Birmingham leads stem cell trial on damaged livers

Doctors have started the largest trial of its kind in the world to see if stem cells can repair damaged livers.

Eighty patients will be treated in Birmingham and Edinburgh to analyse whether the use of targeted stem cells can reduce the amount of scarring or cirrhosis of the liver.

It is also hoped that they can get the liver's own cells to divide creating a benefit for the patient.

In the trial, patients will be given injections of the drug GCSF for five days.

This stimulates adult stem cells, which are normally found in bone marrow, to multiply at a much faster rate so that they spill out into the blood stream.

A machine is then used to collect the cells from the blood.

Patients who are displaying symptoms of liver cirrhosis are involved in the trial

Once harvested, the cells are purified, so that a high concentration of the right type of stem cells can be injected back into the patient's blood stream.

The Repeated Autologous Infusions of Stem Cells in Cirrhosis, or 'Realistic' trial, will compare the current standard treatment to both the effect of giving GCSF injections on their own and giving the injections, collecting the stem cells and putting them back into the bloodstream.

Dr Philip Newsome, from the Centre for Liver Research at Birmingham University, is the clinical leader for the trial.

He said that liver disease was increasing, partly due to the obesity epidemic.

New treatments are needed because a liver transplant is currently the only treatment that will improve a patient's condition.

"We know that when the liver is injured, it changes the molecules on the surface of the liver to attract these particular stem cells," he said.

"So by giving patients the drug, GCSF, not only does it put the stem cells into the blood circulation, but it also makes them more likely to go to the liver where we think that they can help break down scarring and also get the liver's own cells to divide.

"When there's a lot of scarring or cirrhosis of the liver, the liver is unable to overcome the damage. It needs a boost and an injection of stem cells allows the liver to get that boost."

Flu-like symptoms

The trial is recruiting patients who are just beginning to exhibit symptoms of liver cirrhosis.

Patients such as 41-year-old Iain Broomhill, from Ellesmere Port, Cheshire, whose liver disease is unexplained, are being recruited.

Stimulating the stem cells causes flu-like symptoms, but Mr Broomhill believes it is worth getting the treatment.

"I think that you have got to explore every opportunity," he said.

"If it works, it will have been well worth it, but it's not just about the here and now, it's about the future and if they can get results that improve things for patients in the future, then that's a good thing."

The Realistic trial is funded by a £1.5m grant from the National Institute for Health Research. The team hopes to be able to report its results within two years.