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• W2014567489 abstract "Research on hepatic stem cells has entered a new era of controversy and expectations when surprising data have suggested that adult stem cells could migrate from a stem cell niche to an injured organ, transdifferentiate across tissue lineage boundaries, and participate in regeneration. For example, circulating stem cells, mobilized with granulocyte-colony stimulating factor (G-CSF), have shown to be able to colonize a myocardial infarct in rodents and participate in its remodelling and functional amelioration [[1]Orlic D. Kajstura J. Chimenti S. Limana F. Jakoniuk I. Quaini F. et al.Mobilized bone marrow cells repair the infarcted heart, improving function and survival.Proc Natl Acad Sci U S A. 2001; 98: 10344-10349Crossref PubMed Scopus (1930) Google Scholar]. In the liver, donor-derived hepatocytes have been identified after bone marrow transplantation [[2]Alison M.R. Poulsom R. Jeffery R. Dhillon A.P. Quaglia A. Jacob J. et al.Hepatocytes from non-hepatic adult stem cells.Nature. 2000; 406: 257Crossref PubMed Scopus (952) Google Scholar], but this ‘plasticity’ has recently been called into question. The proportion of bone marrow derived hepatocytes is extremely low in rodents [3Wagers A.J. Sherwood R.I. Christensen J.L. Weissman I.L. Little evidence for developmental plasticity of adult hematopoietic stem cells.Science. 2002; 297: 2256-2259Crossref PubMed Scopus (1297) Google Scholar, 4Mallet V.O. Mitchell C. Mezey E. Fabre M. Guidotti J.E. Renia L. et al.Bone marrow transplantation in mice leads to a minor population of hepatocytes that can be selectively amplified in vivo.Hepatology. 2002; 35: 799-804Crossref PubMed Scopus (118) Google Scholar] and in humans [[5]Fogt F. Beyser K.H. Poremba C. Zimmerman R.L. Khettry U. Ruschoff J. Recipient-derived hepatocytes in liver transplants: a rare event in sex-mismatched transplants.Hepatology. 2002; 36: 173-176Crossref PubMed Scopus (66) Google Scholar] and seems more to occur in vivo through cell fusion between a myelomonocytic bone marrow derived cell and a hepatocyte than through true transdifferentiation (For review see [[6]Daley G.Q. Alchemy in the liver: fact or fusion?.Nat Med. 2004; 10: 671-672Crossref PubMed Scopus (8) Google Scholar]). It is not known whether injury is required to enhance (or to detect?) this phenomenon. In the tyrosinemic mice, the frequency of cell fusion seems unchanged with or without liver injury [[7]Wang X. Montini E. Al-Dhalimy M. Lagasse E. Finegold M. Grompe M. Kinetics of liver repopulation after bone marrow transplantation.Am J Pathol. 2002; 161: 565-574Abstract Full Text Full Text PDF PubMed Scopus (229) Google Scholar]. In contrast, other models support that injury correlates with the level of engraftment of bone marrow derived cells in the liver [8Wang X. Ge S. McNamara G. Hao Q.L. Crooks G.M. Nolta J.A. Albumin-expressing hepatocyte-like cells develop in the livers of immune-deficient mice that received transplants of highly purified human hematopoietic stem cells.Blood. 2003; 101: 4201-4208Crossref PubMed Scopus (230) Google Scholar, 9Harris R.G. Herzog E.L. Bruscia E.M. Grove J.E. Van Arnam J.S. Krause D.S. Lack of a fusion requirement for development of bone marrow-derived epithelia.Science. 2004; 305: 90-93Crossref PubMed Scopus (369) Google Scholar, 10Jang Y.Y. Collector M.I. Baylin S.B. Diehl A.M. Sharkis S.J. Hematopoietic stem cells convert into liver cells within days without fusion.Nat Cell Biol. 2004; 6: 532-539Crossref PubMed Scopus (507) Google Scholar]. These inconsistencies, that probably come from the various nature of the cells transplanted, underline the importance of searching for specific markers that could help in purifying adult stem cells with hepatocytic potential. The aim of the study presented by Gehling et al. [[11]Gehling U.M. Willems M. Dandri M. Petersen J. Berna M. Thill M. et al.Partial hepatectomy induces mobilization of a unique population of haematopoietic progenitor cells in human healthy liver donors.J Hepatol. 2005; 43: 845-853Abstract Full Text Full Text PDF PubMed Scopus (76) Google Scholar] in this issue of the Journal was to determine whether liver resection could mobilize adult stem cells that could help liver regeneration. A mobilization of CD34+ cells has already been reported after liver resection in patients with primary liver carcinoma or metastasis [[12]De Silvestro G. Vicarioto M. Donadel C. Menegazzo M. Marson P. Corsini A. Mobilization of peripheral blood hematopoietic stem cells following liver resection surgery.Hepatogastroenterology. 2004; 51: 805-810PubMed Google Scholar]. The fate of the mobilized cells was not reported in this publication. In the work presented here, the authors describe a significant increase in the percentage of CD133+ cells in blood samples of healthy living liver donors, 12 h after surgery, compared to samples obtained from patients undergoing abdominal or traumatic surgery, although the preoperative basal level of these cells is not equivalent in all studied populations. CD133 (AC133) defines a broad population of stem or progenitor cells. This cell surface antigen has first been described in a subset of hematopoietic stem cells mobilized with G-CSF. It has further been found in endothelial progenitor cells [[13]Peichev M. Naiyer A.J. Pereira D. Zhu Z. Lane W.J. Williams M. et al.Expression of VEGFR-2 and AC133 by circulating human CD34(+) cells identifies a population of functional endothelial precursors.Blood. 2000; 95: 952-958Crossref PubMed Google Scholar], in human central nervous system stem cells [[14]Uchida N. Buck D.W. He D. Reitsma M.J. Masek M. Phan T.V. et al.Direct isolation of human central nervous system stem cells.Proc Natl Acad Sci U S A. 2000; 97: 14720-14725Crossref PubMed Scopus (1537) Google Scholar], in brain tumor-initiating stem cells [[15]Singh S.K. Hawkins C. Clarke I.D. Squire J.A. Bayani J. Hide T. et al.Identification of human brain tumour initiating cells.Nature. 2004; 432: 396-401Crossref PubMed Scopus (5972) Google Scholar] and in undifferentiated ES cells [[16]Kania G. Corbeil D. Fuchs J. Tarasov K.V. Blyszczuk P. Huttner W.B. et al.Somatic stem cell marker prominin-1/CD133 Is expressed in embryonic stem cell-derived progenitors.Stem Cells. 2005; 23: 791-804Crossref PubMed Scopus (109) Google Scholar]. Interestingly, circulating CD133+ stem cells can restore dystrophin expression in the mouse model of Duchenne muscular dystrophy, underlining their potential therapeutic effect [[17]Torrente Y. Belicchi M. Sampaolesi M. Pisati F. Meregalli M. D'Antona G. et al.Human circulating AC133(+) stem cells restore dystrophin expression and ameliorate function in dystrophic skeletal muscle.J Clin Invest. 2004; 114: 182-195Crossref PubMed Scopus (322) Google Scholar]. The CD133 positive cell population described here expresses the common leucocyte antigen CD45, the monocyte antigen CD14 and produces colony-forming units of the granulocytic and monocytic lineages. These data are reminiscent of studies showing that human peripheral blood monocytes harbouring CD14 and CD45 can differentiate in vitro at a clonal level into the three embryonic layers [[18]Zhao Y. Glesne D. Huberman E. A human peripheral blood monocyte-derived subset acts as pluripotent stem cells.Proc Natl Acad Sci U S A. 2003; 100: 2426-2431Crossref PubMed Scopus (441) Google Scholar] and in vivo into hepatocytes after a required in vitro reprogrammation period [[19]Ruhnke M. Ungerfroren H. Nussler A. Martin F. Brulport M. Schormann W. et al.Differentiation of in vitro-modified human peripheral blood monocytes into hepatocyte-like and pancreatic islet-like cells.Gastroenterology. 2005; 128: 1774-1786Abstract Full Text Full Text PDF PubMed Scopus (169) Google Scholar]. However, in this latter recent study, these monocytic cells do not express CD133. But are the cells mobilized by liver resection able to give rise to functional hepatocytes? To answer this question, Gehling et al placed immunomagnetically selected CD133+ cells on fibronectin-coated slides in a hepatocyte differentiation medium. The authors conclude that the majority of cells express some hepatocyte markers such as cytokeratin 8, α-fetoprotein and human albumin after 21 days of culture. This expression is confirmed at transcriptional level by RT-PCR, whereas total blood cells obtained after partial hepatectomy or CD133− selected cells do not express these genes. These data do not prove that these cells are true functional hepatocytes but suggest that at least some of them harbour some liver-cell markers after differentiation in vitro, outside any fusion event with hepatocytes. It cannot be excluded however that a minority of cells in this CD133+ heterogeneous population has been selected in culture to express hepatocyte-specific genes. Altogether, these data raise two main questions: Where do these cells come from and are they able, as suggested by the authors, to help liver regeneration? Two origins of these cells can be considered: bone marrow and the remnant liver itself. Among all the studies suggesting the existence of a circulating hepatic progenitor cell, none, including this one, clearly shows its origin. The contribution of bone marrow cells to liver regeneration after partial hepatectomy has been demonstrated in lethally irradiated mice rescued with a bone marrow expressing the GFP marker. In this study, the repopulating GFP+ liver cells were endothelial for 70% and Küpffer cells for 30%. No GFP+ cholangiocytes nor hepatocytes were found [[20]Fujii H. Hirose T. Oe S. Yasuchika K. Azuma H. Fujikawa T. et al.Contribution of bone marrow cells to liver regeneration after partial hepatectomy in mice.J Hepatol. 2002; 36: 653-659Abstract Full Text Full Text PDF PubMed Scopus (136) Google Scholar]. We can therefore reasonably suggest that if bone marrow cells help liver regeneration after hepatectomy, transdifferentiation poorly accounts for this help, at least in rodents! Could these CD133+ cells be of therapeutic interest anyway? In a recent study, autologous CD133+ bone marrow cells have been administered intraportally after portal vein embolization (PVE) in 3 patients suffering from liver carcinomas. Liver regeneration of the remnant hepatic segments was quantified using computerized tomography scan volumetry and compared to a group of three patients subjected to PVE without cell transplantation. Results indicate a 2.5 fold increase in the proliferation rate in the group that had received CD133+ cells [[21]amEsch II, J.S. Knoefel W.T. Klein M. Ghodsizad A. Fuerst G. Poll L.W. Portal application of autologous CD133+ bone marrow cells to the liver: a novel concept to support hepatic regeneration.Stem Cells. 2005; 23: 463-470Crossref PubMed Scopus (241) Google Scholar]. Unfortunately, the mechanisms involved in this effect and particularly the fate of these injected cells was not investigated. The potential of mobilized bone marrow cells to enhance liver regeneration after acute or chronic liver injury has been studied in rodents. While G-CSF increases bone marrow contribution to the liver, ameliorates the histological damage, accelerates regeneration and enhances the survival rate of the animals, this therapeutic effect seems more due to the promotion of endogenous repair mechanisms and increased proliferation of resident hepatocytes than to differentiation [[22]Yannaki E. Athanasiou E. Xagorari A. Constantinou V. Batsis I. et al.G-CSF-primed hematopoietic stem cells or G-CSF per se accelerate recovery and improve survival after liver injury, predominantly by promoting endogenous repair programs.Exp Hematol. 2005; 33: 108-119Abstract Full Text Full Text PDF PubMed Scopus (186) Google Scholar]. HGF (Hepatocyte Growth Factor) induction or participation of cells of bone marrow origin expressing IL-6 could be responsible for this beneficial effect. Transplantation of IL6−/− mice with IL-6+/+ bone marrow restores the regenerative response of these mutant mice after partial hepatectomy [[23]Aldeguer X. Debonera F. Shaked A. Krasinkas A.M. Gelman A.E. Que X. et al.Interleukin-6 from intrahepatic cells of bone marrow origin is required for normal murine liver regeneration.Hepatology. 2002; 35: 40-48Crossref PubMed Scopus (109) Google Scholar]. Therefore, mobilized bone marrow stem cells can trigger endogenous organ regeneration in providing trophic factors, as it has been described for pancreas [[24]Hess D. Li L. Martin M. Sakano S. Hill D. Strutt B. et al.Bone marrow-derived stem cells initiate pancreatic regeneration.Nat Biotechnol. 2003; 21: 763-770Crossref PubMed Scopus (547) Google Scholar] or in promoting survival pathways of resident cells, as recently demonstrated for infarcted heart [[25]Harada M. Qin Y. Takano H. Minamino T. Zou Y. Toko H.. et al.G-CSF prevents cardiac remodeling after myocardial infarction by activating the Jak-Stat pathway in cardiomyocytes.Nat Med. 2005; 11: 305-311Crossref PubMed Scopus (502) Google Scholar]. Can we draw a conclusion from all these data? Looking at the recent literature on stem cells, it seems that time between bench and bedside becomes almost virtual… Consequently, when a clinical effect is observed with stem cells, the underlying mechanisms are frequently not understood. Therefore, before using CD133+ mobilized cells in regenerative cell-based clinical trials, it should be demonstrated that they robustly induce in vivo liver regeneration in preclinical rodent models." @default.
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• W2014567489 title "Mobilizing stem cells to repair liver after surgery: Dream or reality?" @default.
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