国際個別化医療学会

Infused (transplanted) green fluorescent protein (GFP)-positive bone marrow cells (BMCs) migrated into the peri-portal regions of the cirrhotic mouse liver induced continuous CCl4 injection without irradiation (without bone marrow ablation). The differentiation “niche” induced by persistent liver damage due to continuous CCl4 injection seems to be an essential factor. Microarry analysis showed that at an early stage after BMC infusion through mouse tail vein, the genes related to degradation of extracellular matrix (ECM) e.g. MMP-9 were activated. BMC infusion improved liver fibrosis and the survival rate. Based on the results obtained in basic research using the GFP/CCl₄ model, human trials are now undergoing. We have done this autologous bone marrow cell infusion therapy for 23 patients with advanced liver cirrhosis. The clinical study of liver cirrhosis (LC) cases that underwent autologous bone marrow cell infusion from peripheral vein is as follows. Subjects were LC patients with T.B. of <3.0 mg/dl, Plt of >5 (10¹/l) and no viable hepatocellular carcinoma by diagnostic imaging. Autologous bone marrow cells (BMCs, 400 ml) were isolated from the ilium under general anesthesia. BMCs were separated by cell washing and were infused via the peripheral vein. After BMC infusion, liver function was monitored by blood examination for 24 weeks. After washing, 5.20 ± 0.63 × 10⁹ BMCs were infused into LC patients. Serum albumin level and total protein were significantly improved at 24 weeks after BMC infusion (p<0.05). The Child-Pugh score was significantly improved at 4 week and 24 weeks after BMC infusion (p<0.05). No major adverse effects were noted. In conclusion, autologous BMC infusion might be considered as a novel treatment for advanced LC patients.

■Key words：liver fibrosis, bone marrow, stem cell, albumin, hepatocyte
■連絡先　山口大学大学院医学系研究科消化器病態内科学　〒755-8505宇部市南小串1-1-1