Alatab Sudabeh, Najafi Iraj, Atlasi Rasha, Pourmand Gholamreza, Tabatabaei-Malazy Ozra, Ahmadbeigi Naser
Department of Urology, Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran -
Department of Nephrology, Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Minerva Urol Nefrol. 2018 Apr;70(2):162-178. doi: 10.23736/S0393-2249.17.02882-X. Epub 2017 Mar 31.
Peritoneal fibrosis remains a serious complication of long-term peritoneal dialysis. Stem cell therapy is an innovative field of scientific investigation with potential for clinical application. Here, we systematically reviewed the studies to determine whether stem cell based therapy could improve the peritoneal fibrosis in experimental models of peritoneal fibrosis.
Our systematic search of PubMed, Scopus, Web of Science, and Cochrane Library yield 5219 article. After screening for eligibility, in vivo, experimental, interventional studies using stem cells in animal models of peritoneal fibrosis; 11 articles were included. The studies underwent comprehensive review, quality assessment, and data extraction.
Mesenchymal stem cells were the most used type (90.9%) originated either from bone marrow (70%), adipose tissue (20%), or umbilical cord (10%). In 90.9% of studies, stem cells were injected after peritoneal insult and 63.6% of studies used the intraperitoneal injection route. Eight studies met the ≥50% of criteria indicated by ARRIVE recommendation. Information regarding the nature of ethical review permissions, species, strain and gender, dose, route and duration of treatment, was stated by all studies; 81.8% of the studies reported the number of animals in each group. Adverse events were reported in one study. Improvement in histological parameters including attenuation of submesothelial thickness (100%), inflammation (62.5%), angiogenesis (60%), and fibrosis (85.7%) was reported after stem cell therapy. Peritoneal permeability function by assessing the ultrafiltration, glucose transport and solute permeability was improved in all studies. Stem cell treatment resulted in mesothelial recovery in 100% of studies.
In preclinical studies, the use of stem cells is associated with improved peritoneal fibrosis. This may provide an important foundation to support future translational clinical research using stem cell therapy to repair the injured peritoneum and modulate immune responses in PD patients.
腹膜纤维化仍然是长期腹膜透析的严重并发症。干细胞治疗是一个具有临床应用潜力的创新性科学研究领域。在此，我们系统回顾了相关研究，以确定基于干细胞的治疗是否能改善腹膜纤维化实验模型中的腹膜纤维化。
我们对PubMed、Scopus、Web of Science和Cochrane图书馆进行系统检索，共获得5219篇文章。在筛选合格标准后，纳入了在腹膜纤维化动物模型中使用干细胞的体内、实验性、干预性研究；共纳入11篇文章。对这些研究进行了全面审查、质量评估和数据提取。
间充质干细胞是最常用的类型（90.9%），其来源包括骨髓（70%）、脂肪组织（20%）或脐带（10%）。在90.9%的研究中，干细胞在腹膜损伤后注射，63.6%的研究采用腹腔内注射途径。八项研究符合ARRIVE建议所指出标准的≥50%。所有研究都说明了伦理审查许可的性质、物种、品系和性别、剂量、治疗途径和持续时间等信息；81.8%的研究报告了每组动物的数量。一项研究报告了不良事件。干细胞治疗后，组织学参数得到改善，包括间皮下厚度减轻（100%）、炎症减轻（62.5%）、血管生成改善（60%）和纤维化减轻（85.7%）。所有研究中，通过评估超滤、葡萄糖转运和溶质通透性的腹膜通透性功能均得到改善。100%的研究中干细胞治疗导致间皮恢复。
在临床前研究中，使用干细胞与腹膜纤维化改善相关。这可能为支持未来使用干细胞疗法修复受损腹膜并调节腹膜透析患者免疫反应的转化临床研究提供重要基础。
