脐带间充质干细胞治疗自身免疫性肝病患者疗效观察

摘要

目的：探讨观察脐带间充质干细胞（UC-MSCs）治疗自身免疫性肝病患者对肝功能和细胞因子水平的影响。方法采用双酶消化法提取产妇脐带组织，进行贴壁分离和传代培养。经外周静脉输注UC-MSCs 8×107个细胞，观察6例自身免疫性肝病患者肝功能的变化以及治疗后安全性情况。采用ELISA法检测血清AFP、IFN-γ和IL-4水平。结果经UC-MSCs治疗后，6例患者均达到临床病情缓解标准；治疗后血清白蛋白水平为（38.85±6.98） g/L，显著高于治疗前水平[（33.51±5.32） g/L，P＜0.05]，治疗后ALT和AST分别为（39.65±18.87） U/L和（35.52±17.24） U/L，显著低于治疗前水平[分别为（69.95±47.96） U/L和（65.71±43.64） U/L，P＜0.05]，但TBIL、ALP和GGT在治疗前后变化无统计学差异；治疗后无严重并发症发生；治疗前基线血清IFN-γ水平为（139.30～219.34） pg/ml，治疗24个月后下降为（116.82～167.65） pg/ml，差异有统计学意义（P=0.0368）；基线IL-4为（29.31～55.23）g/ml，治疗24个月后上升为（43.89～69.99）pg/ml，差异有统计学意义（P=0.0418）。结论 UC-MSCs治疗可明显减轻自身免疫性肝病患者的临床症状，改善肝功能，且安全性好，可能与UC-MSCs纠正免疫功能紊乱有关。%Objective To investigate the safety and efficacy of umbilical cord mesenchymal stem cell (UC-MSCs) transplantation in patients with autoimmune liver diseases (AILD). Methods The 8×107 UC-MSCs were transfused intravenously in six patients with AILD through the peripheral vein. Serum fetoprotein ,interferon-γand interleukin (IL)-4 levels were detected by ELISA. Results After the UC-MSCs therapy,the six patients achieved clinical remission with elevated albumin (ALB) [(38.85±6.98) g/L vs. (33.51±5.32) g/L,P<0.05],and de-creased alanine aminotransferase [ALT,(69.95±47.96) U/L vs. (39.65±18.87) U/L)] and AST [(65.71±43.64) U/L vs.(35.52±17.24) U/L,P<0.05 for both];However,no significant changes in bilirubin,alkaline phosphatase and glu-tamy transpeptidase were observed after the treatment (P>0.05);There were no side effects after the treatment;The baseline serum IFN-γ and IL-4 before the treatment were (139.30~219.34) pg/ml and (29.31~55.23) pg/ml, respectively,and 24 months later,serum IFN-γ levels declined to [(116.82~167.65) pg/ml,P=0.0368] and serum IL-4 levels increased to [(43.89~69.99) pg/ml,P=0.0418]. Conclusion UC-MSCs therapy can effectively attenu-ate the clinical symptoms and improve the liver function in AILD patients without any severe adverse effects ,and the probable mechanism may lie on the correction of immune dysfunction by UC-MSCs.