ABSTRACT
Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.
Subject(s)
Humans , Middle Aged , End Stage Liver Disease , Follow-Up Studies , Liver Cirrhosis/drug therapy , Peripheral Blood Stem Cells , Severity of Illness Index , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>Screening monoclonal antibodies selectively distribute on hepatocellular membrane by hybridoma technology and exploring their relationship with liver diseases.</p><p><b>METHODS</b>Plasma membrane vesicles of rat hepatocytes were prepared using density gradient centrifugation and BALB/c mice were immunized with the membrane vesicles. Monoclonal antibodies were made with hybridoma technology. The immunizing valences and monoclonal antibodies were detected and screened by ELISA. Mh7 antigen was identified by immunoprecipitation method. Liver tissues of carbon tetrachloride injured rat models and diabetic rat models were used to detect the pathology value of mh7-antigen.</p><p><b>RESULTS</b>Hepatocellular membrane vesicles were obtained successfully. Several monoclonal antibodies were yielded by hybridoma technology. Immunofluorescence and pre-embedding immunogold-silver cytochemistry confirmed that mh7-antigen was a membrane molecule and with a 200KD molecular weight. Immunohistochemistry results indicated mh7 selectively distributed on hepatocellular membrane. Results with rat models demonstrated that mh7-antigen was dramatically reduced in fatty degenerated hepatocyte of carbon tetrachloride injured rat models and distributed as straps in diabetic rat models.</p><p><b>CONCLUSIONS</b>Mh7 is a new hepatocellular membrane monoclonal antibody and may closely related with liver diseases.</p>