Enumeration, isolation, and electron microscopic study of hematopoietic stem cells in Egyptian patients with chronic liver diseases

The contribution of hematopoietic stem cells (HSCs) to liver regeneration in different forms of liver injury remains debatable. Many studies tried to verify whether various liver lesions can activate bone marrow by mobilizing peripheral blood HSCs (CD34/CD133⁺cells) putatively able to induce liver repopulation. The aim of this work was to determine the degree of mobilization of BM-derived HSCs into the peripheral blood of chronic hepatic affection patients and correlating it with various grades of liver damage. This study was conducted on 30 patients with Child A, B, and C grades of chronic liver disease (ten patients for each stage) as well as ten age- and sex-matched normal healthy subjects were enrolled as a control group. The percent of circulating HSCs was determined by flow cytometry. Also, the isolation of such cells was done by magnetic cell-sorting technique for further ultrastructural assessment by transmission electron microscopy (TEM). Our study revealed that chronic liver disease patients compared to healthy control group, exhibited insignificant difference in the percentage of circulating CD133⁺ cells. Regarding the level of CD34⁺ cells, a significant increase was found between Child A chronic liver disease patients and the control group (p = 0.02). However, an insignificant difference was found between Child B and C patients and control group or between each other (p > 0.05). The ultrastructural characteristics of isolated cells were compared in healthy subjects and hepatic patients, the cells were similar in appearance in both groups with no evidence of structural changes. TEM analysis revealed typical features of immaturity. Our study showed that chronic lesions of any degree of severity did not evoke bone marrow to mobilize HSCs into the circulation.