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藻酸盐支架可改善脊髓损伤后的功能恢复。

Alginate scaffolds improve functional recovery after spinal cord injury.

作者信息

Jahandideh Atefeh, Noori Hamid, Rahimi Behnaz, Hamblin Michael R, Behroozi Zahra, Ramezani Moazzameh, Ramezani Fatemeh

机构信息

Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Trauma Emerg Surg. 2022 Jun;48(3):1711-1721. doi: 10.1007/s00068-021-01760-7. Epub 2021 Aug 7.

Abstract

PURPOSE

In this systematic review and meta-analysis, the use of alginate for the repair of the damaged spinal cord was investigated.

METHODS

After an extensive search of databases including MEDLINE, SCOPUS, EMBASE and Web of Science, an initial screening was performed based on inclusion and exclusion criteria. The full text of related articles was reviewed and data mining was performed. Data were analyzed by calculating the mean of ratios between treated and untreated groups using STATA software. Subgroup analysis was also performed due to heterogeneity. Articles were subjected to quality control and PRISMA guidelines were followed.

RESULTS

Twelve studies and 17 experiments were included in the study. After SCI, alginate hydrogel had a moderate effect on motor function recovery (SMD = 0.64; 95% CI 0.28-1.00; p < 0.0001) and alginate scaffolds loaded with drugs, growth factors, or cells on the SCI group compared with untreated SCI animals showed has a strong effect in the treatment of SCI (SMD = 2.82; 95% CI 1.49-4.145; p < 0.0001). Treatment with drug/cell in combination with alginate was more strongly significant compared to the groups treated with drug/cell alone (SMD = 4.55; 95% CI 1.42-7.69; p < 0.0001). Alginate alone or in combination therapy when used as an implant, had a more significant effect than injection.

CONCLUSION

These findings suggest that alginate is an efficient scaffold for functional recovery and even a much better scaffold for drug/cell delivery after SCI.

摘要

目的

在本系统评价和荟萃分析中,研究了藻酸盐在脊髓损伤修复中的应用。

方法

在广泛检索包括MEDLINE、SCOPUS、EMBASE和Web of Science在内的数据库后,根据纳入和排除标准进行初步筛选。对相关文章的全文进行了回顾并进行了数据挖掘。使用STATA软件通过计算治疗组与未治疗组之间的比率均值来分析数据。由于存在异质性,还进行了亚组分析。文章进行了质量控制并遵循PRISMA指南。

结果

该研究纳入了12项研究和17项实验。脊髓损伤后,藻酸盐水凝胶对运动功能恢复有中度影响(标准化均数差=0.64;95%置信区间0.28 - 1.00;p<0.0001),与未治疗的脊髓损伤动物相比,在脊髓损伤组中加载药物、生长因子或细胞的藻酸盐支架对脊髓损伤的治疗有显著效果(标准化均数差=2.82;95%置信区间1.49 - 4.145;p<0.0001)。与单独使用药物/细胞治疗的组相比,药物/细胞与藻酸盐联合治疗的效果更显著(标准化均数差=4.55;95%置信区间1.42 - 7.69;p<0.0001)。藻酸盐单独或作为联合疗法用作植入物时,比注射有更显著的效果。

结论

这些发现表明,藻酸盐是促进功能恢复的有效支架,甚至在脊髓损伤后作为药物/细胞递送的支架效果更佳。

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