Yang Xia, Hua Ye, Kejia Li, Bairu Shi, Xian Sun, Jiajun Wu
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引用次数: 0
Abstract
Purpose: The purpose of this meta-analysis is to determine the efficacy of mesenchymal stromal/stem cell (MSC) transplantation therapy on lupus nephritis (LN) and renal function of patients with systemic lupus erythematosus (SLE).
Methods: Articles that reported the data of MSC therapy on the renal function as well as disease activity of LN in patients with SLE were searched in PubMed, Web of Science, Embase and the Cochrane Library. Mean difference for disease activity and laboratory parameters were pooled to evaluate the efficacy of MSC, and incidence was pooled for clinical remission, death and severe adverse event.
Results: A total of 12 studies with 586 patients were included. The disease activity indices, including SLEDAI and BILAG, were significantly decreased within 12 months after MSC therapy (P< 0.05). Laboratory parameters for renal function and disease control including estimated glomerular filtration rate, creatinine, blood urea nitrogen, complement C3, albumin and urine protein, were also significantly improved after therapy. The pooled rate of clinical remission at 12 months was 28.1% and the total rate during follow-up was 33.7%. The pooled rate of death at 12 months was 5.2% and the total rate during follow-up was 5.5%. Severe adverse events were rare and not associated with the treatment of MSC.
Conclusions: This is the first meta-analysis that focuses on the effect of MSC on LN and renal function of patients with SLE, and the results shows a favorable safety profile and encouraging results of MSC for improving the disease activity of LN as well as the renal function of SLE patients.
目的:本荟萃分析的目的是确定间充质基质/干细胞(MSC)移植治疗对系统性红斑狼疮(SLE)患者狼疮性肾炎(LN)和肾功能的疗效。方法:检索PubMed、Web of Science、Embase、Cochrane图书馆中报道MSC治疗对SLE患者肾功能及LN疾病活动度影响的文章。汇总疾病活动性和实验室参数的平均差异来评估MSC的疗效，并汇总临床缓解、死亡和严重不良事件的发生率。结果:共纳入12项研究，586例患者。MSC治疗后12个月内，SLEDAI、BILAG等疾病活动度指标均显著降低(P< 0.05)。治疗后，肾功能和疾病控制的实验室参数包括肾小球滤过率、肌酐、血尿素氮、补体C3、白蛋白和尿蛋白也有显著改善。12个月临床总缓解率为28.1%，随访总缓解率为33.7%。12个月合并死亡率为5.2%，随访期间总死亡率为5.5%。严重不良事件罕见，与MSC治疗无关。结论:这是首个关注MSC对SLE患者LN和肾功能影响的荟萃分析，结果显示MSC在改善LN疾病活动性和SLE患者肾功能方面具有良好的安全性和令人鼓舞的结果。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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