干细胞细胞外囊泡治疗缺血性卒中的临床前啮齿动物模型的疗效：一项荟萃分析。

Therapeutic potential of stem cell extracellular vesicles for ischemic stroke in preclinical rodent models: a meta-analysis.

机构信息

Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.

Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan Province, People's Republic of China.

出版信息

Stem Cell Res Ther. 2023 Apr 3;14(1):62. doi: 10.1186/s13287-023-03270-2.

DOI:10.1186/s13287-023-03270-2

PMID:37013588

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10071642/

Abstract

BACKGROUND

Extracellular vesicles derived from stem cells (SC-EVs) have been proposed as a novel therapy for ischemic stroke. However, their effects remain incompletely understood. Therefore, we conducted this meta-analysis to systematically review the efficacy of SC-EVs on ischemic stroke in preclinical rodent models.

METHODS

Using PubMed, EMBASE, and the Web of Science, we searched through studies published up to August 2021 that investigated the treatment effects of SC-EVs in a rodent ischemic stroke model. Infarct volume was the primary outcome. Neurological severity scores (mNSS) were the secondary outcome. The standard mean difference (SMD) and the confidence interval (CI) were calculated using a random-effects model. R and Stata 15.1 were used to conduct the meta-analysis.

RESULTS

Twenty-one studies published from 2015 to 2021 met the inclusion criteria. We also found that SCs-EVs reduced infarct volume by an SMD of - 2.05 (95% CI - 2.70, - 1.40; P < 0.001). Meanwhile, our results revealed an overall positive effect of SCs-derived EVs on the mNSS with an SMD of - 1.42 (95% CI - 1.75, - 1.08; P < 0.001). Significant heterogeneity among studies was observed. Further stratified and sensitivity analyses did not identify the source of heterogeneity.

CONCLUSION

The present meta-analysis confirmed that SC-EV therapy could improve neuron function and reduce infarct volume in a preclinical rodent ischemic stroke model, providing helpful clues for human clinical trials on SC-EVs.

摘要

背景

干细胞衍生的细胞外囊泡 (SC-EVs) 已被提议作为缺血性中风的一种新疗法。然而，其作用仍不完全清楚。因此，我们进行了这项荟萃分析，以系统地综述 SC-EVs 在啮齿动物缺血性中风模型中的疗效。

方法

使用 PubMed、EMBASE 和 Web of Science，我们检索了截至 2021 年 8 月发表的研究，这些研究调查了 SC-EVs 在啮齿动物缺血性中风模型中的治疗效果。梗塞体积是主要结局。神经严重程度评分 (mNSS) 是次要结局。使用随机效应模型计算标准均数差 (SMD) 和置信区间 (CI)。使用 R 和 Stata 15.1 进行荟萃分析。

结果

2015 年至 2021 年发表的 21 项研究符合纳入标准。我们还发现，SC-EVs 通过 SMD 减少梗塞体积为-2.05(95%CI-2.70,-1.40;P<0.001)。同时，我们的结果表明，SC 衍生的 EVs 对 mNSS 有整体的积极影响，SMD 为-1.42(95%CI-1.75,-1.08;P<0.001)。研究之间存在显著的异质性。进一步的分层和敏感性分析未能确定异质性的来源。