Abstract
The substantial worldwide burden of liver diseases and related complications is in line with the regular developments of innovative therapeutic strategies that could alleviate the number of patients requiring liver transplantation, the gold standard of care approved so far. Cell transplantation has brought new perspectives to treat those patients while keeping their own livers. The concept was simple as the transplanted cells were used to promote parenchymal regeneration and/or repairing. Isolated hepatocytes were initially applied and demonstrate the proof of concept of this approach at the clinical level. Stem cells, second-generation advanced therapy medicinal products, have provided many technological and logistical solutions to improve the wide clinical use of cell therapy. Mesenchymal stem cells were extensively developed to this end and show a significant ability to migrate in the recipient diseased liver, to differentiate in situ, and to exhibit interesting immunomodulatory, immunosuppressive, and anti-fibrotic features. Most of those paracrine effects were mediated by potent bioactive molecules secreted by those stem cells. Extracellular vesicles represent a significant part of this secretome and display several interesting characteristics that support their development for liver-cell-free therapy. This chapter summarizes and discusses the significant advances related to cell-based and cell-free therapies currently achieved for the treatment of liver diseases. It also addresses the current challenges that extracellular vesicles-based therapy is dealing with before a future clinical use.
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Abbreviations
- ACLF:
-
Acute on chronic liver failure
- ESCs:
-
Embryonic stem cells
- EVs:
-
Extracellular vesicles
- iPSC:
-
Induced pluripotent stem cells
- MSCs:
-
Mesenchymal stem cells
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Najimi, M., Khawaja, H. (2022). Extracellular Vesicles-Based Cell-Free Therapy for Liver Regeneration. In: Haider, K.H. (eds) Handbook of Stem Cell Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-16-6016-0_9-1
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