Olsson Débora Cristina, Teixeira Bianca Luise, Jeremias Talita Da Silva, Réus Jéssica Conti, De Luca Canto Graziela, Porporatti André Luis, Trentin Andrea Gonçalves
Department of Veterinary Medicine, Federal Institute Catarinense, Concórdia, SC, Brazil.
Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Res Vet Sci. 2021 Mar;135:495-503. doi: 10.1016/j.rvsc.2020.11.014. Epub 2020 Nov 24.
This systematic review aimed to determine the effects of intra-articular administration of mesenchymal stem cells from adipose tissue in dogs with hip joint osteoarthritis (OA). Clinical trials were systematically reviewed, using PubMed, EMBASE, Cochrane Library, LILACS, Web of Science, Scopus, Open Grey, Google Scholar, and ProQuest Dissertation and Thesis without publication year restrictions. References were screened and selected based on predefined eligibility criteria by two independent reviewers, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical outcomes were assessed quantitatively using clinical pain scores, physical examination, imaging examination, questionnaire responses, pain in manipulation, gait analysis, range of joint motion, and adverse effects. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Out of 1483 articles, six met the inclusion criteria for qualitative analysis, with two randomized controlled trials and four before-and-after studies. All studies reported significantly better clinical outcomes in the adipose tissue stem cells (ADSC) group with improvements in pain and function and decreased evidence of hip OA. The risk of bias was categorized as high in the before-and-after studies and moderate to high in the randomized studies. The studies were considered heterogeneous owing to clinical results and methodology. Because of this heterogeneity, it was not possible to perform meta-analysis. Assessments of ADSC reports yielded positive clinical effects that showed improvements in pain and function and decreased evidence of hip osteoarthritis. More high-level, larger-cohort dog studies that utilize standardized protocols are needed.
本系统评价旨在确定关节内注射来自脂肪组织的间充质干细胞对患有髋关节骨关节炎(OA)的犬的影响。我们使用PubMed、EMBASE、Cochrane图书馆、LILACS、科学网、Scopus、Open Grey、谷歌学术以及ProQuest学位论文数据库,对临床试验进行了系统评价,且不受发表年份限制。根据PRISMA(系统评价和Meta分析的首选报告项目)指南,由两名独立审阅者基于预定义的纳入标准对参考文献进行筛选和选择。使用临床疼痛评分、体格检查、影像学检查、问卷回复、手法操作时的疼痛、步态分析、关节活动范围以及不良反应对临床结局进行定量评估。使用乔安娜·布里格斯研究所批判性评价清单评估偏倚风险。在1483篇文章中,有6篇符合定性分析的纳入标准,其中包括2项随机对照试验和4项前后对照研究。所有研究均报告脂肪组织干细胞(ADSC)组的临床结局显著更好,疼痛和功能均有改善,髋关节OA的证据减少。前后对照研究中的偏倚风险被归类为高,随机研究中的偏倚风险为中到高。由于临床结果和方法的不同,这些研究被认为具有异质性。因此,无法进行Meta分析。对ADSC报告的评估产生了积极的临床效果,显示疼痛和功能有所改善,髋关节骨关节炎的证据减少。需要更多采用标准化方案的高水平、大样本量犬类研究。