The function of liver progenitor cell (LPC) expansion and the impact of macrophage activation on liver regeneration is less studied in humans. A study illustrated the LPC and macrophage compartments, along with gene expression patterns, to determine good prognosis predictors in alcoholic hepatitis (AH).

Liver biopsies of 58 AH patients were subjected to macrophages, proliferative hepatocytes, total and proliferative LPC, and whole liver microarray gene expression investigation by Immunohistochemical studies at baseline. Abstinent cirrhotic patients were the controls. They were categorized as either “improvers” or “non-improvers” according to the change in MELD score three months after baseline.

 The following observations were made-

• A marked macrophage expansion, LPC invasion and increased proliferating hepatocytes and LPC were seen in AH patients than the controls.
• Total LPC expansion (total Keratin7+ cells) was found to be related to liver disease severity in AH patients. 
• Despite identical clinical and biological variables, "improvers" (n = 34) were characterized at baseline as having a greater number of proliferating hepatocytes, proliferative LPC (double Keratin7+Ki67+ cells) and liver macrophages than "non-improvers" (n = 24). 
• Improvers demonstrated a link between upregulated genes and cell cycle mitosis along with a major expression of SPINK1.

Thus a higher liver macrophage expansion, increased proliferative hepatocyte and LPC number and upregulation of cell proliferation-related genes yield advantageous outcomes. 

Source- Lanthier N, Rubbia-Brandt L, Lin-Marq N, Clément S, Frossard JL, Goossens N, Hadengue A, Spahr L. Hepatic cell proliferation plays a pivotal role in the prognosis of alcoholic hepatitis, Journal of Hepatology, 2015;63(3):609-621. https://doi.org/10.1016/j.jhep.2015.04.003.