Severe alcoholic hepatitis has very high short term mortality. A study done by the Post Graduate Institute of Medical Education and Research has ascertained the fact that patients with serious liver dysfunctions can be treated with the help of stem cell therapy.
The study has been published in American Journal of Gastroenterology online on June 17, 2014. During the course of the study it was found that Granulocyte-colony stimulating factor (G-CSF) was safe and effective in the mobilisation of hematopoietic stem cells and improved liver function as well as survival in patients with severe alcoholic hepatitis.
Dr Virendra Singh, Prof PGI under whom the study was conducted said, “Every year around 60,000 people die in the country due to liver failure. The only treatment available to such patients is liver transplant. However, only about 1,000 lives are saved with liver transplant due to lack of donors. In this scenario stem cell therapy can revolutionise treatment in patients with acute alcoholic hepatitis.” Earlier G-CSF was used to stimulate the bone marrow of a patient to produce stem cells. After that stem cells were cultured externally and later implanted in the affected part of the body. Stem-cells are neo-natal in nature and they get deposited in the injured part of the body to revive it.
However, during the course of this study conducted from July 2010 to June 2102, G-CSF a type of glycoprotein was injected in the patients to stimulate the bone marrow and induce production of pluripotent cells a type of stem cells.
In response to acute or chronic liver injury, bone marrow derived stem cells can spontaneously populate liver and differentiate into hepatic cells. Both animal and human studies have suggested that bone marrow derived circulating pluripotent cells might contribute to hepatic regeneration and repair various forms of acute liver injury.
“In the northern region especially in the State of Punjab around 50 per cent liver patients suffers from acute alcoholic liver cirrhosis, followed by Hepatitis-C which affects around 30 per cent of the patient population. In case of most of the patients, they start to realise the problem when almost 60-70 percent of the liver is damaged,” added Dr Singh. In case of serious liver problems and acute jaundice the thickness of the blood is lowered and in many patients there is water retention in the lower abdomen this pose a risks for invasive stem cell culture treatments or injecting stem cells after externally culturing it.
Also in another study in which the combination of mobilisation with G-CSF, isolation, and direct infusion of bone marrow cells into the liver via hepatic artery of patients did not improve the liver function. Therefore the study which was conducted improvised on the trial to evaluate the safety and efficacy of G-CSF in the treatment of patients with severe alcoholic hepatitis.
In the present research involving 46 patients with alcoholic hepatitis and cirrhosis, G-CSF was injected into patients, 10 shots subcutaneously over a period of 5 days which induced the bone marrow and produced the pluripotent cells within the body. The stem cells were released in the blood stream and reached the affected area, the liver in this case.
In the course of the study it was found that G-CSF was safe and effective in the mobilisation of hematopoietic stem cells and improved liver function as well as survival in patients with severe alcoholic hepatitis said Dr Virender Singh.