[Mesenchymal stem cells as perspective method of fibrosis/cirrhosis treatment]

THE PURPOSE OF THE REVIEW: Discuss the background and available results of transplantation of bone marrow stem cells as a promising treatment of hepatic fibrosis. KEY PROVISIONS: Actuality of the problem of chronic hepatitis is present due to their progressive course with the formation of liver cirrhosis and a high level of mortality. Conservative treatment of patients with decompensated process requires a liver transplantation that is compounded by the high percentage of graft reinfection in infectious hepatology. It is necessary to study the use of bone marrow-derived stem cells transplantation, because MSCs have certain therapeutic potential, low immunogenicity and the capacity for directional migration. In experimental models MSCs mechanisms of action are shown to limit the progression of liver fibrosis and stimulation of regeneration processes. In clinical studies good tolerability and relative safety of administration of autologous MSCs have reported as well as the positive effects on liver synthetic function, a decrease in the severity of cirrhosis on class Child-Pugh and MELD, reduction in overall mortality are shown. The results of our own prospective pilot study using autologous MSCs from bone marrow in patients with HCV-associated liver cirrhosis are described.

MSCs can exert multiple synergistic effects on the hepatic stellate cells, reduce inflammation in the liver tissue remodeling processes and fibrogenesis. For objective evidence of the clinical benefits of the method, evaluation of long-term efficacy and safety of MSCs, as well as developing rational strategies, further clinical studies are required.