Therapeutic efficacy of extracellular vesicles to suppress allograft rejection in preclinical kidney transplantation models: A systematic review and meta-analysis

IF 3.6 2区医学 Q2 IMMUNOLOGY

Transplantation Reviews Pub Date : 2022-12-01 DOI:10.1016/j.trre.2022.100714

Yitian. Fang , Sarah Bouari , Martin J. Hoogduijn , Jan N.M. Ijzermans , Ron W.F. de Bruin , Robert C. Minnee

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引用次数: 2

Abstract

Background

Kidney transplantation is the optimal treatment of end-stage renal disease. Extracellular vesicles (EVs) have tremendous therapeutic potential, but their role in modulating immune responses in kidney transplantation remains unclear.

Methods

We performed a systematic review and meta-analysis to investigate the therapeutic efficacy of EVs in preclinical kidney transplant models. Outcomes for meta-analysis were graft survival and renal function. Subgroup analysis was conducted between immune cell derived EVs (immune cell-EVs) and mesenchymal stromal cell derived EVs (MSC-EVs).

Results

Seven studies published from 2013 to 2021 were included. The overall effects showed that EVs had a positive role in prolonging allograft survival (standardized mean difference (SMD) = 2.00; 95% confidence interval (CI), 0.79 to 3.21; P < 0.01; I² = 94%), reducing serum creatinine (SCr) (SMD = -2.19; 95%CI, −3.35 to −1.04; P < 0.01; I² = 93%) and blood urea nitrogen (BUN) concentrations (SMD = -1.69; 95%CI, −2.98 to −0.40; P = 0.01; I² = 94%). Subgroup analyses indicated that only immune cell-EVs significantly prolonged graft survival and improve renal function but not MSC-EVs.

Conclusions

EVs are promising candidates to suppress allograft rejection and improve kidney transplant outcome. Immune cell-EVs showed their superiority over MSC-EVs in prolonging graft survival and improving renal function. For interpretation of the outcomes, additional studies are needed to validate these findings.

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细胞外囊泡在临床前肾移植模型中抑制同种异体移植排斥反应的疗效:系统回顾和荟萃分析

肾移植是治疗终末期肾病的最佳方法。细胞外囊泡(EVs)具有巨大的治疗潜力，但其在肾移植中调节免疫反应的作用尚不清楚。方法通过系统回顾和荟萃分析，探讨ev在临床前肾移植模型中的治疗效果。荟萃分析的结果是移植物存活和肾功能。对免疫细胞源性ev (immune cell- ev)和间充质基质细胞源性ev (msc - ev)进行亚组分析。结果纳入2013 - 2021年发表的7项研究。总体效果显示，EVs对延长同种异体移植物存活具有积极作用(标准化平均差(SMD) = 2.00;95%置信区间(CI)， 0.79 ~ 3.21;P & lt;0.01;I2 = 94%)，降低血清肌酐(SCr) (SMD = -2.19;95%CI，−3.35 ~−1.04;P & lt;0.01;I2 = 93%)和血尿素氮(BUN)浓度(SMD = -1.69;95%CI，−2.98 ~−0.40;p = 0.01;i2 = 94%)。亚组分析表明，只有免疫细胞- ev能显著延长移植物存活时间和改善肾功能，而msc - ev则不能。结论sev具有抑制同种异体移植排斥反应和改善肾移植预后的作用。免疫细胞ev在延长移植物存活和改善肾功能方面优于间充质干细胞ev。为了解释结果，需要进一步的研究来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation Reviews IMMUNOLOGY-TRANSPLANTATION

CiteScore

7.50

自引率

2.50%

发文量

审稿时长

29 days

期刊介绍： Transplantation Reviews contains state-of-the-art review articles on both clinical and experimental transplantation. The journal features invited articles by authorities in immunology, transplantation medicine and surgery.