Liver Restoration: New Hope for Advanced Hep C
New research presents evidence that reversing cirrhosis is possible – a development that could eliminate the need for a liver transplant and benefit those with advanced Hepatitis C.
End-stage liver disease due to chronic Hepatitis C viral infection has become the leading indication for liver transplantation in the United States. Since there are many more in need of a liver transplant than organs available, scientists are investigating other options by pushing medical technology towards new breakthroughs. Along those lines, researchers from Weill Cornell Medical College in New York have discovered that endothelial cells play a key role in regeneration of the liver – an understanding that could facilitate restoration of an ailing liver.
The liver is a remarkable organ, capable of regenerating when parts of it sustain damage. However, the repeated assault by chronic Hepatitis C infection can outpace the liver’s regenerative capabilities, resulting in scarring that is too dense to be repaired. Studies have shown that 20 to 25 percent of people with Hepatitis C will develop cirrhosis, severe scarring of the liver believed to be irreversible.
Infecting between four and five million Americans, chronic Hepatitis C is an illness of growing concern. About half of those infected with the most common genotype of Hepatitis C are able to eliminate the virus from their blood with aggressive treatment, but the rest are vulnerable to this disease progressing to advanced liver disease. If liver disease escalates to the point where the liver can no longer perform its functions (such as is the case with advanced cirrhosis), a liver transplant is needed. Aside from a liver transplant, there is currently no other approved, therapeutic approach for cirrhosis.
Despite our vast understanding of the human body, the mechanism driving the liver’s ability to repair itself has mostly been a mystery. According to Dr. Bi-Sen Ding, an author of the Weill Cornell Medical College research, “Until our study, the molecular and cellular pathways that would initiate and maintain liver regeneration were not known. Attempts to transplant hepatocytes [liver cells] directly into the liver led to very limited success. But now we have identified liver sinusoidal endothelial cells – that, when activated, are critical to liver regeneration and may enable proper engraftment when hepatocytes are implanted into the injured liver.”
More information about the Weill Cornell Medical college study is as follows:
- The cells that form the lining of blood vessels, endothelial cells appear to play an instructive role in initiation, regeneration and restoration of circulation in the liver.
- These highly specialized blood vessel cells in the liver (sinusoidal endothelial cells), initiate and sustain liver regeneration by producing growth factors that have been identified.
- Mice deficient in sinusoidal endothelial cell growth factors manifest defects throughout the liver regeneration process.
According to Dr. Shahin Rafii and Dr. David Lyden, two additional authors of this research, these findings are likely to open the door for designing new therapies to treat damaged livers.
Because Hepatitis C infection is the leading reason for liver transplants in America – and the livers available for this procedure are limited – those with this condition have a lot to gain from effective liver transplant alternatives. As a result of the recent Weill Cornell Medical College findings, more research into how sinusoidal endothelial cells can grow new liver tissue will soon follow. If all goes well, implanting these specialized cells will help regenerate the liver, ultimately reversing cirrhosis in those with advanced Hepatitis C.
http://weill.cornell.edu/news/releases/wcmc/wcmc_2010/11_11_10.shtml, Specialized Blood Vessels Jumpstart and Sustain Liver Regeneration, Retrieved November 15, 2010, Weil Cornell Medical College, 2010.
http://www.hcvadvocate.org/hcsp/articles/Herrera.html, Cirrhosis in Chronic Hepatitis C Infection, Jorge L. Herrera, MD, Retrieved November 16, 2010, Hepatitis C Support Project, 2010.
http://www.hcvadvocate.org/hcsp/articles/Shaw-Stiffel-1.html, Hepatitis C and Liver Transplantation, Thomas Shaw-Stiffel, MD, Retrieved November 16, 2010, Hepatitis C Support Project, 2010.
http://www.medicaldaily.com/news/20101113/3674/key-blood-cell-helps-liver-regeneration.htm, Key blood cell helps liver regeneration, Retrieved November 15, 2010, MedicalDaily, 2010.
http://www.ncbi.nlm.nih.gov/pubmed/21068842, Inductive angiocrine signals from sinusoidal endothelium are required for liver regeneration, Ding, BS, et al, Retrieved November 17, 2010, Nature, November 2010.