THE old philosophy of 鈥渂ody heal thyself鈥 has been given a new high-tech twist with a treatment for liver failure that uses bone marrow stem cells from the patient鈥檚 own blood.
To obtain the cells, the patient is first given an injection of a chemical called granulocyte colony stimulating factor (GCSF), which stimulates their bone marrow to produce extra stem cells. After five days on the drug, the patient鈥檚 blood is screened for cells bearing the surface protein CD34, which marks them out as stem cells. These are then extracted from the blood, concentrated and injected into the patient鈥檚 portal vein or hepatic artery, both of which feed blood directly to the liver.
No one is sure exactly where these cells go or what they do, but they appear to home in on, and help repair, any liver damage. The liver function and general health of three out of five patients given the treatment improved significantly within two months of treatment, according to liver surgeon Nagy Habib of Imperial College London, who heads the team conducting the trial. He presented the findings at a seminar in London last month hosted by the London Regenerative Medicine Network. The two patients whose health did not improve showed no ill effects from the treatment.
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One patient in his early 60s had a chronic condition called primary sclerosing cholangitis, which progressively damages the liver鈥檚 bile ducts. 鈥淎t the outset, he had jaundice, was vomiting blood and had ascites 鈥 swelling caused by fluid around the liver,鈥 Habib says. Two months later, his jaundice had disappeared, while levels of albumin 鈥 a marker of healthy liver function 鈥 rose to normal. Magnetic resonance scans showed that the swelling had also gone down.
鈥淣o one is sure exactly where these cells go or what they do, but they appear to home in on, and help repair, liver damage鈥
Habib鈥檚 team are hopeful that they will gain approval to conduct a follow-up trial on 18 more people with liver disease. This time, Habib hopes to refine the technique by isolating specialised stem cells that he calls 鈥渓ivercytes鈥 and multiplying them outside the body for around two weeks before re-injecting them. An added benefit of the treatment is that the stem cells can be harvested from the blood rather than from bone marrow, which is a painful procedure.
Other researchers in Japan are close to publishing the results of a similar trial on 10 patients using stem cells to treat liver failure (New 杏吧原创, 18 December 2004, p 6), though their technique involves extracting the cells directly from the bone marrow.