Department of Pediatrics, Division of Neonatology, University of Texas Health-San Antonio, San Antonio, Texas, 78229-3900, USA.
Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.
Respir Res. 2019 Oct 30;20(1):239. doi: 10.1186/s12931-019-1212-x.
Inflammation plays an important role in the pathogenesis of many lung diseases. Preclinical studies suggest that mesenchymal stromal cell (MSC) conditioned media (CdM) can attenuate inflammation. Our aim was threefold: (1) summarize the existing animal literature evaluating CdM as a therapeutic agent for pediatric/adult lung disease, (2) quantify the effects of CdM on inflammation, and (3) compare inflammatory effects of CdM to MSCs.
Adhering to the Systematic Review Protocol for Animal Intervention Studies, a systematic search of English articles was performed in five databases. Meta-analysis and meta-regression were performed to generate random effect size using standardized mean difference (SMD).
A total of 10 studies met inclusion. Lung diseases included bronchopulmonary dysplasia, asthma, pulmonary hypertension, and acute respiratory distress syndrome. CdM decreased inflammatory cells (1.02 SMD, 95% CI 0.86, 1.18) and cytokines (0.71 SMD, 95% CI 0.59, 0.84). The strongest effect for inflammatory cells was in bronchopulmonary dysplasia (3.74 SMD, 95% CI 3.13, 4.36) while pulmonary hypertension had the greatest reduction in inflammatory cytokine expression (1.44 SMD, 95% CI 1.18, 1.71). Overall, CdM and MSCs had similar anti-inflammatory effects.
In this meta-analysis of animal models recapitulating lung disease, CdM improved inflammation and had an effect size comparable to MSCs. While these findings are encouraging, the risk of bias and heterogeneity limited the strength of our findings.
炎症在许多肺部疾病的发病机制中起着重要作用。临床前研究表明，间充质基质细胞（MSC）条件培养基（CdM）可以减轻炎症。我们的目的有三个：（1）总结评估 CdM 作为小儿/成人肺部疾病治疗剂的现有动物文献，（2）量化 CdM 对炎症的影响，（3）比较 CdM 与 MSC 的炎症作用。
根据动物干预研究系统综述方案，在五个数据库中进行了英文文献的系统搜索。使用标准化均数差（SMD）进行随机效应大小的荟萃分析和荟萃回归。
共有 10 项研究符合纳入标准。肺部疾病包括支气管肺发育不良、哮喘、肺动脉高压和急性呼吸窘迫综合征。CdM 减少了炎症细胞（1.02 SMD，95%置信区间 0.86，1.18）和细胞因子（0.71 SMD，95%置信区间 0.59，0.84）。炎症细胞的最强作用是在支气管肺发育不良（3.74 SMD，95%置信区间 3.13，4.36），而肺动脉高压对炎症细胞因子表达的降低最大（1.44 SMD，95%置信区间 1.18，1.71）。总体而言，CdM 和 MSC 具有相似的抗炎作用。
在这项模拟肺部疾病的动物模型荟萃分析中，CdM 改善了炎症，其作用大小与 MSC 相当。虽然这些发现令人鼓舞，但偏倚风险和异质性限制了我们研究结果的强度。
