施万细胞移植用于脊髓损伤的再髓鞘化、再生、组织保护及功能恢复：动物研究的系统评价与荟萃分析
Schwann cell transplantation for remyelination, regeneration, tissue sparing, and functional recovery in spinal cord injury: A systematic review and meta-analysis of animal studies.
作者信息
Hajimirzaei Pooya, Tabatabaei Faeze Sadat Ahmadi, Nasibi-Sis Hamed, Razavian Reyhane Sadat, Nasirinezhad Farinaz
机构信息
Department of Radiation Sciences, Allied Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran; Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran.
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
出版信息
Exp Neurol. 2025 Feb;384:115062. doi: 10.1016/j.expneurol.2024.115062. Epub 2024 Nov 22.
INTRODUCTION
Spinal cord injury (SCI) is a significant global health challenge that results in profound physical and neurological impairments. Despite progress in medical care, the treatment options for SCI are still restricted and often focus on symptom management rather than promoting neural repair and functional recovery. This study focused on clarifying the impact of Schwann cell (SC) transplantation on the molecular, cellular, and functional basis of recovery in animal models of SCI.
MATERIAL AND METHODS
Relevant studies were identified by conducting searches across multiple databases, which included PubMed, Web of Science, Scopus, and ProQuest. The data were analyzed via comprehensive meta-analysis software. We assessed the risk of bias via the SYRCLE method.
RESULTS
The analysis included 59 studies, 48 of which provided quantitative data. The results revealed significant improvements in various outcome variables, including protein zero structures (SMD = 1.66, 95 %CI: 0.96-2.36; p < 0.001; I = 49.8 %), peripherally myelinated axons (SMD = 1.81, 95 %CI: 0.99-2.63; p < 0.001; I = 39.3 %), biotinylated dextran amine-labeled CST only rostral (SMD = 1.31, 95 % CI: 0.50-2.12, p < 0.01, I = 49.7 %), fast blue-labeled reticular formation (SMD = 0.96, 95 %CI: 0.43-1.49, p < 0.001, I = 0.0 %), 5-hydroxytryptamine caudally (SMD = 0.83, 95 %CI: 0.36-1.29, p < 0.001, I = 17.2 %) and epicenter (SMD = 0.85, 95 %CI: 0.17-1.53, p < 0.05, I = 62.7 %), tyrosine hydroxylase caudally (SMD = 1.86, 95 %CI: 1.14-2.59, p < 0.001, I = 0.0 %) and epicenter (SMD = 1.82, 95 %CI: 1.18-2.47, p < 0.001, I = 0.0 %), cavity volume (SMD = -2.07, 95 %CI: -2.90 - -1.24, p < 0.001, I = 67.2 %), and Basso, Beattie, and Bresnahan (SMD = 1.26, 95 %CI: 0.93-1.58; p < 0.001; I = 79.4 %).
CONCLUSIONS
This study demonstrates the promising potential of SC transplantation as a therapeutic approach for SCI, clarifying its impact on various biological processes critical for recovery.
引言
脊髓损伤（SCI）是一项重大的全球健康挑战，会导致严重的身体和神经功能障碍。尽管医疗护理取得了进展，但SCI的治疗选择仍然有限，并且通常侧重于症状管理，而非促进神经修复和功能恢复。本研究的重点是阐明雪旺细胞（SC）移植对SCI动物模型恢复的分子、细胞和功能基础的影响。
材料与方法
通过在多个数据库（包括PubMed、Web of Science、Scopus和ProQuest）中进行检索来识别相关研究。使用综合荟萃分析软件对数据进行分析。我们通过SYRCLE方法评估偏倚风险。
结果
该分析纳入了59项研究，其中48项提供了定量数据。结果显示，各种结果变量都有显著改善，包括蛋白零结构（标准化均数差[SMD]=1.66，95%置信区间[CI]：0.96 - 2.36；p<0.001；异质性指数[I]=49.8%）、外周有髓轴突（SMD = 1.81，95%CI：0.99 - 2.63；p<0.001；I = 39.3%）、生物素化葡聚糖胺标记的皮质脊髓束仅在延髓头端（SMD = 1.31，95%CI：0.50 - 2.12，p<0.01，I = 49.7%）、快蓝标记的网状结构（SMD = 0.96，95%CI：0.43 - 1.49，p<0.001，I = 0.0%）、5-羟色胺在尾端（SMD = 0.83，95%CI：0.36 - 1.29，p<0.001，I = 17.2%）和损伤中心（SMD = 0.85，95%CI：0.17 - 1.53，p<0.05，I = 62.7%）、酪氨酸羟化酶在尾端（SMD = 1.86，95%CI：1.14 - 2.59，p<0.001，I = 0.0%）和损伤中心（SMD = 1.82，95%CI：1.18 - 2.47，p<0.001，I = 0.0%）、空洞体积（SMD = -2.07，95%CI：-2.90 - -1.24，p<0.001，I = 67.2%）以及巴索、贝蒂和布雷斯纳汉评分（SMD = 1.26，95%CI：0.93 - 1.58；p<0.001；I = 79.4%）。
结论
本研究证明了SC移植作为SCI治疗方法具有广阔的潜力，阐明了其对恢复至关重要的各种生物学过程的影响。
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