间充质干细胞注射治疗骨关节炎患者的疗效和安全性:荟萃分析和 RCT 综述。
Efficacy and safety of mesenchymal stem cell injections for patients with osteoarthritis: a meta-analysis and review of RCTs.
机构信息
Affiliated Hospital of Jiangsu University, No.438, Jiefang road, Zhenjiang, 212000, China.
The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing, China.
出版信息
Arch Orthop Trauma Surg. 2021 Jul;141(7):1241-1251. doi: 10.1007/s00402-020-03703-0. Epub 2021 Jan 28.
INTRODUCTION
Osteoarthritis (OA), which has a high incidence in the elderly, brings a huge economic burden to society. MSCs (Mesenchymal Stem Cells) have shown great multidirectional differentiation potential which are expected to treat OA, and numerous clinical trials have been conducted. However, the efficacy and safety of the MSCs still need to be further integrated and analyzed.
MATERIALS AND METHODS
We searched several databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, Ovid, and ScienceDirect) for assessing eligible trials that randomized controlled trials, hyaluronic acid as control, and MSCs injection to treat OA. Vitro studies and animal studies were excluded. Search terms were: "cartilage," "clinical trial," "mesenchymal," "stromal" and "stem cell", "osteoarthritis". The preliminary guidelines and study protocol were published online at PROSPERO.
RESULTS
Many assessment scales could not be improved significantly after 6 months. However, most of the scales were significantly improved after 12 months, indicating that compared with hyaluronic acid, stem cells could relieve OA symptoms significantly. No serious adverse effect was found.
CONCLUSION
There are significant therapeutic effects on joint function, symptoms, and no permanent adverse effect has been found after stem cell treatment. It is promising to apply intro-articular injection of stem cells for OA to clinical application. More researches are needed to supplement present deficiencies.
简介
骨关节炎(OA)在老年人中的发病率很高,给社会带来了巨大的经济负担。间充质干细胞(MSCs)具有很强的多向分化潜能,有望用于治疗 OA,已经进行了许多临床试验。然而,MSCs 的疗效和安全性仍需要进一步综合分析。
材料与方法
我们检索了多个数据库(PubMed、EMBASE、Scopus、Web of Science、Cochrane Library、Ovid 和 ScienceDirect),以评估符合条件的试验,即随机对照试验,透明质酸作为对照,以及 MSCs 注射治疗 OA。排除体外研究和动物研究。检索词为:“软骨”、“临床试验”、“间充质”、“基质”和“干细胞”、“骨关节炎”。初步指南和研究方案已在线发布在 PROSPERO 上。
结果
许多评估量表在 6 个月后不能显著改善。然而,大多数量表在 12 个月后显著改善,表明与透明质酸相比,干细胞能显著缓解 OA 症状。未发现严重不良反应。
结论
干细胞治疗后关节功能和症状有明显的治疗效果,且无永久性不良反应。关节内注射干细胞治疗 OA 具有良好的临床应用前景。需要进一步研究来补充现有不足。