Chronic liver disease is the fifth biggest killer in the world. When a serious damage occurs, the liver loses the ability to repair itself which becomes a life-threatening condition. The only treatment currently available is a liver transplant. Would regenerative medicine be able to help?
The liver is a multifunctional organ that plays a role in digestion, blood sugar control, blood clotting factors for healing, making amino acids, increasing red blood cell growth, fat and cholesterol transport and the removal of waste, especially toxic exposures and the metabolisation of medications into their active ingredients.
Causes of Liver Disease
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- Hepatitis: viral, toxic, autoimmune or hereditary conditions.
- Alcoholic liver disease including fatty liver disease, alcoholic hepatitis and cirrhosis.
- Fatty liver disease may lead to inflammatory disease and then to cirrhosis.
- Cirrhosis is the formation of fibrous tissue in the place of dead liver cells and causes chronic liver failure
- Primary liver cancer.
- Primary biliary cirrhosis is a serious autoimmune disease of the bile capillaries.
- Primary sclerosing cholangitis.
- Budd-Chiari syndrome caused by occlusion of the hepatic vein, which in some cases may lead to cirrhosis.
- Hereditary diseases (hemochromatosis, involving accumulation of iron in the body, and Wilson’s disease, which causes the body to retain copper, Alfa 1-antitripsin deficiency and glycogen storage disease type II).
- Transthyretin-related amyloidosis.
- Gilbert’s syndrome.
Cirrhosis is a term that describes permanent scarring of the liver. Normal liver cells are replaced by scar tissue that cannot perform healthy liver function.
Acute liver failure may be life threatening and at one time it was deemed non reversible; however, stem cell regeneration has proven most effective.
The majority of the liver (80 %) is made up of liver cells called hepatocytes. These cells have an average lifespan of 150 days, which means that the liver is constantly renewing itself under normal conditions. It is the only organ in the body that can easily replace damaged cells, but if enough cells are lost, the liver may not be able to meet the needs of the body that leads to liver failure.
The liver is a regenerative organ, but it is limited in this ability depending on the energy reserve needed to heal and the host of responsibilities that must be attended to daily regardless of this central organ’s ability to keep up the pace.
Liver disease can progress to cirrhosis and liver failure. Associated complications include increased risk of bleeding and infection, malnutrition and weight loss, decreased cognitive function over time and an increased risk of cancer.
Reinforcing therapies can transfer us from a condition of day-to-day survival to ones in which we feel a better quality of life.
Treatment
Although the liver can be recovered, there are no warning signs it is failing until it is too late. Once the line is crossed between the chronic liver disease and the final stage or liver failure, there are fewer options. Up to now, there is no «liver dialysis» that can rehabilitate liver function in the way that kidney failure is treated. Transplantation is currently the only effective treatment for liver failure, but it has many drawbacks, including the risk of rejection, risks associated with surgery, and a shortage of donors. It is estimated that for every donor organ there are 30 patients on a waiting list, and many people die from end-stage liver disease waiting for a donor organ.
Although dozens of patients with acute liver failure have received hepatocyte transplants from cadaveric donors, with some improvement in liver function, the effects were short lived and there was no overall survival benefit. The major challenges with this approach – shortage of cadaveric donors and immune suppression of patients – are essentially the same as for whole organ transplants.
How Stem Cells can help in liver disease treatment?
As far back as 2000, researchers showed that hepatocytes could grow in the body on non-liver cell sources. This phenomenon is called transdifferentiation. Today, we clinically use donated or autologous (from the patient) adipose tissue stem cells for treating liver disease. When introduced to the patient’s body, stem cells are transdifferentiating into hepatocytes as as well as producing soluble factors that promote regeneration and repair. There is also the possibility that the stem cells may be fusing with resident hepatocytes to direct their regeneration.
Mesenchymal stem cells
Mesenchymal stem cells are found throughout the adult body in tissues such as bone, muscle, cartilage and fat.
Mesenchymal stem cells are among the most ‘multipotent’ stem cells that remain in our bodies after birth. This means that they are still able to make a variety of different cell types.
Many trials have shown that patients with liver cirrhosis have benefited from autologous adipose tissue derived mesenchymal stem cells. We have proven results reversing the effects of hepatitis, cirrhosis and liver damage due to chemo and other drug therapies.
Advantages of Regenerative Stem Cell therapy for liver disease:
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- Side effects and rejection free (use the patient’s very own stem cells from their abdomen)
- Avoidance of any allergic and immune reactions (own cells suit chromosomal and genetic structure)
- Does not require general anesthesia
- No risk of contamination by transmissible diseases
- Small quantity of fat tissue is needed (that is why after activation process the stem cells can be at once injected to patient without necessity of growing them on substances. Embryonic stem cells are grown during several months)
- The period of time between getting lipoaspirate and injection of the activated stem cells is only a few hours
- Adipose tissue stem cells are easily accessible