Shang Zhizhong, Li Dongliang, Chen Jinlei, Wang RuiRui, Wang Mingchuan, Zhang Baolin, Wang Xin, Wanyan Pingping
The First Clinical Medical School of Lanzhou University, Lanzhou, China.
Chengren Institute of Traditional Chinese Medicine, Lanzhou, China.
Front Immunol. 2022 Mar 10;13:855309. doi: 10.3389/fimmu.2022.855309. eCollection 2022.
The optimal transplantation timing of neural stem cells in spinal cord injury is fully explored in animal studies to reduce the risk of transformation to clinical practice and to provide valuable reference for future animal studies and clinical research.
Seven electronic databases, namely, PubMed, Web of Science, Embase, Wanfang, Chinese Scientific Journal Database (CSJD-VIP), China Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI), were searched. The studies were retrieved from inception to November 2021. Two researchers independently screened the literature, extracted data, and evaluated the methodological quality based on the inclusion criteria.
Thirty-nine studies were incorporated into the final analyses. Based on the subgroup of animal models and transplantation dose, the results of network meta-analysis showed that the effect of transplantation in the subacute phase might be the best. However, the results of traditional meta-analysis were inconsistent. In the moderate-dose group of moderate spinal cord injury model and the low-dose group of severe spinal cord injury model, transplantation in the subacute phase did not significantly improve motor function. Given the lack of evidence for direct comparison between different transplantation phases, the indirectness of our network meta-analysis, and the low quality of evidence in current animal studies, our confidence in recommending cell transplantation in the subacute phase is limited. In the future, more high-quality, direct comparative studies are needed to explore this issue in depth.
在动物研究中充分探索神经干细胞在脊髓损伤中的最佳移植时机，以降低转化至临床实践的风险，并为未来的动物研究和临床研究提供有价值的参考。
检索了七个电子数据库，即PubMed、Web of Science、Embase、万方、中国科学期刊数据库（CSJD-VIP）、中国生物医学文献数据库（CBM）和中国知网（CNKI）。研究检索时间从数据库建库至2021年11月。两名研究人员根据纳入标准独立筛选文献、提取数据并评估方法学质量。
最终纳入39项研究进行分析。基于动物模型和移植剂量亚组，网状Meta分析结果显示亚急性期移植效果可能最佳。然而，传统Meta分析结果并不一致。在中度脊髓损伤模型的中剂量组和重度脊髓损伤模型的低剂量组中，亚急性期移植并未显著改善运动功能。鉴于缺乏不同移植阶段之间直接比较的证据、我们网状Meta分析的间接性以及当前动物研究中证据质量较低，我们对推荐在亚急性期进行细胞移植的信心有限。未来，需要更多高质量的直接比较研究来深入探讨这个问题。
