Nie Da-Qing, Yan Gui-Xiu, Wang Zheng-Yi, Yan Xue, Yu Gui-Mei, Gao Jin-Liang, Liu Di, Li Hong-Bo
Department of Rheumatism, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China.
The Innovation Practice Center, Changchun University of Chinese Medicine, Changchun, Jilin, China.
J Res Med Sci. 2024 Jul 11;29:29. doi: 10.4103/jrms.jrms_697_21. eCollection 2024.
Mesenchymal stem cells (MSCs) are considered a promising therapeutic strategy for rheumatoid arthritis (RA), but the current clinical results are varied. This study is to analyze the therapeutic effect of cell-based strategies on RA.
The searches were performed with public databases from inception to June 17, 2021. Randomized controlled trials researching cell-based therapies in RA patients were included.
Eight studies, including 480 patients, were included in the analysis. The results showed that compared to the control, MSC treatment significantly reduced the disease activity score (DAS) at the second standardized mean difference (SMD): -0.70; 95% confidence interval (CI): -1.25, -0.15; = 0.01) and 3 month (SMD: -1.47; 95% CI: -2.77, -0.18; < 0.01) and significantly reduced the rheumatoid factor (RF) level at the first (SMD: -0.38; 95% CI: -0.72, -0.05; = 0.03) and 6 months (SMD: -0.81; 95% CI: -1.32, -0.31; < 0.01). In the network meta-analysis, MSCs combined with interferon-γ (MSC_IFN) had a significant effect on increasing the American college of rheumatology criteria (ACR) 20, ACR50, and DAS <3.2 populations, had a significant effect on reducing the DAS, and decreased the RF level for a long period.
MSCs could relieve the DAS of RA patients in the short term and reduce the level of RF. MSC_IFN showed a more obvious effect, which could significantly improve the results of ACR20, ACR50, and DAS <3.2 and reduce the DAS and RF levels.
间充质干细胞(MSCs)被认为是类风湿性关节炎(RA)一种很有前景的治疗策略,但目前的临床结果各不相同。本研究旨在分析基于细胞的治疗策略对RA的治疗效果。
检索自建库至2021年6月17日的公共数据库。纳入研究RA患者基于细胞治疗的随机对照试验。
八项研究(共480例患者)纳入分析。结果显示,与对照组相比,间充质干细胞治疗在第2个标准化均数差(SMD)时显著降低疾病活动评分(DAS):-0.70;95%置信区间(CI):-1.25,-0.15;P = 0.01)和第3个月时(SMD:-1.47;95% CI:-2.77,-0.18;P < 0.01),并在第1个(SMD:-0.38;95% CI:-0.72,-0.05;P = 0.03)和第6个月时显著降低类风湿因子(RF)水平(SMD:-0.81;95% CI:-1.32,-0.31;P < 0.01)。在网状Meta分析中,间充质干细胞联合干扰素-γ(MSC_IFN)对增加美国风湿病学会标准(ACR)20、ACR50以及DAS<3.2人群有显著效果,对降低DAS有显著效果,并能长期降低RF水平。
间充质干细胞可在短期内缓解RA患者的DAS,并降低RF水平。MSC_IFN显示出更明显的效果,可显著改善ACR20、ACR50以及DAS<3.2的结果,并降低DAS和RF水平。