肝臓の再生医療の現状
抗ウイルス剤や分子標的薬の進歩により，肝疾患患者の予後は改善されてきた．しかし，急性肝不全や非代償性肝硬変症の予後は依然として不良であり，肝移植に代わり得るような治療効果の高い内科的治療の開発が必要である．そのため，肝臓再生療法は肝細胞移植（hepatocyte transplantation）に始まり，体性幹細胞を用いた細胞療法へと進歩してきた．それは「肝細胞の補充による残存肝機能の補助」から「肝前駆細胞の活性化と免疫調節による肝再生」への転換を意味し，この転換により，肝不全治療において細胞療法は一定の治療効果をあげている．さらに，バイオ人工肝臓（bioartificial liver sy...
Saved in:
| Published in | 日本内科学会雑誌 Vol. 108; no. 4; pp. 798 - 804 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.04.2019
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.108.798 |
Cover
| Abstract | 抗ウイルス剤や分子標的薬の進歩により，肝疾患患者の予後は改善されてきた．しかし，急性肝不全や非代償性肝硬変症の予後は依然として不良であり，肝移植に代わり得るような治療効果の高い内科的治療の開発が必要である．そのため，肝臓再生療法は肝細胞移植（hepatocyte transplantation）に始まり，体性幹細胞を用いた細胞療法へと進歩してきた．それは「肝細胞の補充による残存肝機能の補助」から「肝前駆細胞の活性化と免疫調節による肝再生」への転換を意味し，この転換により，肝不全治療において細胞療法は一定の治療効果をあげている．さらに，バイオ人工肝臓（bioartificial liver system）や脱細胞化臓器骨格を用いた肝臓再生（bioengineered liver）等の人工臓器の開発も進められており，その実用化にはiPS（induced pluripotent stem）細胞やES（embryonic stem）細胞，線維芽細胞等に由来する肝臓構成細胞の作製技術が重要な役割を担う．今後は，体性幹細胞を用いた細胞療法の標準化と人工臓器の実用化に向けた研究の推進が望まれる． |
|---|---|
| AbstractList | 抗ウイルス剤や分子標的薬の進歩により，肝疾患患者の予後は改善されてきた．しかし，急性肝不全や非代償性肝硬変症の予後は依然として不良であり，肝移植に代わり得るような治療効果の高い内科的治療の開発が必要である．そのため，肝臓再生療法は肝細胞移植（hepatocyte transplantation）に始まり，体性幹細胞を用いた細胞療法へと進歩してきた．それは「肝細胞の補充による残存肝機能の補助」から「肝前駆細胞の活性化と免疫調節による肝再生」への転換を意味し，この転換により，肝不全治療において細胞療法は一定の治療効果をあげている．さらに，バイオ人工肝臓（bioartificial liver system）や脱細胞化臓器骨格を用いた肝臓再生（bioengineered liver）等の人工臓器の開発も進められており，その実用化にはiPS（induced pluripotent stem）細胞やES（embryonic stem）細胞，線維芽細胞等に由来する肝臓構成細胞の作製技術が重要な役割を担う．今後は，体性幹細胞を用いた細胞療法の標準化と人工臓器の実用化に向けた研究の推進が望まれる． |
| Author | 松本, 俊彦 高見, 太郎 坂井田, 功 |
| Author_xml | – sequence: 1 fullname: 高見, 太郎 organization: 山口大学大学院医学系研究科消化器内科学 – sequence: 1 fullname: 松本, 俊彦 organization: 山口大学大学院医学系研究科消化器内科学 – sequence: 1 fullname: 坂井田, 功 organization: 山口大学大学院医学系研究科消化器内科学 |
| BookMark | eNo9j79KBDEYxIOc4HpeaesbZM2XZJNvy-PwHxzYaB2STVZ3PVfZvcbSKxREsdDGQnwDSxvBl5Fj7zFcTrGZYRiY4bdOetVFFQjZBBZzUOl2ZYszGwPDWKe4QiJAFJQzFD0SMcaBJgLlGhk0TeGYFCpBEDIiW4vZ6-L26fv6fX7z0D6_ze8_25dZF9vHr_buY4Os5nbShMGf98nx7s7RaJ-OD_cORsMxLTlPGEWfA9Mhk1Ll4ITwLjh0Osu5Trsnp4MNioNH6b3zIlPoU7TInOaACdeiT4a_u2UztSfBXNbFua2vjK2nRTYJZklnOjojl9ox_nfZqa1NacUP7zxWrA |
| ContentType | Journal Article |
| Copyright | 2019 一般社団法人 日本内科学会 |
| Copyright_xml | – notice: 2019 一般社団法人 日本内科学会 |
| DOI | 10.2169/naika.108.798 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1883-2083 |
| EndPage | 804 |
| ExternalDocumentID | article_naika_108_4_108_798_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS DIK F5P JSF OK1 RJT |
| ID | FETCH-LOGICAL-j2250-8df107ec446f1b33dbeb8b7cf279658b7eae621d84ddbd3c68d98a80b72185273 |
| ISSN | 0021-5384 |
| IngestDate | Wed Sep 03 06:17:19 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 4 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2250-8df107ec446f1b33dbeb8b7cf279658b7eae621d84ddbd3c68d98a80b72185273 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/naika/108/4/108_798/_article/-char/ja |
| PageCount | 7 |
| ParticipantIDs | jstage_primary_article_naika_108_4_108_798_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2019/04/10 |
| PublicationDateYYYYMMDD | 2019-04-10 |
| PublicationDate_xml | – month: 04 year: 2019 text: 2019/04/10 day: 10 |
| PublicationDecade | 2010 |
| PublicationTitle | 日本内科学会雑誌 |
| PublicationTitleAlternate | 日内会誌 |
| PublicationYear | 2019 |
| Publisher | 一般社団法人 日本内科学会 |
| Publisher_xml | – name: 一般社団法人 日本内科学会 |
| References | 6) Duan XZ, et al: Granulocyte-colony stimulating factor therapy improves survival in patients with hepatitis B virus-associated acute-on-chronic liver failure. World J Gastroenterol 19: 1104-1110, 2013. 9) Suk KT, et al: Transplantation with autologous bone marrow-derived mesenchymal stem cells for alcoholic cirrhosis: Phase 2 trial. Hepatology 64: 2185-2197, 2016. 10) Lin BL, et al: Allogeneic bone marrow-derived mesenchymal stromal cells for hepatitis B virus-related acute-on-chronic liver failure: A randomized controlled trial. Hepatology 66: 209-219, 2017. 5) Garg V, et al: Granulocyte colony-stimulating factor mobilizes CD34 (＋) cells and improves survival of patients with acute-on-chronic liver failure. Gastroenterology 142: 505-512, 2012. 2) Verma N, et al: Outcomes after multiple courses of granulocyte colony-stimulating factor and growth hormone in decompensated cirrhosis: a randomized trial. Hepatology 68: 1559-1573, 2018. doi: 10.1002/hep.29763. 12) Ott HC, et al: Perfusion-decellularized matrix: using nature's platform to engineer a bioartificial heart. Nat Med 14: 213-221, 2008. 8) Xu L, et al: Randomized trial of autologous bone marrow mesenchymal stem cells transplantation for hepatitis B virus cirrhosis: regulation of Treg/Th17 cells. J Gastroenterol Hepatol 29: 1620-1628, 2014. 11) Demetriou AA, et al: Prospective, randomized, multicenter, controlled trial of a bioartificial liver in treating acute liver failure. Ann Surg 239: 660-670, 2004. 1) Spahr L, et al: Autologous bone marrow mononuclear cell transplantation in patients with decompensated alcoholic liver disease: a randomized controlled trial. PLoS One 8: e53719, 2013. 3) Newsome PN, et al: Granulocyte colony-stimulating factor and autologous CD133-positive stem-cell therapy in liver cirrhosis (REALISTIC): an open-label, randomised, controlled phase 2 trial. Lancet Gastroenterol Hepatol 3: 25-36, 2018. 4) Kedarisetty CK, et al: Combination of granulocyte colony-stimulating factor and erythropoietin improves outcomes of patients with decompensated cirrhosis. Gastroenterology 148: 1362-1370, 2015. 7) Mohamadnejad M, et al: Randomized placebo-controlled trial of mesenchymal stem cell transplantation in decompensated cirrhosis. Liver Int 33: 1490-1496, 2013. |
| References_xml | – reference: 5) Garg V, et al: Granulocyte colony-stimulating factor mobilizes CD34 (＋) cells and improves survival of patients with acute-on-chronic liver failure. Gastroenterology 142: 505-512, 2012. – reference: 3) Newsome PN, et al: Granulocyte colony-stimulating factor and autologous CD133-positive stem-cell therapy in liver cirrhosis (REALISTIC): an open-label, randomised, controlled phase 2 trial. Lancet Gastroenterol Hepatol 3: 25-36, 2018. – reference: 11) Demetriou AA, et al: Prospective, randomized, multicenter, controlled trial of a bioartificial liver in treating acute liver failure. Ann Surg 239: 660-670, 2004. – reference: 1) Spahr L, et al: Autologous bone marrow mononuclear cell transplantation in patients with decompensated alcoholic liver disease: a randomized controlled trial. PLoS One 8: e53719, 2013. – reference: 4) Kedarisetty CK, et al: Combination of granulocyte colony-stimulating factor and erythropoietin improves outcomes of patients with decompensated cirrhosis. Gastroenterology 148: 1362-1370, 2015. – reference: 9) Suk KT, et al: Transplantation with autologous bone marrow-derived mesenchymal stem cells for alcoholic cirrhosis: Phase 2 trial. Hepatology 64: 2185-2197, 2016. – reference: 2) Verma N, et al: Outcomes after multiple courses of granulocyte colony-stimulating factor and growth hormone in decompensated cirrhosis: a randomized trial. Hepatology 68: 1559-1573, 2018. doi: 10.1002/hep.29763. – reference: 7) Mohamadnejad M, et al: Randomized placebo-controlled trial of mesenchymal stem cell transplantation in decompensated cirrhosis. Liver Int 33: 1490-1496, 2013. – reference: 6) Duan XZ, et al: Granulocyte-colony stimulating factor therapy improves survival in patients with hepatitis B virus-associated acute-on-chronic liver failure. World J Gastroenterol 19: 1104-1110, 2013. – reference: 12) Ott HC, et al: Perfusion-decellularized matrix: using nature's platform to engineer a bioartificial heart. Nat Med 14: 213-221, 2008. – reference: 8) Xu L, et al: Randomized trial of autologous bone marrow mesenchymal stem cells transplantation for hepatitis B virus cirrhosis: regulation of Treg/Th17 cells. J Gastroenterol Hepatol 29: 1620-1628, 2014. – reference: 10) Lin BL, et al: Allogeneic bone marrow-derived mesenchymal stromal cells for hepatitis B virus-related acute-on-chronic liver failure: A randomized controlled trial. Hepatology 66: 209-219, 2017. |
| SSID | ssib043658134 ssj0066765 ssib002821954 ssib005879745 ssib007485360 ssib058493862 ssib000940260 ssib002484664 |
| Score | 2.1721733 |
| Snippet | 抗ウイルス剤や分子標的薬の進歩により，肝疾患患者の予後は改善されてきた．しかし，急性肝不全や非代償性肝硬変症の予後は依然として不良であり，肝移植に代わり得るような治療効果の高い内科的治療の開発が必要である．そのため，肝臓再生療法は肝細胞移植（hepatocyte... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 798 |
| SubjectTerms | 急性肝不全 肝硬変 肝細胞様細胞 肝臓再生療法 造血幹細胞 間葉系幹細胞 |
| Title | 肝臓の再生医療の現状 |
| URI | https://www.jstage.jst.go.jp/article/naika/108/4/108_798/_article/-char/ja |
| Volume | 108 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本内科学会雑誌, 2019/04/10, Vol.108(4), pp.798-804 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR27btRA0ApBQjSIp3hGKZgKOZy9691ZuvXFpwgUJKREikRhne294ooDoUtDRwqQEIgCGgrEH1DSIPEzKLp8BjNr--wgChIaa2_nsTs7a82sb3YmCO46ZyaoYxGKcuBCqSsMMdYuTBSdhsg_daUPHt9-rLZ25cO9ZG_lzNNe1NL-vNgoX_71XslptEp9pFe-JXsCzS6ZUge1Sb_0JA3T8590DBkCxmA2fUODEZAJ8g3BZpAlgAqQQNQvwYx8zxDS1PcYJuyQNeAI0rphIVV9nxUyBUaDTXxjCHbYMk8Y3xK3iHvsJlgFmYR0CMZCZsCkHoRgLQ3d6pYhliDoIcQmZT17DpIxCYw0sazDVywiz64d3-PTQCOeLRGmPHSHnzA-y0coFkzSrEE6aAciKjPqf_CI_H83Tegrb1FPixwHwkuLXmjNE0z90pJkVvB8UuH5-4FSe-90a9U3HXEUknWov3642logCtqQdSWepTkZYO-9kT3joOt6262fUZdd_tOExZHiDLAzvkDGAaAbS6pjWcGbPZd7PM7ymkv_JOy8hfG9vXxKh4ezsdY-huHRk57vbSTnk-v5anis1ACdxaN-rsAEtemXRtCSPL2OXgryZaMu1yA5tkagWuZy41jqupxIs451wlsW9_4xYckVnNLBqA2q9H7ezsXgQnNAW7e1dJeClen4cnBuuwlBuRKsHR18OXrz8derb4ev3y8-fT1892Px-YB-Lj78XLz9fjXYHWU7w62wKTISTsmUDUKsJtFAu1JKNYkKIarCFVjochJrzotUaDd2Ko4qlFVVVKJUWBkc46DQMecd0OJasDp7NnPXg_UK1ZirzWrDWRrRmXEUKSwF-eCJRBHdCB7UkuXP60wy-Qm0ePN_iG8F57s36XawOn-x7-6QMz0v1vym-A3Q85RF |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E8%82%9D%E8%87%93%E3%81%AE%E5%86%8D%E7%94%9F%E5%8C%BB%E7%99%82%E3%81%AE%E7%8F%BE%E7%8A%B6&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%86%85%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E9%AB%98%E8%A6%8B%2C+%E5%A4%AA%E9%83%8E&rft.au=%E6%9D%BE%E6%9C%AC%2C+%E4%BF%8A%E5%BD%A6&rft.au=%E5%9D%82%E4%BA%95%E7%94%B0%2C+%E5%8A%9F&rft.date=2019-04-10&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%86%85%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0021-5384&rft.eissn=1883-2083&rft.volume=108&rft.issue=4&rft.spage=798&rft.epage=804&rft_id=info:doi/10.2169%2Fnaika.108.798&rft.externalDocID=article_naika_108_4_108_798_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0021-5384&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0021-5384&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0021-5384&client=summon |