We know that cirrhosis and severe hepatitis are the end stage of chronic hepatitis and/or other liver diseases. At that time, the synthesis, detoxification, excretion and biotransformation functions of the liver are severely impaired or decompensated, and clinical syndromes with coagulation mechanism disorders and jaundice, hepatic encephalopathy, ascites and other major manifestations occur, with a two-year survival rate of less than 50%. However, the overall treatment effect of some patients is still unsatisfactory, especially in the decompensated stage of chronic hepatitis cirrhosis, and this treatment status seriously affects the survival quality of patients. Tong Qiaoxia, Department of Infection, Wuhan Union Medical College Hospital
Studies have shown that the immune system cannot effectively clear the virus and is susceptible to immune tolerance because of the defective immune function in the patient’s body, resulting in prolonged and recurrent hepatitis B treatment. The virus invades the liver cells, replicates and multiplies in the liver cells, causing liver inflammation and chronic fibrosis, which eventually develops into cirrhosis and liver cancer. When chronic hepatitis is combined with other liver damage, in addition to the damage caused to the liver by viruses and other factors, the imbalance in the immunity of the patient’s organism is also an important reason for the rapid deterioration of liver function. Therefore, in order to remove the virus latent in the cells, alleviate and reduce the inflammation of the liver, and reduce the damaging factors, it is more crucial to increase the number of autoimmune cells, regulate the function of the patient’s immune system, and perform immune reconstruction, in addition to actively and reasonably applying antiviral drugs and actively using liver protection drugs.
The main treatment tools we use now include drugs and “artificial liver”: drugs include anti-viral drugs, liver protection and enzyme-reducing drugs, as well as Chinese medicine to enhance immunity, etc.; “artificial liver”, i.e. plasma replacement, is used in severe cases. Artificial liver” or plasma replacement is to improve the internal environment artificially to promote the discharge of harmful substances and give the liver a chance to regenerate. These two methods are widely used in clinical practice and have achieved good results, but when the disease progresses rapidly and is critical, the patient takes more risks with artificial liver treatment, and artificial liver treatment requires a large amount of plasma (2000-3000ml each time), which is difficult to ensure in time and leads to delays and misses the final treatment time.
An emerging treatment that is becoming known is biologic therapy, also known as immune cell therapy, which is used in the treatment of tumors, leukemia, AIDS, and other diseases. For patients with liver disease, it mainly involves the isolation of sufficient viable single nucleated cells, often referred to as leukocytes, from autologous bone marrow or peripheral blood, which are then targeted to the liver through interventional methods, to regulate systemic immune function while reducing collagen secretion and activation of hepatic stellate cells, providing a clear anti-fibrotic effect.
Why is it necessary to regulate the body’s immunity when treating cirrhosis and liver failure? Because for the organism, the stronger the immune function is not better —– When the immunity is low, the organism does not have the ability to remove viruses and other harmful materials in time, resulting in damage to the body; but if the immunity is too strong, it will kill the body cells, including liver cells, aimlessly and blindly, thus leading to a rapid deterioration of liver function and rapid failure. By transplanting autologous immune cells, we can re-establish the normal immune function of the body and reduce the damage to the liver caused by an overly strong immune response as well as the inflammatory response during liver fibrosis.
The autologous immune cells we choose do not have the risk of rejection and infection with other diseases, are highly operable, less painful for patients, simple and less time-consuming process, and easy for patients to accept. After continuous practice and exploration in recent years, there are cases in Beijing, Shandong and other places suggesting that after immune cell therapy, the ascites of the patients subsided significantly, the biochemical indexes of liver function improved, including the bilirubin level decreased, the albumin level increased or nearly reached normal, the coagulation function improved, the patients’ mental appetite improved, and the symptoms of abdominal distension and weakness were significantly relieved. Compared to the cost of liver transplantation, which can cost hundreds of thousands of dollars, and the painful anti-rejection medication at a later stage, autoimmune cell transplantation can maximize the efficacy of treatment while reducing the patient’s stress.
Therefore, autologous bone marrow nucleated cell transplantation for the treatment of severe hepatitis and post-hepatitis cirrhosis is a proven effective treatment. It can reduce the local inflammatory response by exerting immunomodulatory effects, which can result in significantly smaller areas of liver tissue necrosis in patients with heavy liver disease and significantly increased serum albumin levels in patients with hepatitis cirrhosis, which can improve patient survival, reduce hospitalization time, and improve quality of life. As the famous American biologist George? Daly said: “If the twentieth century is the era of drug therapy, then the twenty-first century is the era of cell therapy”. As a new treatment method, autoimmune cell therapy will become the future light of liver disease treatment! At present, our department has carried out immune cell therapy one after another, and we have seen initial results in promoting liver cell regeneration to improve hypoproteinemia.