Commentary

It is wellknownfor us that stem cellsismore effective in the treatment of liver cirrhosis[1]. Since the different conditions of cirrhosis have different pathophysiological changes, it is necessary to choose adequate transplantation route to achieve better curative effect. That is to say, for liver cirrhosis with different degree inflammation, different transplantation routes should be used in treatment. If it is active in liver cirrhosis, and liver inflammation is high or cirrhosis is associated with acute on chronic liver failure, peripheral vascular administration of stem cells may be superior to local interventional therapy for cirrhotic patients[2]. This is because the inflammatory factors in the liver and peripheral blood has high concentration, while the liver microenvironment is poor, peripheral blood vessel administration makes it easier for the stem cells to home smoothly, and release the related factors through paracrine action to suppress inflammation inside and outside the liver, while avoiding excessive stem cell death from the liver. When allogeneic stem cells are used to treat human cirrhotic patients, the choice of transplantation route for treatment may vary. Probably relative to small experimental animals, if being administered to human through peripheral blood vessels, the stem cells are far removed, and because human are more immune, rejection is severe, causing excessive consumption of stem cells. If local administration, it can reduce the distance loss, and because the liver is immune privilege organ[3], the rejection is light. Although poor liver microenvironment can lead to stem cell death, and invasive intervention may have damage to the liver, but from the comprehensive effect, local intervention may be better[4]. In the case of human cirrhosis with acute liver disease, the question of which route of transplantation is optimal remains to be confirmed by more clinical trials. If cirrhosis is quiescent, or cirrhosis is active but without obvious inflammation, stem cell local treatment is recommended. This is because the lesion is moderated and confined to the liver, and peripheral inflammatory factor level is low which lead to the stem cell homing effect being reduced, then local intervention may be superior to peripheral vascular administration[5]. In clinical practice, the interventional method of hepatic artery is usually used. And there are some risks associated with the use of portal vein interventional procedures in clinical treatment. So, if clinical studies have shown that the effect of the hepatic artery and portal vein approach is of little difference, the hepatic artery approach is recommended.

1.       Berardis S, Sattwika DP, Najimi M, Sokal EM(2015)Use of mesenchymal stem cells to treat liver fibrosis: current situation and future prospects. World J Gastroenterol 21:742-758.

2.       Li DL, He XH, Zhang SA, Fang J, Chen FS,et al.(2013)Bone marrow-derived mesenchymal stem cells promote hepatic regeneration after partial hepatectomy in rats.Pathobiology 80:228-234.

3.       Sánchez-Fueyo A, Strom TB(2004)Immunological tolerance and liver transplantation.J Hepatol 41:698-705.

4.       Deng L, Kong X, Liu G, Li C, Chen H, et al.(2016)Transplantation of adipose-derived mesenchymal stem cells efficiently rescues thioacetamide-induced acute liver failure in mice. Transplant Proc 48:2208-2215.

Zhong Y, Tang Z, Xu R, Lin N, Deng M,et al.(2013)Effect of transplantation route on stem cell migration to fibrotic liver of rats via cellular magnetic resonance imaging.Cytotherapy 15:1266-1274.