Benefit of Adjuvant Mesenchymal Stem Cell Transplantation to Critical-Sized Peripheral Nerve Defect Repair: A Systematic Review and Meta-Analysis of Preclinical Studies.
Benefit of Adjuvant Mesenchymal Stem Cell Transplantation to Critical-Sized Peripheral Nerve Defect Repair: A Systematic Review and Meta-Analysis of Preclinical Studies.
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DOI：
10.3390/jcm12041306
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发表时间：
2023-02-07
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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严重的神经缺陷会导致毁灭性的终身残疾，需要介入重建。另外局部应用间充质干细胞（MSCs）被认为有希望促进周围神经再生。为了更好地了解骨髓间充质干细胞在周围神经重建中的作用，我们对临床前研究中骨髓间充质干细胞对关键尺寸段神经缺损的影响进行了系统回顾和荟萃分析。根据PRISMA指南，使用PubMed和Web of Science筛选了5146篇文章。荟萃分析共纳入27项临床前研究（n = 722只大鼠）。在有严重缺损和自体神经重建的大鼠中，比较了运动功能、传导速度和神经再生的组织形态学参数以及肌肉萎缩程度的平均差异或标准化平均差异（95%置信区间）。骨髓间充质干细胞联合移植可提高坐骨神经功能指数（3.93，95% CI 2.62至5.24，p < 0.00001）和神经传导速度恢复（1.49，95% CI 1.13至1.84，p = 0.009），减少靶肌肉萎缩腓肠肌：0.63，95%CI 0.29 ~ 0.97，p = 0.004;小腿三头肌：0.08，95%CI 0.06 ~ 0.10，p = 0.71（轴突数目：1.10，95%CI 0.78至1.42，p < 0.00001;髓鞘厚度：0.15，95%CI 0.12至0.17，p = 0.28）。严重周围神经缺损的重建常常受到术后再生受损的阻碍，特别是在需要自体神经移植的缺损中。这项荟萃分析表明，额外应用MSC可以促进大鼠术后周围神经再生。基于体内实验的良好结果，需要进一步的研究来证明潜在的临床益处。
Critically sized nerve defects cause devastating life-long disabilities and require interposition for reconstruction. Additional local application of mesenchymal stem cells (MSCs) is considered promising to enhance peripheral nerve regeneration. To better understand the role of MSCs in peripheral nerve reconstruction, we performed a systematic review and meta-analysis of the effects of MSCs on critically sized segment nerve defects in preclinical studies. 5146 articles were screened following PRISMA guidelines using PubMed and Web of Science. A total of 27 preclinical studies (n = 722 rats) were included in the meta-analysis. The mean difference or the standardized mean difference with 95% confidence intervals for motor function, conduction velocity, and histomorphological parameters of nerve regeneration, as well as the degree of muscle atrophy, was compared in rats with critically sized defects and autologous nerve reconstruction treated with or without MSCs. The co-transplantation of MSCs increased the sciatic functional index (3.93, 95% CI 2.62 to 5.24, p < 0.00001) and nerve conduction velocity recovery (1.49, 95% CI 1.13 to 1.84, p = 0.009), decreased the atrophy of targeted muscles (gastrocnemius: 0.63, 95% CI 0.29 to 0.97 p = 0.004; triceps surae: 0.08, 95% CI 0.06 to 0.10 p = 0.71), and promoted the regeneration of injured axons (axon number: 1.10, 95% CI 0.78 to 1.42, p < 0.00001; myelin sheath thickness: 0.15, 95% CI 0.12 to 0.17, p = 0.28). Reconstruction of critically sized peripheral nerve defects is often hindered by impaired postoperative regeneration, especially in defects that require an autologous nerve graft. This meta-analysis indicates that additional application of MSC can enhance postoperative peripheral nerve regeneration in rats. Based on the promising results in vivo experiments, further studies are needed to demonstrate potential clinical benefits.
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