Therapeutic effect of mesenchymal stem cells on acute-on-chronic liver failure： A Meta-analysis

Hang DING; Xiaofen LI; Yan XIONG; Yanyan LI; Xiuji CHEN; Xiaolin WANG

doi:10.12449/JCH240822

Volume 40 Issue 8

Aug. 2024

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2024 > 40(8): 1646-1652

PDF( 1767 KB)

Therapeutic effect of mesenchymal stem cells on acute-on-chronic liver failure： A Meta-analysis

DOI: 10.12449/JCH240822

Department of Gastroenterology，Xiangyang Central Hospital，Affiliated Hospital of Hubei University of Arts and Science，Xiangyang，Hubei 441021，China

Research funding:

Natural Science Foundation of Hubei Province (2013CFB385)

More Information

Corresponding author: WANG Xiaolin， 971619429@qq.com （ORCID： 0000-0003-1369-3160）
Received Date: 2023-11-29
Accepted Date: 2024-02-26
Published Date: 2024-08-25

Abstract

Abstract

Objective To systematically evaluate the efficacy and safety of mesenchymal stem cells （MSC） in the treatment of acute-on-chronic liver failure （ACLF）. Methods This study was conducted according to PRISMA guidelines， with the PROSPERO registration number of CRD42024517851. PubMed， Embase， Wanfang Data， VIP， CNKI， CBM， and the Cochrane Library were searched for randomized controlled trials （RCT） and cohort studies on MSC in the treatment of ACLF published up to November 1， 2023， and the articles were screened according to inclusion and exclusion criteria. After data extraction and quality assessment， RevMan 5.3 software was used to perform the Meta-analysis. Results A total of 11 articles involving 803 subjects were included in this meta-analysis. The results showed that for the patients with ACLF， MSC could improve 8-week survival rate （odds ratio ［OR］=2.71， 95% confidence interval ［CI］： 1.58‍ ‍—‍ ‍4.67， P=0.000 3）， 12-week survival rate （OR=2.24， 95%CI： 1.36‍ ‍—‍ ‍3.69， P=0.001）， 24-week survival rate （OR=2.09， 95%CI： 1.37‍ ‍—‍ ‍3.17， P=0.000 6）， and 48-week survival rate （OR=2.09， 95%CI： 1.29‍ ‍—‍ ‍3.40， P=0.003） and reduce 12-week Model for End-Stage Liver Disease （MELD） score （mean difference ［MD］=-3.27， 95%CI： -6.07 to -0.48， P=0.02） and 24-week MELD score （MD=-2.24， 95%CI： -3.16 to -1.33， P<0.000 01）； it could also reduce the level of total bilirubin after 4 weeks of treatment （MD=-36.86， 95%CI： -48.72 to -25.01， P<0.000 01） and increase 4-week albumin level （MD=2.11， 95%CI： 0.62‍ ‍—‍ ‍3.61， P=0.006） and 24-week albumin level （MD=3.54， 95%CI： 2.06‍ ‍—‍ ‍5.02， P<0.000 01）. Adverse events were evaluated in 6 studies， with no serious adverse events. Conclusion MSC have a good safety in treatment and can improve the survival rate of patients and enhance liver function to some extent， and therefore， it holds promise for clinical application.
- Acute-On-Chronic Liver Failure,
- Mesenchymal Stem Cells,
- Treatment Outcome,
- Meta-Analysis

FullText(HTML)

References(26)

References

[1]	SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific association for the study of the liver(APASL): An update[J]. Hepatol Int, 2019, 13( 4): 353- 390. DOI: 10.1007/s12072-019-09946-3.
[2]	Group of Stem Cell Engineering, Medical Engineering Society of Chinese Medical Association. Expert consensus on standardized treatment of decompensated liver cirrhosis with stem cell transplantation(2021)[J]. J Clin Hepatol, 2021, 37( 7): 1540- 1544. DOI: 10.3969/j.issn.1001-5256.2021.07.012. 中华医学会医学工程学分会干细胞工程专业学组. 干细胞移植规范化治疗肝硬化失代偿的专家共识(2021)[J]. 临床肝胆病杂志, 2021, 37( 7): 1540- 1544. DOI: 10.3969/j.issn.1001-5256.2021.07.012.
[3]	LIU JX, GAO JF, LIANG ZX, et al. Mesenchymal stem cells and their microenvironment[J]. Stem Cell Res Ther, 2022, 13( 1): 429. DOI: 10.1186/s13287-022-02985-y.
[4]	LI YH, XU Y, WU HM, et al. Umbilical cord-derived mesenchymal stem cell transplantation in hepatitis B virus related acute-on-chronic liver failure treated with plasma exchange and entecavir: A 24-month prospective study[J]. Stem Cell Rev Rep, 2016, 12( 6): 645- 653. DOI: 10.1007/s12015-016-9683-3.
[5]	LIN BL, CHEN JF, QIU WH, et al. Allogeneic bone marrow-derived mesenchymal stromal cells for hepatitis B virus-related acute-on-chronic liver failure: A randomized controlled trial[J]. Hepatology, 2017, 66( 1): 209- 219. DOI: 10.1002/hep.29189.
[6]	SCHACHER FC, MARTINS PEZZI DA SILVA A, SILLA LMDR, et al. Bone marrow mesenchymal stem cells in acute-on-chronic liver failure grades 2 and 3: A phase I-II randomized clinical trial[J]. Can J Gastroenterol Hepatol, 2021, 2021: 3662776. DOI: 10.1155/2021/3662776.
[7]	SHI M, ZHANG Z, XU RN, et al. Human mesenchymal stem cell transfusion is safe and improves liver function in acute-on-chronic liver failure patients[J]. Stem Cells Transl Med, 2012, 1( 10): 725- 731. DOI: 10.5966/sctm.2012-0034.
[8]	XU WX, HE HL, PAN SW, et al. Combination treatments of plasma exchange and umbilical cord-derived mesenchymal stem cell transplantation for patients with hepatitis B virus-related acute-on-chronic liver failure: A clinical trial in China[J]. Stem Cells Int, 2019, 2019: 4130757. DOI: 10.1155/2019/4130757.
[9]	CHEN X, CHEN ZL, DONG J, et al. Efficacy of human umbilical cord-derived mesenchymal stem cell transplantation at base of double plasma molecular absorption system in treamtment of patients with acute-on-chronic liver failure[J]. J Pract Hepatol, 2020, 23( 4): 544- 547. DOI: 10.3969/j.issn.1672-5069.2020.04.023. 陈曦, 陈照林, 董静, 等. 脐带间充质干细胞联合双重血浆分子吸附治疗慢加急性肝衰竭患者临床效果初步观察[J]. 实用肝脏病杂志, 2020, 23( 4): 544- 547. DOI: 10.3969/j.issn.1672-5069.2020.04.023.
[10]	LIU B, DONG J, ZHANG JF, et al. Efficacy of human umbilical cord-derived mesenchymal stem cells in treatment of patients with subacute-on-chronic liver failure[J]. J Pract Hepatol, 2013, 16( 1): 29- 31. DOI: 10.3969/j.issn.1672-5069.2013.01.010. 刘波, 董静, 张骏飞, 等. 人脐带间充质干细胞治疗慢加急性肝衰竭患者近期疗效与安全性分析[J]. 实用肝脏病杂志, 2013, 16( 1): 29- 31. DOI: 10.3969/j.issn.1672-5069.2013.01.010.
[11]	SONG Y, WANG F. Efficacy of transhepatic artery autologous bone marrow stem cell transplantation in the treatment of patients with hepatitis B-induced acute-on-chronic liver failure[J]. J Pract Hepatol, 2020, 23( 3): 388- 391. DOI: 10.3969/j.issn.1672-5069.2020.03.022. 宋玉, 王芳. 自体骨髓干细胞移植治疗慢加急性乙型肝炎肝衰竭患者疗效初步研究[J]. 实用肝脏病杂志, 2020, 23( 3): 388- 391. DOI: 10.3969/j.issn.1672-5069.2020.03.022.
[12]	YAN HJ, ZHANG SQ, ZHAO WJ. Therapeutic efficacy of autologous bone marrow stem cell transplantation for treatment of patients with hepatitis B-induced acute-on-chronic liver failure[J]. J Pract Hepatol, 2019, 22( 1): 81- 84. DOI: 10.3969/j.issn.1672-5069.2019.01.022. 闫焕杰, 张淑芹, 赵文静. 自体骨髓干细胞移植治疗慢加急性乙型肝炎肝衰竭患者疗效初步研究[J]. 实用肝脏病杂志, 2019, 22( 1): 81- 84. DOI: 10.3969/j.issn.1672-5069.2019.01.022.
[13]	YANG L, MA YJ, LIU GJ, et al. Study of human umbilical cord derived mesenchymal stem cells in treatment of HBV-related acute-on-chronic liver failure[J]. J Med Res, 2017, 46( 6): 151- 153. DOI: 10.11969/j.issn.1673-548X.2017.06.039. 杨丽, 马英杰, 刘桂举, 等. 脐血间充质干细胞治疗慢性乙型肝炎加急性肝衰竭的疗效分析[J]. 医学研究杂志, 2017, 46( 6): 151- 153. DOI: 10.11969/j.issn.1673-548X.2017.06.039.
[14]	PENG L, XIE DY, LIN BL, et al. Autologous bone marrow mesenchymal stem cell transplantation in liver failure patients caused by hepatitis B: short-term and long-term outcomes[J]. Hepatology, 2011, 54( 3): 820- 828. DOI: 10.1002/hep.24434.
[15]	FAN Q, LI Z. Liver transplantation for acute-on-chronic liver failure[J]. Ogran Transplant, 2022, 13( 3): 333- 337. DOI: 10.3969/j.issn.1674-7445.2022.03.008. 范祺, 李照. 慢加急性肝衰竭的肝移植治疗[J]. 器官移植, 2022, 13( 3): 333- 337. DOI: 10.3969/j.issn.1674-7445.2022.03.008.
[16]	FORBES SJ, GUPTA S, DHAWAN A. Cell therapy for liver disease: From liver transplantation to cell factory[J]. J Hepatol, 2015, 62( 1 Suppl): S157- S169. DOI: 10.1016/j.jhep.2015.02.040.
[17]	ZHANG B, DILIHUMAER ZYE, ZHANG SY, et al. Progress on pathogenesis and medical treatment of hepatitis B virus-related chronic and acute liver failure[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 1): 28- 33. DOI: 10.3969/j.issn.1674-7380.2023.01.005. 张斌, 迪丽胡玛尔·扎依尔, 张诗雨, 等. 乙型肝炎相关慢加急性肝衰竭发病机制及治疗进展[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 1): 28- 33. DOI: 10.3969/j.issn.1674-7380.2023.01.005.
[18]	DONG JL, CHEN Y. Prognostic grade of acute-on-chronic liver failure: Different outcomes of the same disease[J]. J Clin Hepatol, 2021, 37( 9): 2030- 2032. DOI: 10.3969/j.issn.1001-5256.2021.09.006. 董金玲, 陈煜. 慢加急性肝衰竭长期预后转归的等级分析: 同病不同结局[J]. 临床肝胆病杂志, 2021, 37( 9): 2030- 2032. DOI: 10.3969/j.issn.1001-5256.2021.09.006.
[19]	WONG F, PIANO S, SINGH V, et al. Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure[J]. J Hepatol, 2021, 74( 2): 330- 339. DOI: 10.1016/j.jhep.2020.07.046.
[20]	SHI M, LI YY, XU RN, et al. Mesenchymal stem cell therapy in decompensated liver cirrhosis: A long-term follow-up analysis of the randomized controlled clinical trial[J]. Hepatol Int, 2021, 15( 6): 1431- 1441. DOI: 10.1007/s12072-021-10199-2.
[21]	WENG WZ, CHEN JF, MEI YY, et al. Treatment effect of allogeneic bone marrow mesenchymal stem cells transplantation to patients in different phase of HBV acute-on-chronic liver failure[J]. J Sun Yat-Sen Univ(Med Sci), 2013, 34( 3): 422- 428. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2013.0067. 翁伟镇, 陈俊峰, 梅咏予, 等. 异体骨髓间充质干细胞治疗不同时相慢加急性乙肝肝衰竭患者的疗效[J]. 中山大学学报(医学科学版), 2013, 34( 3): 422- 428. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2013.0067.
[22]	ZHOU GP, JIANG YZ, SUN LY, et al. Therapeutic effect and safety of stem cell therapy for chronic liver disease: A systematic review and meta-analysis of randomized controlled trials[J]. Stem Cell Res Ther, 2020, 11( 1): 419. DOI: 10.1186/s13287-020-01935-w.
[23]	LALU MM, MCINTYRE L, PUGLIESE C, et al. Safety of cell therapy with mesenchymal stromal cells(SafeCell): A systematic review and meta-analysis of clinical trials[J]. PLoS One, 2012, 7( 10): e47559. DOI: 10.1371/journal.pone.0047559.
[24]	CAPLAN AI. Mesenchymal stem cells: Time to change the name![J]. Stem Cells Transl Med, 2017, 6( 6): 1445- 1451. DOI: 10.1002/sctm.17-0051.
[25]	LI JJ, XUN YH. Research advances on the immunomodulatory role of mesenchymal stem cells and their exosomes in acute liver failure[J]. Zhejiang Med J, 2023, 45( 21): 2338- 2343. DOI: 10.12056/j.issn.1006-2785.2023.45.21.2023-731. 李佳静, 荀运浩. 间充质干细胞及其外泌体在急性肝衰竭中免疫调节作用的研究进展[J]. 浙江医学, 2023, 45( 21): 2338- 2343. DOI: 10.12056/j.issn.1006-2785.2023.45.21.2023-731.
[26]	WANG ZR, ZHU B, YU LM, et al. Role of stem cell-derived exosomes in treatment of liver diseases[J]. J Clin Hepatol, 2023, 39( 3): 699- 706. DOI: 10.3969/j.issn.1001-5256.2023.03.034. 王卓然, 朱冰, 余丽梅, 等. 干细胞衍生的外泌体在肝脏疾病治疗中的作用[J]. 临床肝胆病杂志, 2023, 39( 3): 699- 706. DOI: 10.3969/j.issn.1001-5256.2023.03.034.

Relative Articles

[1]	Jianxing LUO, Yang ZHANG, Ne XIANG, Xiaoyu HU. Efficacy and safety of microwave ablation versus hepatic resection in treatment of hepatocellular carcinoma with liver cirrhosis： A Meta-analysis[J]. Journal of Clinical Hepatology, 2024, 40(9): 1807-1815. doi: 10.12449/JCH240915
[2]	Zhangpeng WANG, Guangxu JING, Huanhuan LUO, Hongfei DONG, Xuyang WANG, Hongyu SUN, Lijun TANG. Efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in early treatment of acute pancreatitis： A Meta－analysis[J]. Journal of Clinical Hepatology, 2023, 39(9): 2158-2168. doi: 10.3969/j.issn.1001-5256.2023.09.019
[3]	Yin WeiLi, Lian Jia, Xiao ShiXiang, Xiang HuiLing, Liu Ying, Qian BaoXin, Wang Tao, Li Ying, Jin YuXia, Han Tao. Clinical effect of drug-eluting beads and conventional transcatheter arterial chemoembolization in treatment of unresectable liver cancer: A meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(6): 1270-1275. doi: 10.3969/j.issn.1001-5256.2019.06.018
[4]	Li Jing, Jiang Yong, Zhang Xu. Efficacy of transjugular intrahepatic portosystemic shunt versus endoscopic cyanoacrylate injection in treatment of gastric variceal bleeding: A meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(2): 349-353. doi: 10.3969/j.issn.1001-5256.2019.02.021
[5]	Li Min, Dan Shan, Wu XiaoNing, Kong YuanYuan, Ou XiaoJuan, You Hong, Jia JiDong. Clinical effect of interferon in treatment of genotype B or C chronic hepatitis B patients: A meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(6): 1256-1261. doi: 10.3969/j.issn.1001-5256.2019.06.015
[6]	Shi Ke, Wang XiaoJing, Wang XianBo. Clinical effect of Jinlong capsules combined with Western medicine treatment in treatment of primary liver cancer:A Meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(11): 2495-2501. doi: 10.3969/j.issn.1001-5256.2019.11.021
[7]	Yu JiShang, Wu Fan, Tan GuoQian, Wang BaiLin. Clinical effect of mesohepatectomy versus hemihepatectomy in treatment of centrally located hepatocellular carcinoma: A Meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(5): 1008-1013. doi: 10.3969/j.issn.1001-5256.2019.05.015
[8]	Sun YuanPei, Guo XiaoXia. Clinical effect of probiotics in treatment of liver cirrhosis: a Meta-analysis[J]. Journal of Clinical Hepatology, 2018, 34(1): 73-79. doi: 10.3969/j.issn.1001-5256.2018.01.015
[9]	Yan JinZhu, Weng Hong, Zhang Chao, Wang Yuan, Yang Jian, Peng XinYu. Clinical effect and safety of percutaneous radiofrequency ablation versus microwave ablation in treatment of hepatocellular carcinoma:a Meta-analysis[J]. Journal of Clinical Hepatology, 2018, 34(5): 1025-1032. doi: 10.3969/j.issn.1001-5256.2018.05.020
[10]	Hou Jie, Liu LiXin. Effect of probiotics in treatment of nonalcoholic fatty liver disease: A Meta-analysis[J]. Journal of Clinical Hepatology, 2018, 34(12): 2624-2630. doi: 10.3969/j.issn.1001-5256.2018.12.023
[11]	Mao HaiYing, Kang Tao, Yao Ling, Chen Qin. Efficacy of glycyrrhizin in patients with chronic severe hepatitis B:a meta-analysis[J]. Journal of Clinical Hepatology, 2015, 31(1): 63-67. doi: 10.3969/j.issn.1001-5256.2015.01.014
[12]	Zhang WenWen, Qi XingShun, Guo XiaoZhong. Mirabilite umbilical compress in treatment of ascites in liver cirrhosis: a meta-analysis[J]. Journal of Clinical Hepatology, 2015, 31(6): 947-950. doi: 10.3969/j.issn.1001-5256.2015.06.028
[13]	Yu Yuan, Yang ZongGuo, Chen ChiChi, Lu YunFei, Xu QingNian, Chen XiaoRong. Efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis: a Meta-analysis[J]. Journal of Clinical Hepatology, 2015, 31(10): 1630-1633. doi: 10.3969/j.issn.1001-5256.2015.10.017
[14]	Zhou LiJun. Clinical efficacy of Liuweiwuling tablets in treatment of non- alcoholic fatty liver disease: a meta- analysis[J]. Journal of Clinical Hepatology, 2015, 31(7): 1068-1072. doi: 10.3969/j.issn.1001-5256.2015.07.017
[15]	Zhang YuHuai, Luo ZhangJiang. Efficacy and safety of octreotide in treatment of hepatocellular carcinoma: a meta-analysis[J]. Journal of Clinical Hepatology, 2015, 31(6): 922-926. doi: 10.3969/j.issn.1001-5256.2015.06.023
[16]	Wu JiYuan, Zhang DongQin, Zhang HaiYue, Wang LuWen, Gong ZuoJiong. Efficacy and safety of transjugular intrahepatic portosystemic shunt versus endoscopic therapy for prevention of variceal rebleeding in patients with cirrhosis: a meta-analysis[J]. Journal of Clinical Hepatology, 2014, 30(12): 1272-1278. doi: 10.3969/j.issn.1001-5256.2014.12.010
[17]	Chen XiaoHong, Wu ZongYing, Wang YiPing, Ceng Chao, Pan Tao. Fatality and adverse event rates of prostaglandin E in treating acute liver failure: a meta- analysis[J]. Journal of Clinical Hepatology, 2013, 29(9): 681-684. doi: 10.3969/j.issn.1001-5256.2013.09.012
[18]	Yang Jun, Meng QingHua, Yu HongWei. Sorafenib combined with thanscatheter artierial chemoembolzation in treatment of advanced hepatocellular carcinoma: Meta analysis[J]. Journal of Clinical Hepatology, 2013, 29(10): 764-768. doi: 10.3969/j.issn.1001-5256.2013.10.011
[19]	Ye Gang, Ma Yu, Tang ChengJia, Du ChengYou. Clinical outcomes of laparoscopic hepatectomy and open hepatectomy for hepatocellular carcinoma: A meta-analysis[J]. Journal of Clinical Hepatology, 2013, 29(3): 184-190.
[20]	Song LiWen, Zhao GuiMing, Cao WuKui, Lu ChengZhen. Meta analysis of the comparison of the efficacy of lamivudine and telbivudine in the treatment of chronic hepatitis B[J]. Journal of Clinical Hepatology, 2011, 27(9): 955-961.

Supplements(0)

Cited By

Cited by
Periodical cited type(1)
1. 王岁晶，丁洋，张悦清，吴军. 慢加急性肝衰竭的诊治进展. 中国实用内科杂志. 2024(11): 947-952 .
Other cited types(0)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(6) / Tables(1)

Get Citation

PDF

XML

Article Metrics

Article views (364) PDF downloads(33)

Therapeutic effect of mesenchymal stem cells on acute-on-chronic liver failure： A Meta-analysis

DOI: 10.12449/JCH240822

Abstract

References

Relative Articles

Cited by

Periodical cited type(1)

Other cited types(0)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Therapeutic effect of mesenchymal stem cells on acute-on-chronic liver failure： A Meta-analysis

DOI: 10.12449/JCH240822

Abstract

References

Relative Articles

Cited by

Periodical cited type(1)

Other cited types(0)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content