The effectiveness of autologous mesenchymal stem cells in the treatment of liver cirrhosis and the method of their visualization in the patient’s body

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Abstract


Abstract. The effectiveness of the influence of autologous mesenchymal stem cells on the function of liver tissue in liver cirrhosis of alimentary etiology is considered, as well as the possibility of visualization of the introduced cell structures with subsequent cytological confirmation. To be able to track autologous mesenchymal stem cells introduced in the patient’s body, they were labeled with iron oxide nanoparticles. Visualization of the introduced cell structures was performed using magnetic resonance imaging and ultrasound examination of the liver. 6 months after the cell therapy, clinical and biochemical blood tests, lidocaine test results, elastography indicators were evaluated, and the dynamics of hepatic encephalopathy was evaluated. The effectiveness of using autologous mesenchymal stem cells was evidenced by the improvement of the above indicators. Also, 6 months after treatment, a liver tissue biopsy was performed from the sites of fixation of previously introduced cell structures. Histological examination revealed the largest number of labeled cells in the liver micro-nodes, as well as at the borders of micro-nodes and fibrous septa. The use of cell therapy in a patient suffering from liver cirrhosis of alimentary etiology helped to improve the indicators of laboratory and instrumental research methods. No complications were detected during the procedure.


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About the authors

I. E. Kotkas

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: inna.kotkas@yandex.ru

Russian Federation, Saint Petersburg

N. I. Enukashvili

North-Western State Medical University named after I.I. Mechnikov; Institute of Cytology of the Russian Academy of Sciences

Email: inna.kotkas@yandex.ru

Russian Federation, Saint Petersburg; Saint Petersburg

Sh. M. Asadulayev

North-Western State Medical University named after I.I. Mechnikov

Email: inna.kotkas@yandex.ru

Russian Federation, Saint Petersburg

A. V. Chubar’

Institute of Cytology of the Russian Academy of Sciences

Email: inna.kotkas@yandex.ru

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Celiography of patient A. The arrow indicates the right hepatic artery, into which autologous MSCs were injected

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2.
Fig. 2. MRI of the abdominal organs 1 day after the introduction of autologous MSCs into the arterial bed of the liver. The arrow indicates the areas of the liver in which the marked stem cells are visualized

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3.
Fig. 3. Ultrasound of the liver 1 day after the introduction of autologous MSCs into the arterial bed of the liver. The arrow indicates the areas of the liver in which the marked stem cells are visualized

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4.
Fig. 4. The cirrhotic liver of patient A

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5.
Fig. 5. Analysis of the morphofunctional properties of cells containing iron oxide nanoparticles: a - general view of the MSC culture after treatment with IONP 300 μg / ml (scale section - 50 μm). Some of the IONPs are marked with arrows; b - the result of immunophenotyping of MSC cultures after treatment with IONP; c - diagram of the proliferative activity of MSCs not treated with IONP (control) and treated with IONP 300 μg / ml

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6.
Fig. 6. Study of localization of iron oxide nanoparticles in cells by microscopy of preparations stained with iron hexacyanoferrate: a - in MSCs after treatment with IONP 300 μg / ml before transplantation; b - in cells of a histological preparation of a liver biopsy obtained 6 months after transplantation. The scale segment is 50 microns. Some of the IONPs are marked with arrows.

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Copyright (c) 2020 Kotkas I.E., Enukashvili N.I., Asadulayev S.M., Chubar’ A.V.

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