A Comparative Study of Different Stem Cell Transplantation for Spinal Cord Injury: A Systematic Review and Network Meta-Analysis

Liu, Shuangyan; Zhang, Huai; Wang, Haiyan; Hou, Juan; Yang, Yi; Li, Guoxiang; Yu, Kuai; Yang, Lei

doi:10.1016/j.wneu.2021.12.035

Cited by 14 publications

(14 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MSCs from different sources have different intrinsic properties. The use of BMSCs, HUC-MSCs, and AD-MSCs has been reported in the treatment of SCI (Table 1 (136). Compared to UC-MSCs, BMSCs were associated with greater improvement in ASIA exercise scores (weighted mean difference [WMD], 6.67; 95% CI, 0.83-12.73) and ASIA sensory scores (WMD, 12.41; 95% CI, 3.…”

Section: Clinical Application Of Mscs In the Treatment Of Scimentioning

confidence: 99%

Mesenchymal stem cells in the treatment of spinal cord injury: Mechanisms, current advances and future challenges

et al. 2023

View full text Add to dashboard Cite

Spinal cord injury (SCI) has considerable impact on patient physical, mental, and financial health. Secondary SCI is associated with inflammation, vascular destruction, and subsequent permanent damage to the nervous system. Mesenchymal stem cells (MSCs) have anti-inflammatory properties, promoting vascular regeneration and the release neuro-nutrients, and are a promising strategy for the treatment of SCI. Preclinical studies have shown that MSCs promote sensory and motor function recovery in rats. In clinical trials, MSCs have been reported to improve the American Spinal Injury Association (ASIA) sensory and motor scores. However, the effectiveness of MSCs in treating patients with SCI remains controversial. MSCs promote tumorigenesis and ensuring the survival of MSCs in the hostile environment of SCI is challenging. In this article we examine the evidence on the pathophysiological changes occurring after SCI. We then review the underlying mechanisms of MSCs in the treatment of SCI and summarize the potential application of MSCs in clinical practice. Finally, we highlight the challenges surrounding the use of MSCs in the treatment of SCI and discuss future applications.

show abstract

Section: Clinical Application Of Mscs In the Treatment Of Scimentioning

confidence: 99%

Mesenchymal stem cells in the treatment of spinal cord injury: Mechanisms, current advances and future challenges

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In order to better highlight the purpose and value of this study, we compared it with previously published studies. A total of 8 systematic reviews/meta-analyses (SR/MA) of stem cells for SCI were searched [ 20 , 21 , 109 – 114 ], as detailed in Table 2 . Although safety is paramount for the clinical application of any therapy, we found that the published SR/MA focused on efficacy indicators while largely ignoring the safety outcomes of stem cell therapy.…”

Section: Similarities and Differences With Similar Studiesmentioning

confidence: 99%

“…2) More AEs occurred after stem cell transplantation (RR = 4.342, 95%CI [2.248, 6.436], p < 0.001), mainly including fever, headache, and neuropathic pain. Liu et al [ 21 ] Network meta-analysis 12 642 3 ASIA impairment scale grade, Barthel index 1) Stem cells combined with rehabilitation training were significantly more effective than rehabilitation training alone in improving ASIA and Barthel index. 2) More adverse effects occurred after stem cell transplantation, mainly including fever (7.59%), headache (5.69%), and neuropathic pain (4.88%).…”

Section: Similarities and Differences With Similar Studiesmentioning

confidence: 99%

“…However, experts must remain aware that there is still a lot of work to be done. Although systematic reviews of stem cell therapy for SCI have been published previously, they have had certain problems and limitations [ 20 , 21 ]. Most of the current studies are single-arm, early-stage clinical trials with the main purpose of evaluating the safety of stem cells.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical translation of stem cell therapy for spinal cord injury still premature: results from a single-arm meta-analysis based on 62 clinical trials

Shang

Wang

Zhang

et al. 2022

BMC Med

View full text Add to dashboard Cite

Background How much scientific evidence is there to show that stem cell therapy is sufficient in preclinical and clinical studies of spinal cord injury before it is translated into clinical practice? This is a complicated problem. A single, small-sample clinical trial is difficult to answer, and accurate insights into this question can only be given by systematically evaluating all the existing evidence. Methods The PubMed, Ovid-Embase, Web of Science, and Cochrane databases were searched from inception to February 10, 2022. Two independent reviewers performed the literature search, identified and screened the studies, and performed a quality assessment and data extraction. Results In total, 62 studies involving 2439 patients were included in the analysis. Of these, 42 were single-arm studies, and 20 were controlled studies. The meta-analysis showed that stem cells improved the ASIA impairment scale score by at least one grade in 48.9% [40.8%, 56.9%] of patients with spinal cord injury. Moreover, the rate of improvement in urinary and gastrointestinal system function was 42.1% [27.6%, 57.2%] and 52.0% [23.6%, 79.8%], respectively. However, 28 types of adverse effects were observed to occur due to stem cells and transplantation procedures. Of these, neuropathic pain, abnormal feeling, muscle spasms, vomiting, and urinary tract infection were the most common, with an incidence of > 20%. While no serious adverse effects such as tumorigenesis were reported, this could be due to the insufficient follow-up period. Conclusions Overall, the results demonstrated that although the efficacy of stem cell therapy is encouraging, the subsequent adverse effects remain concerning. In addition, the clinical trials had problems such as small sample sizes, poor design, and lack of prospective registration, control, and blinding. Therefore, the current evidence is not sufficiently strong to support the clinical translation of stem cell therapy for spinal cord injury, and several problems remain. Additional well-designed animal experiments and high-quality clinical studies are warranted to address these issues.

show abstract

“…Neurogenic bladder (NB) as a common complication of SCI reduces quality of life [ 3 ]. Such patients might present with detrusor underactivity, detrusor overactivity, or detrusor sphincter dyssynergia, resulting in voiding dysfunction, bladder deformity, and renal failure, which cause severe financial and psychological burdens to patients and society [ 4 , 5 ]. Surgical restabilization of the vertebral column and rehabilitation are currently the primary treatments for patients with SCI [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Implantation of adipose-derived mesenchymal stem cell sheets promotes axonal regeneration and restores bladder function after spinal cord injury

Chen

Wang

et al. 2022

Stem Cell Res Ther

View full text Add to dashboard Cite

Background Cell-based therapy using adipose-derived mesenchymal stem cells (ADSCs) is a promising treatment strategy for neurogenic bladder (NB) associated with spinal cord injury (SCI). However, therapeutic efficacy is low because of inefficient cell delivery. Cell sheets improve the efficacy of cell transplantation. Therefore, this study was conducted to investigate the therapeutic efficacy of transplanting ADSC sheets into an SCI rat model and focused on the function and pathological changes of the bladder. Methods ADSC sheets were prepared from adipose tissue of Sprague–Dawley (SD) rats using temperature-responsive cell culture dishes. Adult female SD rats were subjected to SCI by transection at the T10 level and administered ADSC sheets or gelatin sponge (the control group). Four and 8 weeks later, in vivo cystometrograms were obtained for voiding function assessment. Rats were sacrificed and the expression of various markers was analyzed in spinal and bladder tissues. Results The number of β-tubulin III-positive axons in the ADSC sheet transplantation group was higher than that in the control group. Conversely, expression of glial fibrillary acidic protein in the ADSC sheet transplantation group was lower than that in the control group. Cystometry showed impairment of the voiding function after SCI, which was improved after ADSC sheet transplantation with increased high-frequency oscillation activity. Furthermore, ADSC sheet transplantation prevented disruption of the bladder urothelium in SCI rats, thereby maintaining the intact barrier. Compared with fibrosis of the bladder wall in the control group, the ADSC sheet transplantation group had normal morphology of the bladder wall and reduced tissue fibrosis as shown by downregulation of type 1 collagen. ADSC sheet transplantation also resulted in strong upregulation of contractile smooth muscle cell (SMC) markers (α-smooth muscle actin and smoothelin) and downregulation of synthetic SMC markers (MYH10 and RBP1). Conclusion ADSC sheet transplantation significantly improved voiding function recovery in rats after SCI. ADSC sheet transplantation is a promising cell delivery and treatment option for NB related to SCI.

show abstract

A Comparative Study of Different Stem Cell Transplantation for Spinal Cord Injury: A Systematic Review and Network Meta-Analysis

Cited by 14 publications

References 42 publications

Mesenchymal stem cells in the treatment of spinal cord injury: Mechanisms, current advances and future challenges

Mesenchymal stem cells in the treatment of spinal cord injury: Mechanisms, current advances and future challenges

Clinical translation of stem cell therapy for spinal cord injury still premature: results from a single-arm meta-analysis based on 62 clinical trials

Implantation of adipose-derived mesenchymal stem cell sheets promotes axonal regeneration and restores bladder function after spinal cord injury

Contact Info

Product

Resources

About