Cell and Tissue Therapy for the Treatment of Chronic Liver Disease

Abstract

Liver disease is an important clinical problem, impacting 600 million people worldwide. It is the 11th-leading cause of death in the world. Despite constant improvement in treatment and diagnostics, the aging population and accumulated risk factors led to increased morbidity due to nonalcoholic fatty liver disease and steatohepatitis. Liver transplantation, first established in the 1960s, is the second-most-common solid organ transplantation and is the gold standard for the treatment of liver failure. However, less than 10% of the global need for liver transplantation is met at the current rates of transplantation due to the paucity of available organs. Cell- and tissue-based therapies present an alternative to organ transplantation. This review surveys the approaches and tools that have been developed, discusses the distinctive challenges that exist for cell- and tissue-based therapies, and examines the future directions of regenerative therapies for the treatment of liver disease.

Keywords: cell therapy; liver; stem cell biology; tissue engineering.

Figure 1

Architecture of the liver from the macro to the micro scale. (a) An example of the gross structure of the liver is shown. (b) When zoomed in, the lobular architecture of the liver, including the vascular and biliary components, is revealed. (c) Further examination reveals the cellular composition and architecture of the lobule.

Figure 2

Different sources of hepatocytes for therapeutic and scientific applications. Many different cell types and sources can be differentiated, transdifferentiated, reprogrammed, or expanded to generate hepatocytes for clinical and scientific applications.

Figure 3

Liver tissue engineering approaches. Hepatic tissue engineering consists of cellular components and engineered 3D scaffolds that are assembled and transplanted in vivo to yield hepatic function.