On March 18, 2025, the twenty-fifth "National Liver Care Day" arrived as scheduled. This year's theme is "Combining Traditional Chinese and Western Medicine to Reverse Liver Cirrhosis," aiming to enhance the understanding of the prevention and treatment of chronic hepatitis and liver fibrosis through the integration of traditional Chinese and Western medicine.
2025年3月18日，第二十五个“全国爱肝日”如期而至，今年的主题为“中西医结合，逆转肝硬化”，旨在提高对中西医结合防治慢性肝炎、肝纤维化的认知。
肝脏作为人体最大的实质性器官，承担着代谢、解毒、免疫防御等重任，对生命健康意义非凡。但肝硬化这一肝脏疾病，正无声无息地影响着众多患者的生活。数据显示，我国肝硬化患者高达700万人，并且全球肝硬化患者数量呈逐年上升趋势，其引发的并发症甚至会危及生命。
The liver, as the largest solid organ in the human body, plays a crucial role in metabolism, detoxification, and immune defense. It is of great significance to human health. However, liver cirrhosis, a liver disease, is silently affecting the lives of many patients. Data shows that there are as many as 7 million patients with liver cirrhosis in China, and the number of patients with liver cirrhosis worldwide is on the rise year by year. The complications it causes can even be life-threatening.
近年来，干细胞治疗作为新兴治疗手段，在肝硬化治疗领域展现出巨大潜力，成为逆转肝硬化的关键突破点。
In recent years, stem cell therapy, as an emerging treatment method, has shown great potential in the field of liver cirrhosis treatment and has become a key breakthrough in reversing liver cirrhosis.
一、干细胞治疗肝硬化的机制The Mechanism of Stem Cell Therapy for Liver Cirrhosis
干细胞具有自我更新和多向分化能力，这一特性使其能够分化为肝细胞样细胞，替代受损肝细胞，促进肝脏组织的修复与再生。同时，干细胞还具备免疫调节功能，可减轻肝脏炎症反应，抑制肝纤维化发展。干细胞治疗肝硬化的机制主要包含以下方面：
Stem cells possess the ability to self-renew and differentiate into multiple cell types. This characteristic enables them to differentiate into hepatocyte-like cells, which can replace damaged liver cells and promote the repair and regeneration of liver tissue. Additionally, stem cells have immune regulatory functions that can reduce liver inflammation and inhibit the progression of liver fibrosis. The mechanisms of stem cell therapy for liver cirrhosis mainly include the following aspects:
1、干细胞能分化为肝细胞，补充受损肝脏的细胞数量，恢复肝脏正常功能。临床研究中，部分接受干细胞治疗的患者，在一段时间后，通过肝脏功能检测可发现原本受损的肝功能指标，如转氨酶、胆红素等逐渐趋于正常，这表明新分化的肝细胞开始发挥作用。
Stem cells can differentiate into hepatocytes, replenishing the number of damaged liver cells and restoring normal liver function. In clinical studies, some patients who have received stem cell therapy have shown gradual normalization of previously impaired liver function indicators, such as alanine aminotransferase (ALT) and bilirubin levels, after a period of time. This indicates that the newly differentiated hepatocytes have begun to function effectively.
2、干细胞可分泌多种细胞因子和生长因子，这些物质如同“信号兵”，能促进内源性肝细胞的增殖和修复。它们可以刺激肝脏内原本处于休眠状态的肝细胞重新进入细胞周期，加速肝细胞的分裂和再生，为肝脏修复提供源源不断的新生力量。
Stem cells can secrete a variety of cytokines and growth factors. These substances act like "signaling molecules" that promote the proliferation and repair of endogenous hepatocytes. They can stimulate dormant hepatocytes within the liver to re-enter the cell cycle, accelerating the division and regeneration of hepatocytes and providing a continuous supply of new cells for liver repair.
3、干细胞能够调节肝脏微环境，抑制炎症细胞的浸润和纤维组织的增生，减轻肝纤维化程度。在肝硬化过程中，肝脏内部的微环境紊乱，炎症细胞大量聚集，纤维组织不断增生，而干细胞通过分泌抗炎因子等方式，改变这种不良的微环境，为肝脏的自我修复创造有利条件。
Stem cells can regulate the liver microenvironment by inhibiting the infiltration of inflammatory cells and the proliferation of fibrous tissue, thereby reducing the degree of liver fibrosis. During the progression of liver cirrhosis, the liver microenvironment becomes disordered, with a large accumulation of inflammatory cells and continuous proliferation of fibrous tissue. Stem cells can alter this adverse microenvironment through the secretion of anti-inflammatory factors, creating favorable conditions for the self-repair of the liver.
二、干细胞治疗肝硬化临床疗效显著Significant Clinical Efficacy of Stem Cell Therapy for Liver Cirrhosis
武汉大学人民医院、解放军总医院中心研究团队，对过去10年内的13项间充质干细胞治疗肝硬化、慢性肝衰竭急性发作（ACLF）的临床研究进行了荟萃分析，临床研究综合评估涉及854名患者。
A research team from Renmin Hospital of Wuhan University and the Central Research Institute of the PLA General Hospital conducted a meta-analysis of 13 clinical studies on mesenchymal stem cell (MSC) therapy for liver cirrhosis and acute-on-chronic liver failure (ACLF) over the past decade. The comprehensive assessment of these clinical studies involved a total of 854 patients.
这些研究主要关注了间充质干细胞（MSC）治疗对肝功能的影响，同时评估了脐带来源的间充质干细胞对逆转肝硬化或拯救急慢性肝衰竭患者的效果。
These studies primarily focused on the impact of mesenchymal stem cell (MSC) therapy on liver function and evaluated the effects of umbilical cord-derived mesenchymal stem cells in reversing liver cirrhosis or rescuing patients with acute and chronic liver failure.
研究结果显示，MSC治疗能够显著改善患者的肝功能参数，如MELD评分、TB水平和ALB水平。与常规治疗相比，这意味着MSC治疗可以有效地恢复肝脏的正常功能，从而提高患者的生活质量。
The results showed that MSC therapy significantly improved liver function parameters in patients, such as the Model for End-Stage Liver Disease (MELD) score, total bilirubin (TB) levels, and albumin (ALB) levels. Compared with conventional treatments, this indicates that MSC therapy can effectively restore normal liver function, thereby improving the quality of life for patients.
间充质干细胞治疗与常规治疗在生存率方面比较的荟萃分析
Meta-analysis of Survival Rates Between Mesenchymal Stem Cell Therapy and Conventional Therapy
此外，MSC治疗还能显著提高肝硬化和ACLF患者的生存率。这一发现对于那些无法接受肝移植或其他传统治疗的患者来说，无疑带来了新的希望。
Moreover, MSC therapy significantly increased the survival rates of patients with liver cirrhosis and ACLF. This finding brings new hope to patients who are unable to receive liver transplantation or other traditional treatments.
更进一步的亚组分析显示，相比肝硬化患者，ACLF患者在多数时间点上从MSC治疗中受益更多。本研究表明间充质干细胞治疗可能为ACLF的治疗提供另一种潜在的选择。
Further subgroup analysis showed that, compared with patients with liver cirrhosis, patients with ACLF benefited more from MSC therapy at most time points. This study suggests that mesenchymal stem cell therapy may provide another potential option for the treatment of ACLF.
值得注意的是，这些研究中并没有报告MSC治疗引发的任何严重副作用或不良事件。这进一步证实了MSC治疗的安全性，使其成为一个可靠的治疗选择。
It is worth noting that no serious side effects or adverse events caused by MSC therapy were reported in these studies. This further confirms the safety of MSC therapy, making it a reliable treatment option.
三、总结与展望Summary and Outlook
全球范围内临床研究的深入开展，使细胞疗法在肝病治疗中发挥越来越重要的作用。但是细胞疗法治疗肝病是一个极其复杂的过程，各项研究细节之间也存在差异性，详细的机理还有待更多的临床前和临床研究进行探索。但随着研究的不断深入和技术的持续进步，相信干细胞移植技术将在肝硬化治疗领域发挥越来越重要的作用，为更多患者带来生命的希望与光明。
The in-depth development of clinical studies worldwide has made cell therapy play an increasingly important role in the treatment of liver diseases. However, the treatment of liver diseases with cell therapy is an extremely complex process, and there are differences in the details of various studies. The detailed mechanisms still need to be explored through more preclinical and clinical studies. But with the continuous deepening of research and the ongoing progress of technology, it is believed that stem cell transplantation technology will play an increasingly important role in the treatment of liver cirrhosis and bring hope and light to more patients.
