Cell-based therapies for experimental chronic kidney disease: a systematic review and meta-analysis.
Cell-based therapies for experimental chronic kidney disease: a systematic review and meta-analysis.
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DOI：
10.1242/dmm.017699
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发表时间：
2015-03
影响因子：
4.3
通讯作者：
Verhaar MC
中科院分区：
文献类型：
--
作者：
Papazova DA;Oosterhuis NR;Gremmels H;van Koppen A;Joles JA;Verhaar MC
基于细胞的治疗是治疗慢性肾脏病（CKD）的一种有前途的策略，目前是临床前研究的重点。我们进行了系统回顾和荟萃分析，以评估基于细胞的治疗在CKD临床前（动物）研究中的疗效，并确定影响基于细胞的治疗疗效的因素，以指导未来的临床试验。共有71篇文章符合纳入标准。计算血浆尿素、血浆肌酐、尿蛋白、血压、肾小球滤过率、肾小球硬化和间质纤维化等结局参数的标准化平均差异（SMD）和95%置信区间（CI）。针对模型相关因素（种属、性别、模型和治疗时间）和细胞相关因素（细胞类型、状况和来源、给药途径和治疗方案），对每个结局指标进行子分析。总体而言，荟萃分析显示，基于细胞的治疗减少了CKD的发生和进展。这在尿蛋白（SMD，1.34; 95% CI，1.00-1.68）和尿素（1.09; 0.66-1.51）中最为显著，均P<0.001。血浆尿素的变化与肾小球硬化和间质纤维化的变化相关。亚组分析显示，细胞类型（骨髓来源的祖细胞和间充质基质细胞是最有效的）和给药途径（静脉或肾动脉注射）是治疗效果的重要预测因素。与疾病的临床表现、细胞来源和剂量相关的治疗时机与疗效无关。我们的荟萃分析证实，基于细胞的治疗可以改善CKD临床前模型中受损的肾功能和形态。我们的分析可用于优化实验干预，从而支持临床前研究的改进和临床环境中基于细胞的治疗干预的开发。
Cell-based therapy is a promising strategy for treating chronic kidney disease (CKD) and is currently the focus of preclinical studies. We performed a systematic review and meta-analysis to evaluate the efficacy of cell-based therapy in preclinical (animal) studies of CKD, and determined factors affecting cell-based therapy efficacy in order to guide future clinical trials. In total, 71 articles met the inclusion criteria. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcome parameters including plasma urea, plasma creatinine, urinary protein, blood pressure, glomerular filtration rate, glomerulosclerosis and interstitial fibrosis. Sub-analysis for each outcome measure was performed for model-related factors (species, gender, model and timing of therapy) and cell-related factors (cell type, condition and origin, administration route and regime of therapy). Overall, meta-analysis showed that cell-based therapy reduced the development and progression of CKD. This was most prominent for urinary protein (SMD, 1.34; 95% CI, 1.00–1.68) and urea (1.09; 0.66–1.51), both P<0.001. Changes in plasma urea were associated with changes in both glomerulosclerosis and interstitial fibrosis. Sub-analysis showed that cell type (bone-marrow-derived progenitors and mesenchymal stromal cells being most effective) and administration route (intravenous or renal artery injection) were significant predictors of therapeutic efficacy. The timing of therapy in relation to clinical manifestation of disease, and cell origin and dose, were not associated with efficacy. Our meta-analysis confirms that cell-based therapies improve impaired renal function and morphology in preclinical models of CKD. Our analyses can be used to optimise experimental interventions and thus support both improved preclinical research and development of cell-based therapeutic interventions in a clinical setting.
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影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
13.6
作者：
De Chiara, Letizia;Fagoonee, Sharmila;Altruda, Fiorella
通讯作者：
Altruda, Fiorella
影响因子：
5.2
作者：
Eirin, Alfonso;Zhu, Xiang-Yang;Krier, James D.;Tang, Hui;Jordan, Kyra L.;Grande, Joseph P.;Lerman, Amir;Textor, Stephen C.;Lerman, Lilach O.
通讯作者：
Lerman, Lilach O.
条件间充质干细胞通过抑制上皮到间质转变和免疫调节来减轻慢性肾脏疾病的进展。
影响因子：
5.3
作者：
Chang JW;Tsai HL;Chen CW;Yang HW;Yang AH;Yang LY;Wang PS;Ng YY;Lin TL;Lee OK
通讯作者：
Lee OK
影响因子：
13.2
作者：
Cantaluppi, Vincenzo;Biancone, Luigi;Camussi, Giovanni
通讯作者：
Camussi, Giovanni