Sarveazad Arash, Toloui Amirmohammad, Moarrefzadeh Aida, Nafchi Hanieh Ghasemian, Neishaboori Arian Madani, Yousefifard Mahmoud
Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
Spine Surg Relat Res. 2022 Jun 13;6(5):433-442. doi: 10.22603/ssrr.2022-0004. eCollection 2022 Sep 27.
Considering the limitations of cell therapy, in case of adequate treatment efficacy, conditioned media (CM) may be a desirable alternative to cell therapy. Hence, the present systematic review and meta-analysis aims to evaluate the efficacy of mesenchymal stem cell-derived conditioned media (MSC-CM) in movement resolution following spinal cord injury (SCI) in animal models.
A comprehensive search in the databases of Medline, Scopus, Web of Science, and Embase was completed until the end of March 2021. Animal studies that evaluate the efficacy of MSC-CM on movement resolution following SCI were defined as the inclusion criteria. Lack of an SCI-untreated group, CM derived from a source other than MSC, not assessing motor function, failure to report CM administered dose, a follow-up period of less than 4 weeks, duplicates, and review articles were counted as the exclusion criteria. Final results are presented as overall standardized mean difference (SMD) with a 95% confidence interval (CI).
From the 361 nonduplicate articles, data from 11 articles were entered into the present meta-analysis. The analyses showed that MSC-CM administration in SCI animal models promotes motor recovery (SMD=2.32; 95% CI: 1.55, 3.09; p<0.0001). Subgroup analysis was performed because of the noticeable heterogeneity between the studies (I=80.97%, p<0.0001), depicting that antibiotic administration, delivery amount, delivery type, and follow-up time were the possible sources of heterogeneity. Moreover, multiple meta-regression demonstrated that in cases of delivery amount of more than 120 μL, the efficacy of MSC-CM administration in motor recovery is more than that of delivery amount of less than 120 μL (regression coefficient=3.30; 95% CI: 0.72, 5.89; p=0.019).
Based on the results of the present study, it can be concluded that MSC-CM administration in SCI models improves motor recovery. The efficacy of this treatment strategy significantly increases at doses higher than 120 μL.
考虑到细胞治疗的局限性，在治疗效果足够的情况下，条件培养基（CM）可能是细胞治疗的理想替代方案。因此，本系统评价和荟萃分析旨在评估间充质干细胞来源的条件培养基（MSC-CM）在动物模型脊髓损伤（SCI）后运动功能恢复中的疗效。
截至2021年3月，对Medline、Scopus、Web of Science和Embase数据库进行了全面检索。评估MSC-CM对SCI后运动功能恢复疗效的动物研究被定义为纳入标准。缺乏未治疗SCI组、非MSC来源的CM、未评估运动功能、未报告CM给药剂量、随访期少于4周、重复文章以及综述文章被视为排除标准。最终结果以总体标准化均数差（SMD）及95%置信区间（CI）表示。
从361篇非重复文章中，11篇文章的数据被纳入本荟萃分析。分析表明，在SCI动物模型中给予MSC-CM可促进运动功能恢复（SMD=2.32；95%CI：[1.55, 3.09]；p<0.0001）。由于研究之间存在显著异质性（I=80.97%，p<0.0001），进行了亚组分析，结果表明抗生素给药、给药量、给药方式和随访时间可能是异质性的来源。此外，多元meta回归表明，当给药量超过120μL时，给予MSC-CM在运动功能恢复方面的疗效高于给药量小于120μL的情况（回归系数=3.30；95%CI：[0.72, 5.89]；p=0.019）。
基于本研究结果，可以得出结论，在SCI模型中给予MSC-CM可改善运动功能恢复。当剂量高于120μL时，这种治疗策略的疗效显著增加。
