Selection of Route of Stem Cells in the Treatment of Cirrhosis
Fan Chen*
Department of Gastroenterology, Fuzhou General Hospital,Fuzhou, China
*Corresponding author: Fan Chen, Department of Gastroenterology, Fuzhou General Hospital,Fuzhou 350000, China.Tel: +8613338433186; Fax: +86059124937099; Email: yangqh4848@sina.com
Received Date: 07 February, 2018; Accepted Date: 15 February, 2018; Published Date: 26 February, 2018
Citation:ChenF (2018) Selection of Route of Stem Cells in the Treatment of Cirrhosis. Stem Cell Adv Res Ther: SCRT-121. DOI: 10.29011/SCRT-121. 100021
Commentary
It is wellknownfor us that stem cellsismore effective in the treatment
of liver cirrhosis[1]. Since the different conditions of cirrhosis have
different pathophysiological changes, it is necessary to choose adequate
transplantation route to achieve better curative effect. That is to say, for
liver cirrhosis with different degree inflammation, different transplantation
routes should be used in treatment. If it is active in liver cirrhosis, and
liver inflammation is high or cirrhosis is associated with acute on chronic
liver failure, peripheral vascular administration of stem cells may be superior
to local interventional therapy for cirrhotic patients[2]. This is because the
inflammatory factors in the liver and peripheral blood has high concentration,
while the liver microenvironment is poor, peripheral blood vessel
administration makes it easier for the stem cells to home smoothly, and release
the related factors through paracrine action to suppress inflammation inside
and outside the liver, while avoiding excessive stem cell death from the liver.
When allogeneic stem cells are used to treat human cirrhotic
patients, the choice of transplantation route for treatment may vary. Probably
relative to small experimental animals, if being administered to human through
peripheral blood vessels, the stem cells are far removed, and because human are
more immune, rejection is severe, causing excessive consumption of stem cells.
If local administration, it can reduce the distance loss, and because the liver
is immune privilege organ[3], the rejection is light. Although poor liver
microenvironment can lead to stem cell death, and invasive intervention may
have damage to the liver, but from the comprehensive effect, local intervention
may be better[4]. In the case of human cirrhosis with acute liver disease, the
question of which route of transplantation is optimal remains to be confirmed
by more clinical trials. If cirrhosis is quiescent, or cirrhosis is active but
without obvious inflammation, stem cell local treatment is recommended. This is
because the lesion is moderated and confined to the liver, and peripheral inflammatory
factor level is low which lead to the stem cell homing effect being reduced,
then local intervention may be superior to peripheral vascular
administration[5]. In clinical practice, the interventional method of hepatic
artery is usually used. And there are some risks associated with the use of
portal vein interventional procedures in clinical treatment. So, if clinical
studies have shown that the effect of the hepatic artery and portal vein
approach is of little difference, the hepatic artery approach is recommended.