CLINICAL TRIALS AND THERAPEUTICS
A study about immunomodulatory effect and efﬁcacy and
prognosis of human umbilical cord mesenchymal stem cells in
patients with chronic hepatitis B-induced decompensated liver
Youliang Song,* Yizhe Huang,*
Xiaoling Cui,* Jian Lin,* Congxin Chen,
and Xi Chen
*Department of Infectious Diseases, Tongling People’s Hospital, Tongling City,
Cellular Central Laboratory and
Department of Infectious Diseases, 105th
Hospital of PLA, Hefei, Anhui Province, China
cytokine, decompensated liver cirrhosis,
efﬁcacy, immunomodulatory, lymphocyte
subsets, mesenchymal stem cell, prognosis.
Accepted for publication 18 December 2017.
Youliang Song, Department of Infectious
Diseases, Tongling People’s Hospital, Tongling
City 244000, Anhui Province, China.
Declaration of conflict of interest: We claim
that there is no conﬂict of interest.
Financial support: This study was supported by
the General Project of Nanjing Military Region
of PLA, no. 15MS048 and the the Scientiﬁc
Research Project of No. 105 Hospital of PLA in
China, no. 2013YG04.
First author: Xueqing Fang, Co-ﬁrst author:
Background and Aim: The aim of our study was to investigate the immunomodulatory
effect and short-term efﬁcacy and long-term prognosis of decompensated liver cirrhosis
patients caused by hepatitis B after a double transplantation with human umbilical cord
mesenchymal stem cells (hUCMSCs).
Methods: Fifty inpatients were recruited and given the same medical treatments, receiving
hUCMSCs injection intravenously. Fifty-three patients (Group B) matched for age, sex,
and baseline alanine aminotransferase, aspartate aminotransferase, albumin, total bilirubin,
prothrombin time, and model for end-stage liver disease score and Child–Pugh classiﬁca-
tion, acted as the control group.
Results: Interleukin-6 and tumor necrosis factor alpha levels markedly decreased, and
interleukin-10 level apparently increased in Group A at 2 and 4 weeks after treatment.
Transforming growth factor beta in Group A increased more remarkably at 2 weeks after
treatment. T4 cells and Treg cells in Group A were apparently higher than those in Group
B at 2 and 4 weeks after treatment, and T8 cells and B cells were signiﬁcantly lower than
those in Group B. Aspartate aminotransferase levels in Group A were dramatically declin-
ing at 8 and 12 weeks after treatment. Levels of albumin, total bilirubin, and prothrombin
time in Group A were apparently improved from 4 to 12 weeks after treatment. The
improvements in model for end-stage liver disease and Child–Pugh scores in Group A were
notably superior to those in Group B from 4 to 36 weeks after treatment. There were no
remarkable differences in the incidence of developing liver failure throughout the follow-
up period, but the mortality rate of Group A was lower than that of Group B.
Conclusion: This therapeutic method may be an appropriate choice for patients with
decompensated liver cirrhosis.
Though liver owns a considerable inherent regenerate ability,
continuous and chronic injury leads to the onset of hepatic
cirrhosis. Various stimuli such as hepatitis virus, alcohol, drugs,
and autoimmune assault by hepatic cells can touch off hepatocyte
apoptosis, damage the endothelial barrier, accumulate the inﬂam-
matory cells, and activate hepatic stellate cells.
In China, chronic
hepatitis B virus (HBV) infection is the major factor of liver
LC generally progresses irreversibly into a
decompensated phase, which is featured by a sequence of clinical
manifestations, including ascites, variceal hemorrhage, and hepatic
Apparently, hepatic cirrhosis is easy to progress
to liver failure, and the condition of patient in hepatic failure with
accompanying LC is more serious, and the prognosis is worse.
Currently, the most effective therapy for end-stage LC is liver
transplantation. However, transplantation is limited by a shortage
of donor organs, surgical complications, immunological rejection,
and high medical expense.
While originally isolated from bone marrow, mesenchymal stem
cells (MSCs) are widely distributed in the postnatal organism and
adult organs or tissues,
which are multipotent stromal cells
with self-renewing potential characterized by their capacity to
differentiate into the cells of the mesodermal and ectodermal
Furthermore, a large quantity of experiments in vitro
has shown that MSCs can particularly produce anti-inﬂammatory
molecules, which can modulate humoral and cellular immune
More recently, MSCs are increasingly investigated
as an effectively therapeutic alternative for end-stage hepatic
Journal of Gastroenterology and Hepatology 33 (2018) 774–780
© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd