Application of Embryonic Hematopoietic Stem Cells in Treatment of Patients with Chronic Active Hepatitis

Olexandr I. Smikodub

Cell Therapy Clinic of National Medical University and Embryonic Tissues Center EmCell

Observed were 8 patients with chronic active hepatitis, duration of the disease being 6-23 months.  In all patients, the process was estimated as active, in 3 patients it was expressed, in 5 – moderate.  Hepatitis B markers were found in the serum of 2 patients (HbsAg, anti-HBc, HbcAg); there were no antibodies to smooth musculature, immunoregulating index was also reduced (1.2 – 0.8) secondary to decreased CD4+ count.  The above taken into consideration, 6 patients were described as having autoimmune hepatitis, and 2 – chronic active hepatitis.  All patients reported loss of weight (7-12% lower than the norm), expressed weakness, low appetite, jaundice, subfebrile fever, itching.  2 patients had vasculitis rash.  In 1 case, hepatitis was combined with non-specific ulcerative colitis (expressed reaction to smooth musculature antibodies).

3 patients had systemic osteoporosis, calcinosis of large arteries, cartilages, stones.  All patients were noted to have hepatomegalia: in 1 case there was a combination of hepatomegalia and spleenomegalia with hypersplenism (anemia, thrombocytopenia).  4 patients had expressed asthenoneurotic syndrome, others – somatogenic depression. 

Hematopoeitic embryonic stem cells (HESC) were obtained from liver, spleen, and bone marrow of 4-8 weeks old embryonic cadavers.

After HESC transplantation, all patients reported syndrome of early post-transplantation improvements and syndrome of psychofunctional changes.  In 8-12 hours, patients already felt improvement of general condition, decrease of weakness and sweating, temperature drop, improvement of the appetite.   Many patients also reported improvement of sleep and normalization of its formula.  As for psycho-functional status, it is necessary to note the following: improvement of general emotional state, decrease of alertness and anxiety, growing faith in recovery.   Clinical manifestations of these syndromes were expressed during the first month of post-transplantation period.  Within two weeks, there was a considerable increase of CD3+, CD4+, CD8+, CD19+ counts; immunoregulation index decreased. Concentration of bilirubin in the blood was also reduced.  This resulted in the increase of ferment activity, which indicates activation of cylolysis in liver cells.  This process was well maintained within first 2-3 weeks, by 4-5 week, as a rule, there appeared a tendency for the decrease of transferase activity.  Clinical manifestations of jaundice, choleamia and intoxication decreased and disappeared at the end of 1-2 months after transplantation.  In the future, parameter changes of inflammatory process activity and liver cell insufficiency had wave-like pattern and were characterized by minimal activity.  Remission achieved lasted for 4.3±0,5 years.