Advances in mesenchymal stem cell therapy and natural antioxidants for hepatic fibrosis: A comprehensive review

Liver damage resulting from the administration of various allopathic drugs and their associated toxicity has become a major health problem, leading to hepatic fibrosis, cirrhosis, and metabolic disorders. This epidemic condition of liver disease represents a major global cause of death and morbidity. Although orthotopic liver transplantation remains a vital treatment option for fibrotic liver conditions, its efficacy is limited by organ scarcity and the risk of immunological rejection. Consequently, alternative therapeutic approaches are urgently needed. Cell-based therapy utilizing mesenchymal stem cells (MSCs) has garnered considerable interest as a promising treatment modality. MSCs exhibit immunomodulatory properties and can differentiate into hepatocytes, thus facilitating the regeneration of damaged hepatocytes and increasing residual hepatocyte proliferation while inhibiting activation or apoptosis of liver stellate cells. However, despite their potential benefits, transplanted cells often exhibit low survival rates due to inadequate oxidative and inflammatory stress resistance. Plants harbor a diverse array of bioactive compounds known to possess hepatoprotective and antioxidant properties. Nanomaterials play a crucial role in regenerative medicine by providing targeted delivery of therapeutic agents and scaffolds for tissue engineering. In treating fibrotic liver, nanomaterials can help mitigate fibrosis progression and promote liver regeneration through controlled release of anti-fibrotic agents and growth factors. This review highlights the synergistic potential of stem cell-based therapy, natural antioxidants, differentiation factors, and nanotechnology in combating hepatic fibrosis and advancing liver regenerative medicine. These combined approaches offer promising avenues for effectively treating fibrotic liver conditions and promoting tissue regeneration.