The effect of transplantation of autologous hematopoietic stem cells (AHSCT) in patients with primary biliary cirrhosis (PBC)

Ilyassova B.S., Askarov M.B., Kaliaskarova K.S., Trimova R.S., Gaipov A.

Research output: Contribution to journalArticle

Abstract

Background: PBC is a liver disease in which an immune-mediated injury targets the small intrahepatic bile ducts. It is proposed, the AHSCT influence on the molecules of autoreactivity and then the proinflammatory cells are eliminated. Consequently generation new naïve T-lymphocytes in patients is interrupted, it results to the restoration of the tolerance to autoantigens. The aim of the study: to evaluate of efficiency of AHSCT including to the PBC treatment. Indication: the refractory to the standard therapy. The methods: 10 patients with primary biliary cirrhosis: 4 with the II morphological stage PBC, 2-III stage, 2-IV stage and 2-with overlap syndrome: PBC IIIst + AIH. The AHSCT has realized by 2 stages: 1-aspiration of bone marrow suspension in the amount 200 ml; phenotyping of cells by cell cytometer BD; isolation of the mononuclear fraction and precultivation it during 24-48 h. 2-intravenous transplantation of the cells suspension. The cytokines levels were investigated in the cell supernatant and in the blood serum by ELISA. The results: 7 days after AHSCT the tests have shown the decrease of ALT level from 1.930 ± 0.300, Std. Deviation (SD) 0.949, to 1.466 ± 0.260, SD = 0.821, p = 0.007, of AST level from 1.926 ± 0.415, SD = 1.313 to 1.384 ± 0.207, SD = 0.655, p = 0.005, the total bilirubin level from 60.184 ± 22.539 mkmol/l, SD = 71.275 to 43.619 ± 17.498, SD = 55.334, p = 0.005, the level of direct bilirubin from 44.751 ± 20.605, SD = 65.158, to 20.074 ± 11.447, SD = 36.200, p = 0.007. The parameters of serum protein 69.688 ± 2.457, SD = 7.770, to 77.465 ± 1.172, SD = 3.706, p = 0.005 and serum albumin 39.712 ± 2.853, SD = 9.0197, to 44.088 ± 2.619, SD = 8.282, p = 0.028 increased. Three months later the levels of IL-10, IL-12p70, IL-17, IL-2 and IL-4 didn't change significantly, IFN-γ level was increased (p = 0.005). IL-1b level (p = 0.006) and TNF-α level (p = 0.005) decreased. The SF36 results showed significant improvement. These results have shown the efficiency of AHSCT including to PBC treatment. But clinical trial needs to histological confirming.
Original languageEnglish
Pages (from-to)S14-S15
JournalHepatology International
Volume7
DOIs
Publication statusPublished - 2013

Keywords

  • Asian
  • T lymphocyte
  • aspiration
  • autoantigen
  • bilirubin
  • bilirubin glucuronide
  • bone marrow
  • clinical trial
  • cytokine
  • enzyme linked immunosorbent assay
  • hematopoietic stem cell
  • human
  • immune mediated injury
  • interleukin 1
  • interleukin 10
  • interleukin 12p70
  • interleukin 2
  • interleukin 4
  • intrahepatic bile duct
  • liver
  • liver disease
  • parameters
  • patient
  • phenotype
  • plasma protein
  • primary biliary cirrhosis
  • serum
  • serum albumin
  • sexually transmitted disease
  • supernatant
  • therapy
  • transplantation

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