间充质干细胞和胚胎干细胞治疗脊髓损伤的疗效:人类研究的系统回顾和荟萃分析。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Zachary Troiani, Danielle E Chipman, Thomas J Ryan, Mohammad N Haider, David Kowalski, Bilal Hasanspahic, Maxwell M Scott, Emily K Vallee, Christopher Lucasti
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引用次数: 0

摘要

研究设计:系统回顾和荟萃分析。本研究的目的是对胚胎干细胞和间充质干细胞治疗人类创伤性脊髓损伤(SCI)的文献进行系统回顾和荟萃分析。主要结局指标为美国脊髓损伤协会(ASIA)评分、亚洲运动和感觉评分、泌尿和肠功能、疼痛和不良事件。方法纳入18-80岁接受胚胎干细胞、诱导多能干细胞或间充质干细胞治疗脊髓损伤的人类患者的研究。研究质量分别使用Cochrane风险偏倚2工具和纽卡斯尔渥太华量表对随机和非随机研究进行评估。主要结局是总体ASIA评分、ASIA运动评分、ASIA感觉评分、膀胱和肠道功能、疼痛和不良事件。结果共纳入30项研究,共纳入656例患者,其中43.3%的患者ASIA级改善,49.4%的患者运动功能改善,73.6%的患者感觉功能改善。膀胱和肠道结果的定性分析表明感觉和控制的总体改善。无严重不良事件报告。最常见的副作用是轻微的,在几小时到几周内消失,不需要额外的药物治疗。结论:脊髓损伤的系统细胞移植似乎在整体ASIA分级、运动、感觉、膀胱和肠道功能方面提供了适度的改善,伴随着相对轻微和短暂的副作用。进一步的研究,特别是高质量、盲法、随机对照试验,对于优化治疗方案和实现更加一致和改善的临床结果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of Mesenchymal and Embryonic Stem Cell Therapy for the Treatment of Spinal Cord Injury: A Systematic Review and Meta-Analysis of Human Studies.

Study DesignSystematic review and meta-analysis.ObjectivesThe objective of this study was to conduct a systematic review and meta-analysis of the literature regarding the therapeutic effect of embryonic and mesenchymal stem cells on the treatment of traumatic spinal cord injury (SCI) in humans. Primary outcome measures were overall American Spinal Injury Association (ASIA) scores, ASIA motor and sensory scores, urinary and bowel function, pain, and adverse events.MethodsStudies with human patients ages 18-80 years receiving embryonic, induced pluripotent, or mesenchymal stem cells for SCI were included. Study quality was assessed using the Cochrane risk of bias 2 tool and the Newcastle Ottawa scale for randomized and non-randomized studies, respectively. Primary outcomes were overall ASIA grade, ASIA motor scores, ASIA sensory scores, bladder and bowel function, pain, and adverse events.ResultsThirty total studies with 656 patients were included, with 43.3% of patients experiencing improvement in ASIA grade, 49.4% in motor function, and 73.6% in sensory function. Qualitative analysis of bladder and bowel outcomes suggests overall improved sensation and control. No serious adverse events were reported. The most common side effects were mild and resolved within hours to weeks without requiring additional medical treatment.ConclusionsStem cell transplantation for SCI appears to offer moderate improvements in overall ASIA grade, motor, sensory, bladder, and bowel function, accompanied by a relatively mild and transient side effect profile. Further research, particularly high-quality, blinded, randomized controlled trials, is essential to optimize treatment protocols and achieve more consistent and improved clinical outcomes.

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来源期刊
Global Spine Journal
Global Spine Journal Medicine-Surgery
CiteScore
6.20
自引率
8.30%
发文量
278
审稿时长
8 weeks
期刊介绍: Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).
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