Liver transplantation is the only life-saving procedure for patients with end-stage liver disease.However,its potential benefits are hampered by many disadvantages,such as the relative shortage of donors,operative ris...Liver transplantation is the only life-saving procedure for patients with end-stage liver disease.However,its potential benefits are hampered by many disadvantages,such as the relative shortage of donors,operative risks,and high costs.These issues have prompted the search for new alternative therapies for irreversible liver disease.Stem cell therapy,with the ability for self-renewal and potential for multilineage differentiation,is a promising alternative approach.Several studies have demonstrated that transplantation of hepatic stem/progenitor cells or hepatocyte-like cells derived from multipotent stem cells leads to donor cell-mediated repopulation of the liver and improved survival rates in experimental models of liver disease.However,a registered clinical application based on stem cell technology will take at least an additional 5 to 10 years because of some limitations;e.g.the lack of suitable cell sources and risk of teratoma formation.This review summarizes the general understanding of the therapeutic potentials of stem cells in liver disease,including the sources,mechanisms,and delivery methods of hepatic stem cells in liver regeneration,and discusses some challenges for their therapeutic application.展开更多
Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalop-athy and impaired synthetic function (international normal-ized ratio of≥1.5) in the absence of ...Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalop-athy and impaired synthetic function (international normal-ized ratio of≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulop-athy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagu-lable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy.展开更多
基金This study was supported by the National Natural Science Foundation of China(Grant NO.81070374,NO.3080112).
文摘Liver transplantation is the only life-saving procedure for patients with end-stage liver disease.However,its potential benefits are hampered by many disadvantages,such as the relative shortage of donors,operative risks,and high costs.These issues have prompted the search for new alternative therapies for irreversible liver disease.Stem cell therapy,with the ability for self-renewal and potential for multilineage differentiation,is a promising alternative approach.Several studies have demonstrated that transplantation of hepatic stem/progenitor cells or hepatocyte-like cells derived from multipotent stem cells leads to donor cell-mediated repopulation of the liver and improved survival rates in experimental models of liver disease.However,a registered clinical application based on stem cell technology will take at least an additional 5 to 10 years because of some limitations;e.g.the lack of suitable cell sources and risk of teratoma formation.This review summarizes the general understanding of the therapeutic potentials of stem cells in liver disease,including the sources,mechanisms,and delivery methods of hepatic stem cells in liver regeneration,and discusses some challenges for their therapeutic application.
基金This work was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under award number K23AA028297(to PHC)and Johns Hopkins University Clinician Scientist Award(to PHC).
文摘Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalop-athy and impaired synthetic function (international normal-ized ratio of≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulop-athy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagu-lable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy.
