Stem Cell Therapy as a Potential Treatment of Non-Alcoholic Steatohepatitis-Related End-Stage Liver Disease: A Narrative Review

To review recent research using various stem cell-related therapies, including bone marrow, adipose tissue, hematopoietic stem cells, umbilical cord and induced pluripotent stem cells, both animal and human studies in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH); to discuss the current challenges and future expectations in stem cell therapy for treating liver disease.

NAFLD is one of the most prevalent chronic liver diseases, affecting around 25% of adults, potentially evolving to NASH and cirrhosis. Currently, liver transplantation is the conventional treatment for NASH related end-stage liver disease; however, this is very costly and with the increased difficulties of finding suitable organs, using permanent immunosuppressive agents and surgical complications. Stem cell technology may be a viable future alternative treatment. Stem cells are self-renewing and undifferentiated cells that possess the potential to differentiate into terminal cell types such as hepatocytes that could be used as a novel treatment for NAFLD and NASH. In addition to using the conventional approach in stem cell therapy, other novel techniques such as gene-modified MSCs, 3-D and co-culture systems and others approaches may be helpful in making this a future therapeutic reality.

Stem cell therapy remains in its infancy though may have a major role in the future of regenerative medicine and in particular for the treatment of NAFLD and NASH, either alone or in combination with other approaches. Promising results from recent clinical trials suggest that stem cell technology in this area has some utility though there are still many obstacles to overcome.