Stanford School of Medicine
Children's Surgical Research

Liver Regeneration


There are a variety of infectious, neoplastic, metabolic, and autoimmune disease states which affect the developing liver in the pediatric population. The unique ability of the liver to regenerate after injury or resection remains a fascinating yet poorly understood biologic phenomenon, one with unclear significance to the treatment of pediatric liver disease. Cell therapy and tissue engineering are possible alternatives to whole organ transplantation. For the liver, transplantation of the most logical source of cells, hepatocytes, is both laborious and inefficient. Recognizing the successful paradigm of hematopoietic stem cell (HSC) transplantation, there is renewed interest in the clinical utility of specific stem cells for therapeutic application. We have developed three mouse models to study the inherent regenerative capacity of the adult organism liver. We are currently investigating the humoral contribution from bone marrow to liver repair and regeneration. Ongoing studies address the responsible cell type, mechanism of fusion and nuclear re-programming, inducibility of the phenomenon, and overall relevance to liver function. In addition we are examining the issue of tolerance to bone marrow derived hepatocytes with reference to hepatocyte transplantation in both the syngeneic and allogeneic host.

The concept of tissue committed stem cells is a fundamental premise of biology and has served as the paradigm for the regeneration and renewal of postnatal tissue. Unique among solid organs, the liver parenchyma possesses significant regenerative potential after acute injury, able to restore completely lost liver mass within days, without the activation of a stem cell compartment. The oval cell is the liver-specific stem cell; a blast-like cell capable of self renewal and multipotent differentiation, the oval cell can only be identified in the setting of chronic liver injury when resident hepatocytes are unable to enter the cell cycle to restore liver mass. Wnts are a collection of secreted proteins that are evolutionarily conserved, and have been shown to play diverse roles in cell proliferation and differentiation during both development and postnatal life. Similar to their role in tissue morphogenesis, Wnt proteins have been recently determined to be major regulators of postnatal cell proliferation and differentiation. We are currently studying the role of the Wnt-ß-catenin signaling pathway in the regeneration of liver parenchyma in response to both acute and chronic injury.

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