A combination of mesenchymal stem cells and scaffolds promotes motor functional recovery in spinal cord injury: a systematic review and meta-analysis

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>There is controversy about the role of scaffolds as an adjunctive therapy to mesenchymal stem cell (MSC) transplantation in spinal cord injury (SCI). Thus, the authors aimed to design a meta-analysis on preclinical evidence to evaluate the effectiveness of combination therapy of scaffold + MSC transplantation in comparison with scaffolds alone and MSCs alone in improving motor dysfunction in SCI.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Electronic databases including Medline, Embase, Scopus, and Web of Science were searched from inception until the end of August 2018. Two independent reviewers screened related experimental studies. Animal studies that evaluated the effectiveness of scaffolds and/or MSCs on motor function recovery following experimental SCI were included. The findings were reported as standardized mean difference (SMD) and 95% confidence interval (CI).</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>A total of 34 articles were included in the meta-analysis. Analyses show that combination therapy in comparison with the scaffold group alone (SMD 2.00, 95% CI 1.53–2.46, p &lt; 0.0001), the MSCs alone (SMD 1.58, 95% CI 0.84–2.31, p &lt; 0.0001), and the nontreated group (SMD 3.52, 95% CI 2.84–4.20, p &lt; 0.0001) significantly improved motor function recovery. Co-administration of MSCs + scaffolds only in the acute phase of injury (during the first 3 days after injury) leads to a significant recovery compared to scaffold alone (SMD 2.18, p &lt; 0.0001). In addition, the cotransplantation of scaffolds with bone marrow–derived MSCs (SMD 1.99, p &lt; 0.0001) and umbilical cord–derived MSCs (SMD 1.50, p = 0.001) also improved motor function following SCI.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>The findings showed that scaffolds + MSCs is more effective than scaffolds and MSCs alone in improving motor function following SCI in animal models, when used in the acute phase of injury.</jats:p></jats:sec>

Advances in Tissue Engineering and Innovative Fabrication Techniques for 3-D-Structures: Translational Applications in Neurodegenerative Diseases

“…After SCI was induced, the protocol required the injection of biomaterials (made of diblock copolypeptide hydrogels) delivering fibroblast growth factor 2, EGF, glial cell-derived neurotrophic factor (GDNF), and integrin-blocking antibody [ 170 ]. Other than compounds, bio-scaffolds can also in this case be used to deliver stem cells, most frequently human mesenchymal stem cells, widely used in the treatment of the disease [ 269 , 270 , 271 ], but scaffolds complexed with NPCs have also been developed [ 166 , 272 , 273 ]. It is worth mentioning that in the case of SCI, biomaterials (in particular the Neuro-Spinal Scaffold - InVivo Therapeutics Corp.) have also been used in clinical practice [ 167 , 168 ].…”

Mesenchymal Stem Cells for Neurological Disorders

“…[ 175–179 ] Furthermore, it was demonstrated that MSCs seeded in different scaffolds transplanted into injured spinal cord facilitate post‐traumatic regeneration of nervous tissue to a greater extent than MSCs infused as a cell suspension. [ 180–182 ]…”

Treatment of spinal cord injury with mesenchymal stem cells

“…Furthermore, the scaffold itself also has the function of inhibiting glial scar formation, subside inflammation, stimulate angiogenesis and promote neurogenesis [ 94 , 97 ]. The systematic review and meta-analysis conducted by Yousefifard et al [ 98 ] showed that combination of MSCs and scaffolds is more effective compared to MSCs and scaffolds alone in improving the motor function in animal SCI models.…”