Yitian. Fang , Sarah Bouari , Martin J. Hoogduijn , Jan N.M. Ijzermans , Ron W.F. de Bruin , Robert C. Minnee
{"title":"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","authors":"Yitian. Fang , Sarah Bouari , Martin J. Hoogduijn , Jan N.M. Ijzermans , Ron W.F. de Bruin , Robert C. Minnee","doi":"10.1016/j.trre.2022.100714","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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; <em>P</em> < 0.01; I<sup>2</sup> = 94%), reducing serum creatinine (SCr) (SMD = -2.19; 95%CI, −3.35 to −1.04; P < 0.01; I<sup>2</sup> = 93%) and blood urea nitrogen (BUN) concentrations (SMD = -1.69; 95%CI, −2.98 to −0.40; <em>P</em> = 0.01; I<sup>2</sup> = 94%). Subgroup analyses indicated that only immune cell-EVs significantly prolonged graft survival and improve renal function but not MSC-EVs.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"36 4","pages":"Article 100714"},"PeriodicalIF":3.6000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X22000374/pdfft?md5=4e12dd4eebd178393ab27d7aa5fa9d38&pid=1-s2.0-S0955470X22000374-main.pdf","citationCount":"2","resultStr":"{\"title\":\"Therapeutic efficacy of extracellular vesicles to suppress allograft rejection in preclinical kidney transplantation models: A systematic review and meta-analysis\",\"authors\":\"Yitian. Fang , Sarah Bouari , Martin J. Hoogduijn , Jan N.M. Ijzermans , Ron W.F. de Bruin , Robert C. Minnee\",\"doi\":\"10.1016/j.trre.2022.100714\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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; <em>P</em> < 0.01; I<sup>2</sup> = 94%), reducing serum creatinine (SCr) (SMD = -2.19; 95%CI, −3.35 to −1.04; P < 0.01; I<sup>2</sup> = 93%) and blood urea nitrogen (BUN) concentrations (SMD = -1.69; 95%CI, −2.98 to −0.40; <em>P</em> = 0.01; I<sup>2</sup> = 94%). Subgroup analyses indicated that only immune cell-EVs significantly prolonged graft survival and improve renal function but not MSC-EVs.</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":48973,\"journal\":{\"name\":\"Transplantation Reviews\",\"volume\":\"36 4\",\"pages\":\"Article 100714\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0955470X22000374/pdfft?md5=4e12dd4eebd178393ab27d7aa5fa9d38&pid=1-s2.0-S0955470X22000374-main.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0955470X22000374\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0955470X22000374","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Therapeutic efficacy of extracellular vesicles to suppress allograft rejection in preclinical kidney transplantation models: A systematic review and meta-analysis
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.
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.
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