Tissue Engineering Group, Biodonostia Health Research Institute, 20014, San Sebastián, Spain.
Gynecology Oncology Unit, Donostia University Hospital, 20014, San Sebastián, Spain.
Stem Cell Res Ther. 2021 Nov 20;12(1):578. doi: 10.1186/s13287-021-02632-y.
Lymphedema, the accumulation of interstitial fluid caused by poor lymphatic drainage, is a progressive and permanent disease with no curative treatment. Several studies have evaluated cell-based therapies in secondary lymphedema, but no meta-analysis has been performed to assess their efficacy.
We conducted a systematic review and meta-analysis of all available preclinical and clinical studies, with assessment of their quality and risk of bias.
A total of 20 articles using diverse cell types were selected for analysis, including six clinical trials and 14 pre-clinical studies in three species. The meta-analysis showed a positive effect of cell-based therapies on relevant disease outcomes (quantification of edema, density of lymphatic capillaries, evaluation of the lymphatic flow, and tissue fibrosis). No significant publication bias was observed.
Cell-based therapies have the potential to improve secondary lymphedema. The underlying mechanisms remain unclear. Due to relevant heterogeneity between studies, further randomized controlled and blinded studies are required to substantiate the use of these novel therapies in clinical practice.
淋巴水肿是由于淋巴引流不良导致的间质液积聚，是一种进行性和永久性疾病，目前尚无治愈方法。一些研究已经评估了细胞疗法在继发性淋巴水肿中的应用，但尚未进行荟萃分析来评估其疗效。
我们对所有可用的临床前和临床研究进行了系统评价和荟萃分析，并评估了它们的质量和偏倚风险。
共选择了 20 篇使用不同细胞类型的文章进行分析，包括 6 项临床试验和 3 种物种的 14 项临床前研究。荟萃分析显示细胞疗法对相关疾病结局（水肿程度、淋巴管密度、淋巴流量评估和组织纤维化）有积极影响。未观察到明显的发表偏倚。
细胞疗法有可能改善继发性淋巴水肿。其潜在机制尚不清楚。由于研究之间存在显著的异质性，需要进一步的随机对照和盲法研究来证实这些新型疗法在临床实践中的应用。
