Zelltherapie in der Hepatologie[*]

Zusammenfassung

In den letzten 10 Jahren konnten große Fortschritte auf dem Gebiet der Leberzelltransplantation und des leberspezifischen Gentransfers erreicht werden. Tierexperimentelle Untersuchungen haben gezeigt, dass neues Lebergewebe sowohl aus transplantierten primären Hepatozyten als auch aus Stammzellen des Knochenmarks entstehen kann. Dies hat wesentlich zu unserem Verständnis der Organogenese und Hepatozytenbiologie beigetragen. Weiterhin sind mithilfe der Leberzelltransplantation neue Kleintiermodelle zum Studium der Virushepatitis entwickelt worden. In der Klinik bietet das Verfahren ein breites Spektrum potenzieller Anwendungsgebiete, insbesondere bei der Therapie erblicher Stoffwechselerkrankungen. Der therapeutische Nutzen transplantierter Hepatozyten konnte erstmals 1998 bei einer Patientin mit Crigler-Najjar-Syndrom Typ I belegt werden. Weitere Studien im Bereich der Grundlagenforschung und Klinik erscheinen gerechtfertigt, um den Stellenwert der Zelltherapie in der Hepatologie zu evaluieren.

Current status of cell-based therapies in liver diseases

Major strides have been made during the past 10 years in the fields of liver cell transplantation and liver-directed gene therapy. Pre-clinical studies in animals have shown that primary hepatocytes transplanted into the liver as well as intravenously transfused bone marrow stem cells can generate new liver tissue. Such cell transplantation studies have contributed to our understanding of organogenesis and hepatocyte biology. Furthermore, transplantation of xenogenic hepatocytes has led to the development of new small animal models for studying viral hepatitis. In the clinical setting, liver cell transplantation offers a wide range of potential therapeutic applications, especially in metabolic diseases. In particular, the case of a patient with Crigler-Najjar Syndrome Type I clearly demonstrated the long-term viability of transplanted hepatocytes with stable metabolic function. Further studies are warranted to assess the full potential of cell- based therapies and their clinical application.

Hepatozyten - Stammzellen - Progenitorzellen - Transplantation - Gentherapie - Hepatitis B - Organogenese - Hepatozytenbiologie

Hepatocytes - Stem Cells - Progenitor Cells - Transplantation - Gene Therapy - Hepatitis B - Hepatocyte Biology

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1 Teile dieses Manuskripts sind im Rahmen des Forschungsforums Nummer 11 auf der DGVS-Tagung Gastroenterologie 2000 in Hamburg präsentiert worden.

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