间充质干细胞及其分泌产物与支架在烧伤创面愈合中的协同作用:一项临床前研究的系统评价和荟萃分析
Synergistic effects of mesenchymal stem cells and their secretomes with scaffolds in burn wound healing: a systematic review and meta-analysis of preclinical studies.
作者信息
Aghayan Amir Hossein, Mohammadi Davood, Atashi Amir, Jamalpoor Zahra
机构信息
Trauma and Surgery Research Center, Aja University of Medical Sciences, Tehran, Iran.
Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
出版信息
J Transl Med. 2025 Jul 1;23(1):708. doi: 10.1186/s12967-025-06712-y.
BACKGROUND
Burn injuries cause severe physical and psychological challenges. Current treatments have limitations, such as incomplete skin regeneration and prolonged healing times, necessitating innovative solutions. Tissue engineering integrates mesenchymal stem cells (MSCs) and scaffolds in preclinical studies to enhance healing, reduce scarring, and regenerate skin. This study examines their combined effects to optimize burn wound therapies.
METHODS
This systematic review and meta-analysis was conducted per PRISMA guidelines, with the protocol registered in PROSPERO. Databases (PubMed, Embase, Scopus, Web of Science, ProQuest) were searched for published studies.The SYRCLE tool assessed risk of bias. Standardized mean difference (SMD) evaluated the therapeutic effect of MSC-scaffold combinations. Statistical analysis employed a random-effects model. Sensitivity analysis, publication bias assessment, and subgroup analysis addressed heterogeneity.
RESULTS
Our meta-analysis reveals that animals treated with MSC-scaffold combinations exhibit enhanced wound closure compared to untreated controls across short-term (SMD = 3.97), mid-term (SMD = 3.47), and long-term (SMD = 3.03) timeframes. Additionally, MSC-scaffold combinations significantly improve angiogenesis (SMD = 6.24), collagen deposition (SMD = 4.97), and growth factor expression (SMD = 6.68), while effectively modulating inflammatory cytokine levels (SMD = -4.88).
CONCLUSION
Our research demonstrates that MSC-scaffold synergy in preclinical burn wound healing significantly improves wound closure, collagen deposition, angiogenesis, and growth factor expression, while effectively modulating inflammatory responses. Despite its potential as an adjunctive therapy, substantial study heterogeneity impedes clinical translation, necessitating standardized protocols to refine and validate this approach for efficacious clinical application.
背景
烧伤会导致严重的身体和心理挑战。目前的治疗方法存在局限性,如皮肤再生不完全和愈合时间延长,因此需要创新的解决方案。在临床前研究中,组织工程将间充质干细胞(MSC)和支架相结合,以促进愈合、减少瘢痕形成并实现皮肤再生。本研究考察了它们的联合作用,以优化烧伤创面治疗。
方法
按照PRISMA指南进行本系统评价和荟萃分析,并在PROSPERO中注册了方案。检索数据库(PubMed、Embase、Scopus、Web of Science、ProQuest)以查找已发表的研究。使用SYRCLE工具评估偏倚风险。标准化均数差(SMD)评估MSC-支架组合的治疗效果。统计分析采用随机效应模型。敏感性分析、发表偏倚评估和亚组分析处理异质性问题。
结果
我们的荟萃分析表明,在短期(SMD = 3.97)、中期(SMD = 3.47)和长期(SMD = 3.03)时间范围内,与未治疗的对照组相比,接受MSC-支架组合治疗的动物伤口愈合情况更好。此外,MSC-支架组合显著改善血管生成(SMD = 6.24)、胶原蛋白沉积(SMD = 4.97)和生长因子表达(SMD = 6.68),同时有效调节炎症细胞因子水平(SMD = -4.88)。
结论
我们的研究表明,临床前烧伤创面愈合中MSC-支架的协同作用显著改善了伤口闭合、胶原蛋白沉积、血管生成和生长因子表达,同时有效调节炎症反应。尽管其作为辅助治疗具有潜力,但大量的研究异质性阻碍了临床转化,需要标准化方案来完善和验证这种方法,以实现有效的临床应用。