Cirrhosis is associated with dysregulated immune cell activation and immune dysfunction. These conditions modify gut flora, facilitate bacterial translocation, and increase susceptibility to bacterial peritonitis and consequent systemic infections by dramatically affecting long-term patient survival. Human amnion-derived mesenchymal stromal cells (hA-MSCs) exert immunomodulatory potential benefit, and have the ability to modulate their actions, especially in situations requiring immune activation through mechanisms not fully understood. In this study, we aimed to investigate, in vitro, the immunostimulant or immunosuppressive effects of hA-MSCs on cellular components of ascitic fluid obtained from cirrhotic patients with refractory ascites. We found that hA-MSCs viability is not affected by ascitic fluid and, interestingly, hA-MSCs diminished the pro-inflammatory cytokine production, and promoted anti-inflammatory M2 macrophage polarization. Moreover, we found that there was no simultaneous significant decrease in the M1-like component, allowing a continual phagocytosis activity of macrophages and NK cells to restore a physiological condition. These data highlight the plasticity of hA-MSCs’ immunomodulatory capacity, and pave the way to further understanding their role in conditions such as spontaneous bacterial peritonitis.

Graphical abstract

中文翻译：

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难治性腹水肝硬化患者羊膜来源间充质基质细胞：预防自发性细菌性腹膜炎的一种可能的抗炎疗法

肝硬化与失调的免疫细胞活化和免疫功能障碍有关。这些情况会改变肠道菌群，促进细菌易位，并通过显着影响患者的长期生存率来增加对细菌性腹膜炎和随之而来的全身感染的易感性。人羊膜来源的间充质基质细胞 (hA-MSCs) 发挥免疫调节的潜在益处，并具有调节其作用的能力，特别是在需要通过未完全了解的机制进行免疫激活的情况下。在这项研究中，我们旨在在体外研究 hA-MSCs 对从患有顽固性腹水的肝硬化患者获得的腹水细胞成分中的免疫刺激或免疫抑制作用。我们发现 hA-MSCs 的活力不受腹水的影响，有趣的是，hA-MSCs 减少促炎细胞因子的产生，并促进抗炎 M2 巨噬细胞极化。此外，我们发现 M1 样成分没有同时显着减少，使巨噬细胞和 NK 细胞的持续吞噬活性恢复生理状态。这些数据突出了 hA-MSCs 免疫调节能力的可塑性，并为进一步了解它们在自发性细菌性腹膜炎等疾病中的作用铺平了道路。

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