Effects of mesenchymal stem cells in renovascular disease of preclinical and clinical studies: a systematic review and meta-analysis.
Effects of mesenchymal stem cells in renovascular disease of preclinical and clinical studies: a systematic review and meta-analysis.
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间充质干细胞在肾血管疾病中的作用的临床前和临床研究：系统评价和荟萃分析
DOI：
10.1038/s41598-022-23059-2
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发表时间：
2022-10-27
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
肾动脉狭窄(RAS)会导致严重的肾血管性高血压、肾功能恶化和心血管并发症的增加。根据最近的研究，间充质干细胞(MSCs)移植是改善RAS预后的一种有前途的治疗方法。Meta分析旨在评价MSC治疗RAS的疗效。我们检索了MEDLINE、Web of Science、Embase和Cochrane图书馆，检索时间为2022年10月5日。我们在这项荟萃分析中纳入了16项临床前研究和3项临床研究。在临床前研究中，综合结果表明，接受骨髓间充质干细胞处理的动物的收缩压(Smd = − 1.019，95%CI− 1.434至− 0.604，I2 = 37.2%，P = 0.000)、血清肌酐(Smd = − 1.112，95%CI− 1.932至− 0.293，I2 = 72.0%，P = 0.008)水平较低，血浆肾素活性( = − )为0.477，95%CI− 为0.913~0.042，I2 = 为43.4%，P = 为0.032。狭窄组肾血流量增加( = 0.774，95%CI− 0.351~1.197，I2 = 0%，P = 0.000)，肾小球滤过率增加( = 1.825，95%CI 0.963~2.688，I2 = 72.6%，P = 0.000)。在临床研究中，MSC治疗可以减轻对侧肾(CLK)的皮质灌注和部分缺氧。综上所述，这项荟萃分析显示，骨髓间充质干细胞疗法可能是治疗RAS的一种有前途的疗法。然而，由于临床前研究和早期临床试验结果之间的差异，目前还不能推荐使用MSC治疗，需要更多高质量的随机对照临床试验来验证我们的结论并规范MSCs方案。
Renal artery stenosis (RAS) causes severe renovascular hypertension, worsening kidney function, and increased cardiovascular morbidity. According to recent studies, mesenchymal stem cells (MSCs) administration is a promising therapy for the improvement of RAS outcomes. The meta-analysis aims to evaluate the therapeutic effects of MSC therapy on RAS. We performed a search in MEDLINE, Web of Science, Embase, and Cochrane Library from inception to 5, October 2022. We included 16 preclinical and 3 clinical studies in this meta-analysis. In preclinical studies, the pooled results indicated that animals treated with MSCs had lower levels of systolic blood pressure (SBP) (SMD = − 1.019, 95% CI − 1.434 to − 0.604, I2 = 37.2%, P = 0.000), serum creatinine (Scr) (SMD = − 1.112, 95% CI − 1.932 to − 0.293, I2 = 72.0%, P = 0.008), and plasma renin activity (PRA) (SMD = − 0.477, 95% CI − 0.913 to 0.042, I2 = 43.4%, P = 0.032). The studies also revealed increased levels of renal blood flow (RBF) in stenotic kidney (STK) (SMD = 0.774, 95% CI − 0.351 to 1.197, I2 = 0%, P = 0.000) and the glomerular filtration rate (GFR) of STK (SMD = 1.825, 95% CI 0.963 to 2.688, I2 = 72.6%, P = 0.000). In clinical studies, the cortical perfusion and fractional hypoxia of the contralateral kidney (CLK) were alleviated by MSC therapy. Taken together, this meta-analysis revealed that MSCs therapy might be a promising treatment for RAS. However, due to the discrepancy between preclinical studies and early clinical trials outcomes, MSC therapy couldn’t be recommended in clinical care for the moment, more high-quality randomized controlled clinical trials are needed to validate our conclusions and standardize MSCs protocols.
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影响因子：
3.3
作者：
Eirin A;Zhu XY;Ebrahimi B;Krier JD;Riester SM;van Wijnen AJ;Lerman A;Lerman LO
通讯作者：
Lerman LO
影响因子：
10.4
作者：
Krauth D;Woodruff TJ;Bero L
通讯作者：
Bero L
影响因子：
5
作者：
Boergel, Jan;Springer, Stephanie;Muegge, Andreas
通讯作者：
Muegge, Andreas
影响因子：
3.7
作者：
Ebrahimi B;Eirin A;Li Z;Zhu XY;Zhang X;Lerman A;Textor SC;Lerman LO
通讯作者：
Lerman LO
影响因子：
12.3
作者：
de Oliveira-Sales, Elizabeth Barbosa;Varela, Vanessa Araujo;Boim, Mirian Aparecida
通讯作者：
Boim, Mirian Aparecida