進行性肝疾患治療に向けた細胞療法の前進 (Cell therapy boost for advanced liver disease treatment)

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2026-05-25 エディンバラ大学

英エディンバラ大学の研究チームは、進行性肝疾患に対する新たな細胞治療法として、患者自身の免疫細胞「マクロファージ」を利用した治療が有望であることを報告した。肝硬変は重度の肝線維化を伴う致死性疾患で、現在の根治療法は肝移植に限られるが、ドナー不足や適応制限が大きな課題となっている。今回の「MATCH Phase 2」臨床試験では、肝硬変患者50人を対象に自己由来マクロファージ細胞療法を実施し、治療群では1年間に重篤な肝関連有害事象が発生しなかった一方、対照群では重篤事象や死亡例が確認された。マクロファージは本来組織修復を担う免疫細胞であり、本治療では肝線維化抑制や再生促進作用が期待される。研究チームは、将来的に肝移植の必要性を遅らせる可能性があるとしており、慢性肝疾患に対する初の有効な細胞治療法となる可能性が示された。

<関連情報>

自己マクロファージ療法は肝硬変患者の移植なし生存率を向上させる:第2相臨床試験の長期追跡調査 Autologous macrophage therapy increases transplant-free survival in cirrhosis: Long-term follow-up of a phase 2 clinical trial

Paul N. Brennan ∙ Alastair M. Kilpatrick ∙ Alison Glover ∙ … ∙ John F. Dillon ∙ Jonathan A. Fallowfield ∙ Stuart J. Forbes
Cell Stem Cell  Published:May 25, 2026
DOI:https://doi.org/10.1016/j.stem.2026.04.016

Graphical abstract

進行性肝疾患治療に向けた細胞療法の前進 (Cell therapy boost for advanced liver disease treatment)

Highlights

  • Cirrhosis patients were treated with autologous macrophages vs. standard care
  • Macrophage-treated patients had significantly prolonged transplant-free survival
  • No evidence of increased serious adverse events attributable to macrophage therapy
  • Stabilization of proinflammatory cytokines was associated with improved long-term survival

Summary

Liver cirrhosis is a major contributor to global morbidity and mortality, and transplantation remains the only cure for end-stage disease. Preclinical studies have indicated that macrophage injections reduce inflammation, resolve fibrosis, and stimulate liver regeneration. The phase 1/2 Macrophage Therapy for Liver Cirrhosis trial (MATCH01; ISRCTN10368050) demonstrated the safety and potential efficacy of autologous monocyte-derived macrophage therapy in cirrhosis. Following MATCH01, participants were re-enrolled in a long-term follow-up (LTFU) study, extending observation to up to 4 years from randomization. Macrophage-treated patients in MATCH01 phase 2 demonstrated a significantly lower risk of death or transplant within the LTFU period (30.8%) compared with standard medical care (58.3%); macrophage-treated patients had an additional 252 days of restricted mean survival time within the LTFU period. There was no evidence of increased serious adverse events attributable to cell therapy. These results support the continued advancement of macrophage-based regenerative strategies as a promising therapeutic option for end-stage liver disease.

医療・健康
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