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• W2077174354 abstract "Hepatitis B, hepatitis C, alcohol consumption, and other chronic liver diseases lead to the development of liver fibrosis and cirrhosis characterized pathologically by rings of scar tissue that circumscribe areas of injury and interfere with liver function. Because this fibrosis has been considered to be irreversible, the therapy of choice is liver transplantation. However, more recent preclinical evidence suggests that mesenchymal stem cells (MSCs) can be delivered to the liver, where they engraft. Once engrafted, MSCs can differentiate into hepatocytes or serve as paracrine cells that promote the proliferation of endogenous hepatocytes or matrix remodeling (1). The preclinical studies that have been published so far have been conducted primarily in rodents (2–5). In contrast, the study by Avritscher et al (6) published in JVIR was conducted in pigs to enable the use of catheter-based cell delivery. For this study, MSCs were collected from adipose tissue; cultured; engineered to express green fluorescent protein as a cell marker; and characterized by their ability to differentiate into hepatocytes, adipocytes, and chondrocytes. However, neither gene and protein expression nor immunostaining was used to characterize further the identity, functional capacity, or purity of these cells. The cells were delivered via the portal vein into the fibrotic liver of pigs. The porcine model used has been described only more recently (7) and has not been fully characterized in terms of expressing ligands and chemokines needed for MSC attachment and engraftment. An occlusion balloon catheter was used to deliver the MSCs into the portal venous system to facilitate cell retention by providing time for cell adhesion and reducing cell washout. Using these methods, the cells were successfully delivered into the liver as indicated by fluorescence microscopy of biopsy specimens collected 2 hours after cell delivery, but the efficiency of cell delivery is unknown because other organs were not sampled. In addition, it is unclear how long the cells remained in the liver because they were absent 28 days later; it is unclear if the cells underwent necrosis or apoptosis or simply passed downstream, perhaps into another organ. Cell delivery did not affect portal venous pressure; however, it also did not benefit liver function as assessed by various biomarkers. Potential adverse effects of stem cell delivery, including teratoma and tumor formation, were not evaluated or addressed. The authors are to be commended for addressing such an important problem. Although this initial effort demonstrates the role of the interventionalist in sitespecific cell delivery, it also suggests that much more work is needed. Further progress will require a strong collaborative effort between interventionalists, hepatologists, cell and molecular biologists, and others. Such collaboration is certain to lead to much cross-fertilization and to needed therapeutic innovations." @default.
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• W2077174354 date "2013-12-01" @default.
• W2077174354 modified "2023-10-14" @default.
• W2077174354 title "Catheter-based Stem Cell Delivery for Liver Repair: Getting It There Is Half the Battle" @default.
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• W2077174354 doi "https://doi.org/10.1016/j.jvir.2013.09.019" @default.
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