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Mesenchymal Stem Cell Therapy in Stroke: A Systematic Review of Literature in Pre-Clinical and Clinical Research

机译:中风的间充质干细胞治疗:临床前和临床研究文献的系统评价

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摘要

Exogenous stem cell therapy (SCT) has been recognized recently as a promising neuroregenerative strategy to augment recovery in stroke survivors. Mesenchymal stem cells (MSCs) are the primary source of stem cells used in the majority of both pre-clinical and clinical studies in stroke. In the absence of evidence-based guidelines on the use of SCT in stroke patients, understanding the progress of MSC research across published studies will assist researchers and clinicians in better achieving success in translating research. We conducted a systematic review on published literature using MSCs in both pre-clinical studies and clinical trials between 2008 and 2017 using the public databases PubMed and Ovid Medline, and the clinical trial registry (). A total of 78 pre-clinical studies and eight clinical studies were identified. While majority of the pre-clinical and clinical studies demonstrated statistically significant effects, the clinical significance of these findings was still unclear. Effect sizes could not be measured mainly due to reporting issues in pre-clinical studies, thus limiting our ability to compare results across studies quantitatively. The overall quality of both pre-clinical and clinical studies was sub-optimal. By conducting a systematic review of both pre-clinical and clinical studies on MSCs therapy in stroke, we assessed the quality of current evidence and identified several issues and gaps in translating animal studies to human trials. Addressing these issues and incorporating changes into future animal studies and human trials may lead to better success of stem cells-based therapeutics in the near future.
机译:外源性干细胞疗法(SCT)最近已被公认为是增加中风幸存者恢复能力的有希望的神经再生策略。间充质干细胞(MSC)是中风的大多数临床前和临床研究中使用的干细胞的主要来源。在缺乏针对中风患者使用SCT的循证指南的情况下,了解已发表研究中MSC研究的进展将有助于研究人员和临床医生更好地实现翻译研究的成功。我们使用公开数据库PubMed和Ovid Medline在临床前研究和临床试验之间使用MSC对公开发表的文献进行了系统的综述,这些文献在2008年至2017年之间使用了公共数据库PubMed和Ovid Medline进行了临床试验注册。总共确定了78项临床前研究和8项临床研究。尽管大多数临床前和临床研究均显示出统计学上的显着效果,但这些发现的临床意义仍不清楚。无法测量疗效的大小主要是由于临床前研究中存在报告问题,因此限制了我们对各研究结果进行定量比较的能力。临床前和临床研究的总体质量均欠佳。通过对中风MSCs治疗的临床前和临床研究进行系统评价,我们评估了现有证据的质量,并确定了将动物研究转化为人体试验的若干问题和差距。解决这些问题并将变化纳入未来的动物研究和人体试验中,可能会在不久的将来使基于干细胞的疗法取得更好的成功。

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