Stem cells for treatment of cardiovascular diseases: An umbrella review of randomized controlled trials

Demurtas, Jacopo; Fanelli, Giuseppe Nicolò; Romano, Simone; Solari, Marco; Yang, Lin; Soysal, Pınar; Sánchez, Guillermo Felipe López; Grabovac, Igor; Smıth, Lee; Zorzi, Alessandro; Luchini, Claudio; Veronese, Nicola

doi:10.1016/j.arr.2021.101257

Cited by 10 publications

(6 citation statements)

References 36 publications

(28 reference statements)

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“…There are papers that discuss the importance of MSC therapy in the treatment of cardiovascular diseases, with the following references being highly recommended. [301][302][303][304][305][306] To date, 36 trials have evaluated the therapeutic potential of MSCs in different pathological conditions, with the most prevalent types being BM-MSCs (25 trials), followed by UC-MSCs (7 trials) and AT-MSCs (4 trials). 303 However, the reported results are contradictory and create controversy about the efficacy of the treatments.…”

Section: Msc Applications In Cardiovascular Disease: a Promising But ...mentioning

confidence: 99%

Stem cell-based therapy for human diseases

Hoang

Pham

Bach

et al. 2022

Sig Transduct Target Ther

398

138

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Recent advancements in stem cell technology open a new door for patients suffering from diseases and disorders that have yet to be treated. Stem cell-based therapy, including human pluripotent stem cells (hPSCs) and multipotent mesenchymal stem cells (MSCs), has recently emerged as a key player in regenerative medicine. hPSCs are defined as self-renewable cell types conferring the ability to differentiate into various cellular phenotypes of the human body, including three germ layers. MSCs are multipotent progenitor cells possessing self-renewal ability (limited in vitro) and differentiation potential into mesenchymal lineages, according to the International Society for Cell and Gene Therapy (ISCT). This review provides an update on recent clinical applications using either hPSCs or MSCs derived from bone marrow (BM), adipose tissue (AT), or the umbilical cord (UC) for the treatment of human diseases, including neurological disorders, pulmonary dysfunctions, metabolic/endocrine-related diseases, reproductive disorders, skin burns, and cardiovascular conditions. Moreover, we discuss our own clinical trial experiences on targeted therapies using MSCs in a clinical setting, and we propose and discuss the MSC tissue origin concept and how MSC origin may contribute to the role of MSCs in downstream applications, with the ultimate objective of facilitating translational research in regenerative medicine into clinical applications. The mechanisms discussed here support the proposed hypothesis that BM-MSCs are potentially good candidates for brain and spinal cord injury treatment, AT-MSCs are potentially good candidates for reproductive disorder treatment and skin regeneration, and UC-MSCs are potentially good candidates for pulmonary disease and acute respiratory distress syndrome treatment.

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Section: Msc Applications In Cardiovascular Disease: a Promising But ...mentioning

confidence: 99%

Stem cell-based therapy for human diseases

Hoang

Pham

Bach

et al. 2022

Sig Transduct Target Ther

398

138

View full text Add to dashboard Cite

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“…We used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) assessment to evaluate the credibility of the evidence provided by each association in the meta-analysis ( Guyatt et al., 2008 ; Demurtas et al., 2021 ). Evidence from the meta-analysis of randomized controlled trials was evaluated based on the significance of the pooled effect, using a p-value of <0.05 as statistical significance.…”

Section: Methodsmentioning

confidence: 99%

Fecal Microbiota Transplantation and Health Outcomes: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

Zhang

Sun

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundMeta-analysis of randomized clinical trials (RCT) demonstrated several health benefits of fecal microbiota transplantation (FMT). However, there has been little comprehensive assessment of the strength and quality of evidence. We conducted an umbrella review to summarize the evidence of the association between FMT and health outcomes.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to August 6, 2021. The random-effects model was applied to recalculate the effect estimates. We used AMSTAR 2 and GRADE to assess the methodological quality and to grade the evidence.ResultsA total of 7 meta-analyses comprising 26 RCTs (median [IQR] primary study, 6 [2-7]; median [IQR] sample size, 267 [147-431] participants) were included in the current umbrella review describing 45 unique associations. There were 22 statistically significant associations (49%) demonstrating beneficial outcomes of FMT for antibiotic resistance burden, functional constipation, inflammatory bowel disease, and C. difficile infection. FMT does not appear to be associated with positive outcomes in irritable bowel syndrome and metabolic syndrome. Eight significant associations (36%) were supported by moderate-quality evidence, nine associations (41%) were supported by low-quality evidence, and the remaining associations found to be significant were supported by very low-quality evidence.ConclusionAlthough we found that FMT was positively associated with several outcomes, caution should be exercised in choosing this approach, given the insufficient number of primary studies, low methodological quality, and low quality of evidence. Further high-quality randomized controlled trials with long-term follow-up are needed to improve the strength and credibility of the evidence base.

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“…We used AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2), a strict, validated, and reliable measurement tool, to assess the methodological quality of each meta-analysis 25 . It consists of 16 items, of which 7 are key items, including quality ratings for meta-analysis of search, reporting, analysis, and transparency 26 .…”

Section: Methodsmentioning

confidence: 99%

The clinical efficacy of faecal microbiota transplantation: An umbrella review of randomized controlled trials

Liu

Zhang

Sun

et al. 2021

Preprint

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INTRODUCTIONFaecal microbiota transplantation (FMT) therapeutic strategy has been associated with positive outcomes in multiple diseases. We conducted an umbrella review of the meta-analysis to summarize the available evidence and assess its credibility.METHODSWe evaluated a meta-analysis of randomized controlled trials that investigated the efficacy and safety of FMT for any condition. We used the random-effects model to obtain estimates and corresponding 95% confidence intervals, heterogeneity estimates, and small-study effects. We used AMSTAR 2 to assess methodological quality and GRADE tools to grade the evidence.RESULTSSeven meta-analyses with a total of 33 outcomes were included in the current umbrella review to evaluate the efficacy and safety of FMT. Overall, there is a moderate certainty of evidence supporting the associations of the use of FMT with better clinical remission in patients with Clostridium difficile infection (RR = 1.74; 95% CI: 1.37-2.22) and inflammatory bowel disease (RR = 1.70; 95% CI: 1.12-2.56). A very low certainty evidence supports the use of FMT to treat antibiotic-resistant bacteria (RR = 5.67; 95% CI: 2.20-14.63) and functional constipation (RR = 1.35; 95% CI: 1.14-1.60) but does not support irritable bowel syndrome (RR = 1.08; 95% CI: 0.65-1.77).DISCUSSIONThe umbrella review of the current meta-analysis demonstrates that FMT intervention is associated with positive outcomes for several diseases. However, the credibility of the evidence is not high. Further high-quality randomized controlled trials should be carried out to improve the strength and credibility of the evidence base.

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Stem cells for treatment of cardiovascular diseases: An umbrella review of randomized controlled trials

Cited by 10 publications

References 36 publications

Stem cell-based therapy for human diseases

Stem cell-based therapy for human diseases

Fecal Microbiota Transplantation and Health Outcomes: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

The clinical efficacy of faecal microbiota transplantation: An umbrella review of randomized controlled trials

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