Systematic Review and Meta-Analysis of Bone Marrow-Derived Mononuclear Cells in Animal Models of Ischemic Stroke.
Systematic Review and Meta-Analysis of Bone Marrow-Derived Mononuclear Cells in Animal Models of Ischemic Stroke.
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DOI：
10.1161/strokeaha.116.012701
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发表时间：
2016-06
期刊：
影响因子：
8.3
通讯作者：
Savitz SI
中科院分区：
文献类型：
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作者：
Vahidy FS;Rahbar MH;Zhu H;Rowan PJ;Bambhroliya AB;Savitz SI
骨髓来源的单核细胞 (BMMNC) 有望增强中风后的恢复。缺血性中风 (IS) 的临床前研究有越来越多的证据表明 BMMNC 的安全性和有效性，但其综合效应尚未描述。使用 PRIMSA 指南，我们对静脉使用 BMMNC 的临床前文献进行了系统回顾，然后对组织学和行为结果进行了荟萃分析。研究是根据预先定义的标准选择的。数据由两名独立研究人员提取。质量评估后，使用混合效应模型生成汇总效应。评估了可能的偏差对估计效应大小的影响。病变体积缩小的标准化平均差 (SMD)、95% 置信区间 (CI) 对 BMMNC 治疗显着有益（SMD -3.3，95% CI：-4.3，-2.3），BMMNC 和对照组各 n = 113。与对照组 (n = 205) 相比，BMMNC 治疗的动物 (n = 161) 的功能也通过圆柱测试测量得到改善 (SMD -2.4, 95% CI: -3.1, -1.6)。观察到粘合剂去除测试和神经功能缺损评分的获益趋势。研究质量得分（中位数：6，Q1-Q3：5-7）与发表年份相关。存在漏斗图不对称性，但合并效应对于纠正这种偏差是稳健的，并且仍然显着支持 BMMNC 治疗。 BMMNC 在动物 IS 模型中表现出对组织学和行为结果的有益影响。尽管研究质量随着时间的推移有所提高，但相当程度的异质性要求实验的进行和报告标准化。
Bone marrow derived mononuclear cells (BMMNCs) offer the promise of augmenting post-stroke recovery. There is mounting evidence of safety and efficacy of BMMNCs from pre-clinical studies of ischemic stroke (IS), however their pooled effects have not been described. Using PRIMSA guidelines, we conducted a systematic review of pre-clinical literature for intravenous use of BMMNCs followed by meta-analyses of histological and behavioral outcomes. Studies were selected based on pre-defined criteria. Data were abstracted by two independent investigators. Following quality assessment, the pooled effects were generated using mixed effect models. Impact of possible biases on estimated effect size was evaluated. Standardized mean difference (SMD), 95% confidence interval (CI) for reduction in lesion volume was significantly beneficial for BMMNC treatment (SMD −3.3, 95% CI: −4.3, −2.3), n = 113 each for BMMNC and controls. BMMNC treated animals (n = 161) also had improved function measured by cylinder test (SMD −2.4, 95% CI: −3.1, −1.6), as compared to controls (n = 205). A trend for benefit was observed for adhesive removal test and neurological deficit score. Study quality score (median: 6, Q1-Q3: 5-7) was correlated with year of publication. There was funnel plot asymmetry, however the pooled effects were robust to the correction of this bias and remained significant in favor of BMMNC treatment. BMMNCs demonstrate beneficial effects across histological and behavioral outcomes in animal IS models. Though study quality has improved over time, considerable degree of heterogeneity calls for standardization in the conduct and reporting of experimentation.