Мезенхимальные стромальные клетки при хронических фиброзирующих заболеваниях печени: роль в патогенезе и при терапевтическом применении

Цель: провести сравнительный анализ биорегуляторной роли мезенхимальных стромальных клеток (МСК) печени в норме, при остром и хроническом повреждении печени с развитием деструктивных фиброзирующих процессов, а также при коррекции структурных нарушений в печени путем имплантации в организм экзогенных МСК из здоровых тканей. Анализ показал, что МСК в печени поддерживают ее структурный гомеостаз, взаимодействуя с тканевыми миофибробластами и мигрирующими клетками иммунной системы. При остром повреждении печени, не истощающем резервы тканевой адаптации, печеночные (резидентные) МСК регуляторно поддерживают тканевой гомеостаз. При хроническом повреждении печени, истощающем резервы тканевой адаптации, наступает активация иммунных клеток и печеночных МСК, которые индуцируют воспаление печени и переход МСК в миофибробласты. Миофибробласты, становясь активированными фибробластами, начинают продуцировать избыточные количества внеклеточного матрикса и участвовать в активации процессов фиброзирования печени. Экзогенные апоптотические МСК из здоровых ауто- или аллогенных тканей при введении в организм при хроническом повреждении печени способны восполнить дефицит регуляторных факторов, а также восстановить регуляцию метаболизма и структурного гомеостаза в печени за счет выделяемых ими паракринных и трофических факторов. Экзогенные МСК позволяют надежно восстановить метаболизм и структурный гомеостаз в печени, если перед использованием дополнительно усилить их регуляторную активность и если не применять их у реципиентов с необратимым повреждением печени.

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