ashraful Alam4, Faiz Ahmad Khondaker5, Sheikh Mohammad Noor-E-Alam1, Md Sakirul Islam Khan6, Md Zahurul Huq7, Musarrat Mahtab8 and Sheikh Mohammad Fazle Akbar9,10*

1Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2Department of Medicine, Kurmitola General Hospital, Dhaka, Bangladesh
3Department of Hepatology, Abdul Malek Ukil Medical College, Noakhali, Bangladesh
4Department of Hepatology, Shaheed Tajuddin Ahmed Medical College, Gazipur, Bangladesh
5Department of Hepatology, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh
6Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Ehime, Japan
7Department of Anesthesiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
8Department of Biochemistry and Biotechnology, North South University, Dhaka, Bangladesh
9Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
10Researcher, Miyakawa Memorial Research Foundation, Tokyo, Japan

*Corresponding Author: Sheikh Mohammad Fazle Akbar, Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.

Received: September 14, 2020; Published: October 12, 2020

×

Abstract

Aims and Objectives: The safety and efficacy of stem cell administration via portal vein was assessed in patients with cirrhosis of liver (LC).

Materials and Methods: In order to increase the numbers of white blood cell, 20 patients with liver cirrhosis were administered with granulocyte colony-stimulating factor at a dose of 60 IU, daily for 3 to 4 days. Stem cells were isolated from these patients as CD34-positive cells and variable numbers of autologous stem cells were injected to LC patients for once. Various hematological and clinical parameters of these patients were evaluated at point 0 (before administration of stem cells) and 1 and 3 months after administrations.

Results: None of these 20 patients died within 3 months of observation period. Regarding safety issues, there was no notable adverse event including acute liver failure related to stem cell therapy in these patients. Stem cell therapy had a dominant effect on ascites in this cohort. Although 7 of 20 patients had ascites at the start of therapy, 2 of these patients became ascites free at the end of 3 months of follow up. On the other hand, 5 patients of LC who did not have ascites at base line developed ascites during therapy. Different biochemical parameters of these patients remain mostly unchanged and did not show any significant difference dur to stem cell therapy. However, serum albumin level was increased significantly after 1 and 3 months.

Conclusion: The safety of stem cell therapy via portal vein has been shown here. The efficacy of stem cell therapy via portal vein may not be notable. However, observed effects of this therapy on ascites reduction in some patients and on effect on serum albumin indicate that repeated administration of stem cell therapy may be needed for maintaining quality of life.

Keywords: Cirrhosis of Liver (LC); Stem Cell Therapy; Hepatic Parenchyma

×

References

  1. Barnett R. “Liver cirrhosis”. Lancet10144 (2018): 275.
  2. Romanelli RG and Stasi C. “Recent Advancements in Diagnosis and Therapy of Liver Cirrhosis”. Current Cancer Drug Targets 15 (2016): 1804-1817.
  3. Sun M and Kisseleva T. “Reversibility of liver fibrosis”. Clinics and Research in Hepatology and Gastroenterology 1.01 (2015): S60-S63.
  4. Jung YK and Yim HJ. “Reversal of liver cirrhosis: current evidence and expectations”. The Korean Journal of Internal Medicine 2 (2017): 213-228.
  5. Newsome PN., et al. “Granulocyte colony-stimulating factor and autologous CD133-positive stem-cell therapy in liver cirrhosis (REALISTIC): an open-label, randomised, controlled phase 2 trial”. The Lancet Gastroenterology and Hepatology 1 (2018): 25-36.
  6. Lin PC., et al. “A proposed novel stem cell therapy protocol for liver cirrhosis”. Cell Transplantation 3 (2015): 533-540.
  7. Al Mahtab M., et al. “Stem Cell Therapy for Cirrhosis of Liver in Bangladesh: Specific Design Compatible for Developing Country”. Euroasian Journal of Hepato-Gastroenterology 2 (2018): 121-125.
  8. Terrault NA., et al. “American Association for the Study of Liver Diseases. AASLD guidelines for treatment of chronic hepatitis B”. Hepatology1 (2016): 261-283.
  9. European Association for Study of Liver. “EASL Clinical Practice Guidelines: management of hepatitis C virus infection”. The Journal of Hepatology 2 (2014): 392-420.
  10. Sarin SK., et al. “Asian-Pacific clinical practice guidelines on the management of hepatitis B: A 2015 update”. Hepatology International 1 (2016): 1-98.
  11. Al Mahtab M., et al. “Therapy Targeting Stem Cell in Patients with Decompensated Cirrhosis of Liver in a Tertiary Treatment Care Center of Bangladesh”. Euroasian Journal of Hepato-Gastroenterology 1 (2017): 113-115.
  12. Kaibori M., et al. “Stimulation of liver regeneration after hepatectomy in mice by injection of bone marrow mesenchymal stem cells via the portal vein”. Transplantation Proceedings 4 (2012): 1107-1109.
  13. Huang XL., et al. “Clinical outcome of autologous hematopoietic stem cell infusion via hepatic artery and portal vein in patients with end-stage liver disease”. Chinese Medical Sciences Journal 1 (2014): 15-22.
  14. Nicolas C., et al. “Stem Cell Therapies for Treatment of Liver Disease”. Biomedicines1 (2016): 2.
  15. Saha BK., et al. “Therapeutic implications of granulocyte colony stimulating factor in patients with acute-on-chronic liver failure: increased survival and containment of liver damage”. Hepatology International 6 (2017): 540-546.
  16. Pai M., et al. “Autologous infusion of expanded mobilized adult bone marrow-derived CD34+ cells into patients with alcoholic liver cirrhosis”. The American Journal of Gastroenterology 8 (2008): 1952-1958.
  17. Sellamuthu S., et al. “In vitro transdifferentiation of human umbilical cord derived hematopoietic stem cells into hepatocyte like cells using combination of growth factors for cell-based therapy”. Cytotechnology 63 (2011): 259-268.
×

Citation

Citation: Sheikh Mohammad Fazle Akbar.. et al. “Evaluation of Route of Administration (Via Portal Vein) for Assessing the Role of Stem Cell Therapy in Cirrhosis of Liver". Acta Scientific Medical Sciences 4.11 (2020): 27-31.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





Contact US