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Last Updated: Monday, 23 May, 2005, 22:09 GMT 23:09 UK
Stem cell hope for liver disease
By Rachael Buchanan
BBC News

John Jones
John Jones took part in the trial
Researchers have begun a pioneering trial using patients' own stem cells to treat their chronic liver disease.

A team at London's Hammersmith Hospital is attempting to reverse cirrhosis of the liver by harnessing and enhancing the body's own repair mechanism.

They are using adult stem cells extracted from patients' bone marrow to generate new tissue in damaged areas.

A Japanese group is also testing adult stem cells as a treatment for liver fibrosis.

Liver disease is dramatically on the increase in the UK - something doctors mostly blame on burgeoning lifestyles of excess.

Deaths from alcoholic liver disease have doubled in the last 10 years, with figures for the condition in young people increasing eight-fold due to binge drinking.

Add to that a growing obesity problem and a predicted trebling of the disorder from viral hepatitis in the next 20 years and it is clear that this condition is becoming a major challenge for the NHS.

Longsuffering organ

The liver is a forgiving organ and can tolerate, and recover from, a certain amount of abuse so long as the damage is not too advanced.

However, the liver is also rather stoic and there are often no warning signals until it is too late.

There is no equivalent dialysis machine for liver disorders so patients with chronic disease are eventually left with two stark outcomes, organ transplantation or death.

Putting aside the rigours of a transplant operation and a life on immunosuppression regime, patients often do not even get offered that choice.

Only a few will be deemed suitable for transplant and although there are about 600-700 liver transplants a year, for every donor organ there are 10 patients on the waiting list.

Which is why other options are urgently needed.

Five patients have now received this novel stem cell treatment at the West London hospital.

The last was John Jones, who owns a hairdressing salon in Shropshire.

Rare condition

John's condition is rarer. It is not a product of his lifestyle but is due to his body's immune system attacking his own organ.

Professor Nagy Habib
Professor Habib is excited by the potential

It was picked up during a routine prostate examination six years ago and since then his condition has deteriorated to the point of liver failure.

Although a little daunted at undergoing an experimental treatment, John signed up for the trial because he could not face the alternative.

"It was worth the risk and I would go through it again," he told the BBC News website just two hours after his operation.

"I didn't want to have a transplant and spend the rest of my life on anti-rejection drugs, so I thought I would grasp at a straw."

John and his four fellow patients had their blood filtered and their stem cells separated out.

These were then injected into the hepatic artery in the liver under local anaesthetic, while the red blood cells were returned to the body through the arm.

Tests

The five patients are being regularly monitored for any signs of a reaction to the treatment or signs of improvement.

Laboratory tests have shown the function of the liver can be improved by repopulating it with stem cells.

You are taking the patients' own cells, making them behave like a liver cell and then giving them back to the patient, so they treat themselves
Professor Nagy Habib

As this initial trial was just designed to check the safety of the procedures, with only a small amount of stem cells being put into the liver, no real recovery in function was expected.

However, Professor Nagy Habib, head of liver surgery at Hammersmith, who is leading the research, is encouraged by the early results.

He said: "The icing on the cake was that some of the blood results were already improved."

He is now looking forward to the second phase of the trial this summer, which will see much larger preparations of stem cells injected into the livers of a greater number of patients, and is designed to test the treatment's ability to actually reverse disease.

"I think it would be very exciting if it works because you are taking the patients' own cells, making them behave like a liver cell and then giving them back to the patient, so they treat themselves."

Huge promise

Alison Rogers, chief executive of the British Liver Trust which campaigns for patients with liver disease, is also hopeful of the promises this treatment holds out.

"Like many new technologies under development they take time and you hear of exciting results that in the end don't come to fruition, but stem cell technology represents a huge leap forward in treating many diseases.

"In liver disease in particular it has the potential for tremendous advances.

"We have seen that stem cell technology can do so much in general medicine so we can be confident it will really help in liver disease - the question is just when this starts to be seen in the clinic."




SEE ALSO:
Stem cells tailored to patients
20 May 05 |  Health
Liver disease drive not enough
08 Dec 04 |  Health


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