Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.
Respir Res. 2020 Nov 20;21(1):307. doi: 10.1186/s12931-020-01574-y.
The investigation of mesenchymal stromal cell (MSC)-conditioned medium or extracellular vesicles (exosomes or microvesicles) as a remedy for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) has become a fast-growing field in recent years. Our purpose was to conduct a meta-analysis to investigate the efficacy of MSC-derived therapies (MDTs) for ALI/ARDS in animal models.
A meta-analysis of MDTs for ALI/ARDS in animal trials was performed. PubMed and EMBASE were searched to screen relevant preclinical trials with a predetermined search strategy.
A total of 17 studies that compared MDT with the ALI control group were included in our study. The pooled result derived from the comparison of the two groups suggested that MDT could significantly reduce the lung injury score (standardized mean difference (SMD) = - 4.02, 95% CI [- 5.28, - 2.23], P < 0.0001) and improve animal survival (OR = - 6.45, 95% CI [2.78, 14.97], P < 0.0001). MDT mitigated the infiltration of neutrophils in alveoli (SMD = - 3.38, 95% CI [- 4.58, - 2.18], P < 0.00001). MDT also reduced the wet-dry weight ratio of the lung (SMD = - 2.34, 95% CI [- 3.42, - 1.26], P < 0.0001) and the total protein in BALF (SMD = - 2.23, 95% CI [- 3.07, - 1.40], P < 0.00001). Furthermore, MDT was found to downregulate proinflammatory mediators such as IL-1, IL-6 and TNF-a and to upregulate anti-inflammatory mediators such as IL-10.
MDT reduces lung injury and improves survival in animal ARDS models since it can ameliorate lung permeability, decrease inflammatory cell infiltration, downregulate proinflammatory mediators, and upregulate anti-inflammatory mediators. However, more animal studies and human trials are needed for further investigation.
近年来，间充质基质细胞（MSC）条件培养基或细胞外囊泡（外泌体或微囊泡）作为急性肺损伤（ALI）或急性呼吸窘迫综合征（ARDS）的治疗方法的研究已经成为一个快速发展的领域。我们的目的是进行荟萃分析，以调查动物模型中 MSC 衍生疗法（MDT）治疗 ALI/ARDS 的疗效。
对动物试验中 MDT 治疗 ALI/ARDS 进行了荟萃分析。使用 PubMed 和 EMBASE 进行了搜索，以使用预定的搜索策略筛选相关的临床前试验。
共有 17 项比较 MDT 与 ALI 对照组的研究被纳入本研究。两组比较的汇总结果表明，MDT 可显著降低肺损伤评分（标准化均数差（SMD）=-4.02，95%CI[-5.28，-2.23]，P<0.0001）和提高动物生存率（OR=-6.45，95%CI[2.78，14.97]，P<0.0001）。MDT 减轻了肺泡中中性粒细胞的浸润（SMD=-3.38，95%CI[-4.58，-2.18]，P<0.00001）。MDT 还降低了肺湿干重比（SMD=-2.34，95%CI[-3.42，-1.26]，P<0.0001）和 BALF 中的总蛋白（SMD=-2.23，95%CI[-3.07，-1.40]，P<0.00001）。此外，MDT 被发现下调促炎介质如 IL-1、IL-6 和 TNF-a，并上调抗炎介质如 IL-10。
MDT 可减轻肺通透性，减少炎症细胞浸润，下调促炎介质，上调抗炎介质，从而减少动物 ARDS 模型中的肺损伤并提高生存率。然而，还需要更多的动物研究和临床试验来进一步研究。
