Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Nephrology (Carlton). 2013 Mar;18(3):201-8. doi: 10.1111/nep.12018.
The meta-analysis of recent small animal experiments of mesenchymal stem/stromal cells (MSC) therapy for impaired kidney could provide significant clues to design large animal experiments as well as human clinical trials.
A total of 21 studies was analyzed. These, were indexed from PubMed and Embase databases. All data were analyzed by RevMan 5.1 and SPSS 17.0. Pooled analysis and multivariable meta-regression were calculated by random effects models. Heterogeneity and publication bias across the studies were also explored.
Pooled analysis showed elevated serum creatinine (Scr) reduction in the animal models of renal failure following MSC therapy. By exploratory multivariable meta-regression, significant influence factors of Scr reduction were the time point of Scr measurement (early measurement showed greater reduction than the late (P = 0.005)) and the route of MSC delivery (arterial delivery of MSCs caused greater reduction in elevated Scr, when compared with the intra-renal delivery and intravenous injection (P = 0.040)). Subgroup analysis showed there tended to be greater reduction in Scr with higher MSC number (>10(6)), the renal ischemia-reperfusion injury (IRI) model, and late administration (>1 day) after injury.
The present meta-analysis confirmed that MSC therapy could improve impaired renal function. MSCs might get obvious effect in the early stage of renal injuries after arterial delivery. Further, this meta-analysis may provide important clues for animal experiments even for human clinical trials in MSC studies.
对间充质干细胞(MSC)治疗受损肾脏的近期小动物实验的荟萃分析可为大型动物实验和人体临床试验的设计提供重要线索。
共分析了 21 项研究。这些研究均来自 PubMed 和 Embase 数据库。所有数据均采用 RevMan 5.1 和 SPSS 17.0 进行分析。采用随机效应模型计算合并分析和多变量 meta 回归。还探索了研究之间的异质性和发表偏倚。
合并分析显示,MSC 治疗肾衰竭动物模型后血清肌酐(Scr)降低。通过探索性多变量 meta 回归,Scr 降低的显著影响因素是 Scr 测量的时间点(早期测量比晚期测量降低更大(P=0.005))和 MSC 输送途径(与肾内输送和静脉注射相比,MSC 动脉输送导致 Scr 升高降低更大(P=0.040))。亚组分析表明,随着 MSC 数量(>10(6))的增加、肾缺血再灌注损伤(IRI)模型和损伤后晚期(>1 天)给药,Scr 降低的趋势更大。
本荟萃分析证实 MSC 治疗可改善受损肾功能。MSC 动脉输送后肾脏损伤的早期可能会产生明显效果。此外,这项荟萃分析可能为 MSC 研究中的动物实验甚至人体临床试验提供重要线索。