Edinburgh Research Archive

View Item 
  •   DSpace Home
  • Edinburgh Medical School
  • Edinburgh Medical School thesis and dissertation collection
  • View Item
  •   DSpace Home
  • Edinburgh Medical School
  • Edinburgh Medical School thesis and dissertation collection
  • View Item
    • Login
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Monocytes-macrophages in liver injury and regeneration

    Download
    NHS study permission forms.zip (2.950Mb)
    published papers.zip (2.371Mb)
    Moore2016.pdf (5.534Mb)
    Date
    2016-07-02
    Author
    Moore, Joanna Kirsty
    Metadata
    Show full item record
    Abstract
    Chronic Liver Disease (CLD) and Acute Liver Failure (ALF) are serious medical syndromes. Current therapeutic options consist of managing complications, and liver transplant. Even if liver transplantation is thought to be suitable for CLD or ALF patients, there are not enough organs available and thus increasingly more deaths occur on the transplant waiting list. Therefore, there is a pressing need to develop additional therapies. This thesis firstly systematically reviews trials in autologous cell therapies as possible treatments for patients with cirrhosis. The published literature is imperfect and the difference in trial design means it has not been possible to conduct a meta-analysis. Regardless of these shortcomings, cell therapy is a potentially positive prospect. In ALF and CLD monocyte-macrophages have diverse roles within the liver. Monocyte and immune cell changes in ALF are investigated and it is demonstrated for the first time that patients with paracetamol induced ALF have a significantly altered blood compartment and that these changes correlate with patient outcome. It is possible that these results may help stratify which patients may spontaneously survive and which patients may require an emergency liver transplant. Furthermore, modulation of these changes may improve outcomes for patients. The thesis also examines monocyte-macrophages in cirrhotic patients and demonstrates the feasibility of differentiating cirrhotic patients’ monocytes into functional macrophages, comparable to healthy volunteers in a Good Manufacturing Practice (GMP) environment. A first in-man trial using macrophages infused to patients with cirrhosis as a potential new treatment is also detailed. Finally, this thesis outlines developmental work for cell therapy in patients with cirrhosis in the multi-centre REALISTIC trial. Patients were randomly assigned to receive; standard medical care, Granulocyte Stimulating Factor (GCSF) injections alone or GCSF combined with repeated stem cell infusion.
    URI
    http://hdl.handle.net/1842/25857
    Collections
    • Edinburgh Medical School thesis and dissertation collection

    Privacy & Cookies | Takedown Policy | Accessibility | Contact
    Privacy & Cookies
    Takedown Policy
    Accessibility
    Contact
     

     

    Browse

    All of DSpaceCommunities & CollectionsIssue DateAuthorsTitlesSubjectsPublication TypeSponsorThis CollectionIssue DateAuthorsTitlesSubjectsPublication TypeSponsor

    My Account

    LoginRegister

    Privacy & Cookies | Takedown Policy | Accessibility | Contact
    Privacy & Cookies
    Takedown Policy
    Accessibility
    Contact