Effectiveness of Autologous Stem Cell Therapy for the Treatment of Lower Extremity Ulcers

Jiang, Xupin; Zhang, Hengshu; Teng, Miao

doi:10.1097/md.0000000000002716

Cited by 25 publications

(18 citation statements)

References 34 publications

(79 reference statements)

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“…At present, no effective treatment for POF is currently available. Stem cells, as a multipotent cell type with the capacity of self-renewal and multilineage differentiation, have been proposed as a promising tool in tissue engineering for regenerative medicine ( 37 ). Their therapeutic potential has provided a novel strategy for preserving or recovering damaged ovarian function of women who receive chemotherapy or radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of stem cell transplantation of premature ovarian failure in animal models and patients: A meta-analysis and case report

Chen¹,

Guo²,

Wei³

et al. 2018

Exp Ther Med

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Stem cell transplantation has been considered a promising therapeutic approach for premature ovarian failure (POF). However, to date, no quantitative data analysis of stem cell therapy for POF has been performed. Therefore, the present study performed a meta-analysis to assess the efficacy of stem cell transplantation in improving ovarian function in animal models of POF. In addition, a case report of a patient with POF subjected to stem cell treatment was included to demonstrate that stem cell therapy also contributes to the recovery of ovarian function in patients. Published studies were identified by a systematic review of the PubMed, Embase, and Cochrane's library databases, and references cited in associated reviews were also considered. Data regarding follicle-stimulating hormone (FSH), estradiol (E2), ovarian weight, follicle count, the number of pregnancies and other parameters, including delivery route and cell type, were extracted. Pooled analysis, sensitivity analyses, subgroup analyses and meta-regression were performed. In the case of POF, transvaginal ultrasound (TVS), abdominal ultrasound (TAS) and color Doppler flow imaging (CDFI) were performed to observe the endometrial morphology and blood flow signals in the patient. Overall, pooled results from 16 pre-clinical studies demonstrated that stem cell-based therapy significantly improved FSH levels [standardized mean difference (SMD)=−1.330; 95% confidence interval (CI), -(2.095–0.565); P=0.001], E2 levels (SMD=2.334; 95% CI, 1.350–3.319; P<0.001), ovarian weight (SMD=1.310; 95% CI, 0.157–2.463; P=0.026), follicle count (SMD=1.871; 95% CI, 1.226–2.516; P<0.001), and the number of pregnancies (risk ratio=1.715, 95% CI, 1.213–2.424; P=0.002). The results of TVS and TAS demonstrated improved ovarian size and endometrial thickness in the patient with POF after MSC treatment. Of note, a rich blood flow signal in the endometrium was observed on CDFI. It appeared that stem cell-based therapy may be an effective method for the resumption of ovarian function in a patient and in animal models of POF; however, large-scale and high-quality future studies are required to confirm the present findings due to heterogeneity.

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Section: Discussionmentioning

confidence: 99%

Effect of stem cell transplantation of premature ovarian failure in animal models and patients: A meta-analysis and case report

Chen¹,

Guo²,

Wei³

et al. 2018

Exp Ther Med

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show abstract

“…Given that both studies had a mean age close to the age endpoint of 70 years, this may have interfered with the accuracy of the RCT study results. Jiang et al evaluated the effects of autologous stem cells on lower extremity ulcers and found autologous stem cell-based therapy was associated with better healing of lower extremity ulcers [ 33 ]; however, this study focused on patients with lower extremity ulcers that included diabetic patients and the non-diabetic population. Considering diabetes foot ulcers have specificity and distinctive risk factors, DFU patients should be seen as an independent observational target.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis on the treatment of diabetic foot ulcers with autologous stem cells

et al. 2017

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Over the last decade, many studies have indicated a therapeutic potential for treating diabetic lower extremity ulcers with autologous stem cells. The aim of the current study was to conduct a systematic review and meta-analysis of the treatment of diabetic foot ulcers (DFUs) with autologous stem cells. The search strategy included the Pubmed, EMBASE, Web of Science, and Cochrane’s Library databases. The endpoint measured was the healing of DFUs.Six eligible randomized controlled trial (RCT) studies were screened from related published studies and reviewed for meta-analysis. The overall meta-analysis showed that stem cell administration was significantly favorable for healing diabetic ulcers (mean difference (MD) 0.52, 95% confidence interval (CI) 0.38–0.65; p < 0.00001). Subgroup analyses indicated that stem cells seemed to exert similar beneficial effects on patients with ulcer size ≥ 5 cm2 (MD 0.76, 95% CI 0.55–0.97; p < 0.00001) and < 5 cm2 (MD 0.43, 95% CI 0.31–0.54; p < 0.00001). Furthermore, stem cells had similar effects on patients aged ≥ 70 years (MD 0.61, 95% CI 0.14–1.08; p = 0.01) and < 70 years (MD 0.47, 95% CI 0.35–0.58; p < 0.00001). This systematic review and meta-analysis suggests a promising role for stem cells in DFU treatment. This review will pave the way to further study on the long-term effects of stem cell-based therapy and large-scale RCTs.

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“…In summary, BMSC and ADSC appear to have a positive effect on the healing of chronic wounds [ 38 ]. A systematic review and meta-analysis of BMSC in treatment of chronic leg ulcers [ 39 ] found that BMSC, like ADSC, are both safe and efficient. BMSC and ADSC seem to be alike in terms of differentiation capacities and immune-modulatory properties [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Adipose-derived stem cells for treatment of chronic ulcers: current status

2018

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Chronic ulcers remain a difficult challenge in healthcare systems. While treatment options are limited, stem cells may be a novel alternative. Adipose-derived stem cells (ADSC) have become increasingly popular compared with bone marrow-derived stem cells as they are far easier to harvest. To summarize the current status of treating chronic ulcers with ADSC, this systematic review includes all clinical trials on the subject from PubMed and EmBase, as well as all registered clinical trials on ClinicalTrials.Gov. A total of nine clinical trials and fourteen registered trials were included. The studies were significantly different in terms of study design and patient population, and the overall quality of the studies was low to moderate. Despite the overall low study quality and the significant differences between the studies, some conclusions were consistent: ADSCs are safe, improve the healing of chronic ulcers, and reduce pain. As these results are consistent despite the shortcomings of the studies, they appear to highlight the efficacy of ADSCs in the treatment of chronic ulcers. Larger numbers of higher quality studies are needed to determine the precise role of ADSCs in treating chronic leg ulcers.

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Effectiveness of Autologous Stem Cell Therapy for the Treatment of Lower Extremity Ulcers

Cited by 25 publications

References 34 publications

Effect of stem cell transplantation of premature ovarian failure in animal models and patients: A meta-analysis and case report

Effect of stem cell transplantation of premature ovarian failure in animal models and patients: A meta-analysis and case report

Meta-analysis on the treatment of diabetic foot ulcers with autologous stem cells

Adipose-derived stem cells for treatment of chronic ulcers: current status

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