Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time

Sharma, Mithun; Kulkarni, Anand V.; Sasikala, Mitnala; Kumar, Pramod; Jaggaiahgari, Shasidhar; Pondugala, Kumar; Jaishetwar, Ganesh; Darisetty, Santosh; Jagtap, Nitin; Gupta, Rajesh; Singh, Jagdeep; Fatima, Syeda; Rao, Padaki Nagaraja; Rao, Guduru Venkat; Reddy, D. Nageshwar

doi:10.14218/jcth.2020.00052

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…In any case, administration of G-CSF subcutaneously was shown to be safe in patients with ACLF, to increase the number of CD34+ cells and to promote hepatic regeneration. Additionally, a recent study has demonstrated that autologous infusion of G-CSF-induced CD34+ cells effectively improves liver function and HSA levels up to one year although this benefit was not sustained at the long-term [114]. Moreover, G-CSF treatment has been shown to prevent hepatorenal syndrome, hepatic encephalopathy and sepsis [110,112].…”

Section: Therapeutic Approaches To Limit Systemic Inflammation In Aclfmentioning

confidence: 99%

Leukocytes, Systemic Inflammation and Immunopathology in Acute-on-Chronic Liver Failure

Casulleras

Zhang

Clària

2020

Cells

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Acute-on-chronic liver failure (ACLF) is a complex syndrome that develops in patients with cirrhosis and is characterized by acute decompensation, organ failure(s) and high short-term mortality. ACLF frequently occurs in close temporal relationship to a precipitating event, such as acute alcoholic, drug-induced or viral hepatitis or bacterial infection and, in cases without precipitating events, probably related to intestinal translocation of bacterial products. Dysbalanced immune function is central to its pathogenesis and outcome with an initial excessive systemic inflammatory response that drives organ failure and mortality. This hyperinflammatory state ultimately impairs the host defensive mechanisms of immune cells, rendering ACLF patients immunocompromised and more vulnerable to secondary infections, and therefore to higher organ dysfunction and mortality. In this review, we describe the prevailing characteristics of the hyperinflammatory state in patients with acutely decompensated cirrhosis developing ACLF, with special emphasis on cells of the innate immune system (i.e., monocytes and neutrophils), their triggers (pathogen- and damage-associated molecular patterns [PAMPs and DAMPs]), their effector molecules (cytokines, chemokines, growth factors and bioactive lipid mediators) and the consequences on tissue immunopathology. In addition, this review includes a chapter discussing new emerging therapies based on the modulation of leukocyte function by the administration of pleiotropic proteins such as albumin, Toll-like receptor 4 antagonists, interleukin-22 or stem cell therapy. Finally, the importance of finding an appropriate intervention that reduces inflammation without inducing immunosuppression is highlighted as one of the main therapeutic challenges in cirrhosis.

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Section: Therapeutic Approaches To Limit Systemic Inflammation In Aclfmentioning

confidence: 99%

Leukocytes, Systemic Inflammation and Immunopathology in Acute-on-Chronic Liver Failure

Casulleras

Zhang

Clària

2020

Cells

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“…137 Furthermore, the effect of short-course G-CSF may not provide long-term prevention. 138 G-CSF may have a role in patients with early cirrhosis and low MELD score. However, despite more than a decade since the primary use of this drug, there is no concrete evidence for its role in hepatic regeneration and in preventing sepsis.…”

Section: Primary Preventionmentioning

confidence: 98%

“…Furthermore, the effect of short-course G-CSF may not provide long-term prevention [138]. G-CSF may have a role in patients with early cirrhosis and low MELD score.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Early Diagnosis and Prevention of Infections in Cirrhosis

et al. 2022

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Cirrhosis is a risk factor for infections. Majority of hospital admissions in patients with cirrhosis are due to infections. Sepsis is an immunological response to an infectious process that leads to end-organ dysfunction and death. Preventing infections may avoid the downstream complications and early diagnosis of infections may improve the outcomes. In this review, we discuss the pathogenesis, diagnosis, and biomarkers of infection, as well as incremental preventive strategies for infections and sepsis and consequent organ failures in cirrhosis. Strategies for primary prevention include reducing gut translocation by selective intestinal decontamination, avoiding unnecessary proton pump inhibitors’ use, appropriate use of beta-blockers and vaccinations for viral diseases, including coronavirus disease-2019. Secondary prevention includes early diagnosis and timely and judicious use of antibiotics to prevent organ dysfunction. Organ failure support constitutes tertiary intervention in cirrhosis. In conclusion, infections in cirrhosis are potentially preventable with appropriate care strategies to then enable to improve outcomes.

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“…None of the proposed regenerative therapies have long-term effects. The effect wanes over time 119 .…”

Section: Limitations Of Cell Based Therapiesmentioning

confidence: 98%

Hepatic Regeneration in Cirrhosis

Jindal

Jagdish

Kumar

2022

Journal of Clinical and Experimental Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time

Cited by 7 publications

References 27 publications

Leukocytes, Systemic Inflammation and Immunopathology in Acute-on-Chronic Liver Failure

Leukocytes, Systemic Inflammation and Immunopathology in Acute-on-Chronic Liver Failure

Early Diagnosis and Prevention of Infections in Cirrhosis

Hepatic Regeneration in Cirrhosis

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