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Experimental and clinical proof-of-concept to establish stem cell treatment of post-hepatectomy liver failure

Subject Area General and Visceral Surgery
Term from 2019 to 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 428832822
 
Final Report Year 2024

Final Report Abstract

Thrombospondin-1 (THBS1) was identified a negative predictor of liver regeneration after partial hepatectomy (PHx). Yet, the cellular and molecular actions of THBS1 remained largely unknown. We have shown in various mouse and rat models of acute and chronic liver dysfunction that mesenchymal stromal cells (MSC) improved liver function and supported regeneration after PHx. We hypothesized that MSC might interfere with THBS1 and its downstream actions. Therefore, it was the goal to substantiate this interference and unravel cellular and molecular mechanisms involved. In a mouse model of 2/3 PHx, transfusion of MSC ameliorated circulatory and hepatic THBS1. In the liver, MSC lowered the THBS1-mediated increase in TGF-β, an activator of parenchymal plasticity, thereby supporting epithelial integrity and liver regeneration. Mechanistically, MSC attenuated the secretion of THBS1 from thrombocytes and non-parenchymal cells of the liver. MSC reduced the number of thrombocytes in the liver, and simultaneously stimulated their activation. In addition, they attenuated the hepatic recruitment of other inflammatory cells, thus supporting regeneration after PHx. In patients undergoing the ALPPS procedure or partial liver resections, we found, as in mice, the coincidence of high THBS1/TGF-β and the loss of tissue and function homeostasis indicating a causal relationship. This analogy may hence open the clinical perspective to establish MSC therapy to support tissue and functional homeostasis after complex liver surgery. This, however, needs further clinical proof.

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