Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.

Spinal cord injury (SCI) is a devastating condition that causes substantial morbidity and mortality and for which no treatments are available. Stem cells offer some promise in the restoration of neurological function. We used systematic review, meta-analysis, and meta-regression to study the impact...

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Autores principales:	Ana Antonic, Emily S Sena, Jennifer S Lees, Taryn E Wills, Peta Skeers, Peter E Batchelor, Malcolm R Macleod, David W Howells
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/45f5956858734163946af93f4ac91320
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spelling	oai:doaj.org-article:45f5956858734163946af93f4ac913202021-11-18T05:37:41ZStem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.1544-91731545-788510.1371/journal.pbio.1001738https://doaj.org/article/45f5956858734163946af93f4ac913202013-12-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24358022/?tool=EBIhttps://doaj.org/toc/1544-9173https://doaj.org/toc/1545-7885Spinal cord injury (SCI) is a devastating condition that causes substantial morbidity and mortality and for which no treatments are available. Stem cells offer some promise in the restoration of neurological function. We used systematic review, meta-analysis, and meta-regression to study the impact of stem cell biology and experimental design on motor and sensory outcomes following stem cell treatments in animal models of SCI. One hundred and fifty-six publications using 45 different stem cell preparations met our prespecified inclusion criteria. Only one publication used autologous stem cells. Overall, allogeneic stem cell treatment appears to improve both motor (effect size, 27.2%; 95% Confidence Interval [CI], 25.0%-29.4%; 312 comparisons in 5,628 animals) and sensory (effect size, 26.3%; 95% CI, 7.9%-44.7%; 23 comparisons in 473 animals) outcome. For sensory outcome, most heterogeneity between experiments was accounted for by facets of stem cell biology. Differentiation before implantation and intravenous route of delivery favoured better outcome. Stem cell implantation did not appear to improve sensory outcome in female animals and appeared to be enhanced by isoflurane anaesthesia. Biological plausibility was supported by the presence of a dose-response relationship. For motor outcome, facets of stem cell biology had little detectable effect. Instead most heterogeneity could be explained by the experimental modelling and the outcome measure used. The location of injury, method of injury induction, and presence of immunosuppression all had an impact. Reporting of measures to reduce bias was higher than has been seen in other neuroscience domains but were still suboptimal. Motor outcomes studies that did not report the blinded assessment of outcome gave inflated estimates of efficacy. Extensive recent preclinical literature suggests that stem-cell-based therapies may offer promise, however the impact of compromised internal validity and publication bias mean that efficacy is likely to be somewhat lower than reported here.Ana AntonicEmily S SenaJennifer S LeesTaryn E WillsPeta SkeersPeter E BatchelorMalcolm R MacleodDavid W HowellsPublic Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Biology, Vol 11, Iss 12, p e1001738 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 Ana Antonic Emily S Sena Jennifer S Lees Taryn E Wills Peta Skeers Peter E Batchelor Malcolm R Macleod David W Howells Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
description	Spinal cord injury (SCI) is a devastating condition that causes substantial morbidity and mortality and for which no treatments are available. Stem cells offer some promise in the restoration of neurological function. We used systematic review, meta-analysis, and meta-regression to study the impact of stem cell biology and experimental design on motor and sensory outcomes following stem cell treatments in animal models of SCI. One hundred and fifty-six publications using 45 different stem cell preparations met our prespecified inclusion criteria. Only one publication used autologous stem cells. Overall, allogeneic stem cell treatment appears to improve both motor (effect size, 27.2%; 95% Confidence Interval [CI], 25.0%-29.4%; 312 comparisons in 5,628 animals) and sensory (effect size, 26.3%; 95% CI, 7.9%-44.7%; 23 comparisons in 473 animals) outcome. For sensory outcome, most heterogeneity between experiments was accounted for by facets of stem cell biology. Differentiation before implantation and intravenous route of delivery favoured better outcome. Stem cell implantation did not appear to improve sensory outcome in female animals and appeared to be enhanced by isoflurane anaesthesia. Biological plausibility was supported by the presence of a dose-response relationship. For motor outcome, facets of stem cell biology had little detectable effect. Instead most heterogeneity could be explained by the experimental modelling and the outcome measure used. The location of injury, method of injury induction, and presence of immunosuppression all had an impact. Reporting of measures to reduce bias was higher than has been seen in other neuroscience domains but were still suboptimal. Motor outcomes studies that did not report the blinded assessment of outcome gave inflated estimates of efficacy. Extensive recent preclinical literature suggests that stem-cell-based therapies may offer promise, however the impact of compromised internal validity and publication bias mean that efficacy is likely to be somewhat lower than reported here.
format	article
author	Ana Antonic Emily S Sena Jennifer S Lees Taryn E Wills Peta Skeers Peter E Batchelor Malcolm R Macleod David W Howells
author_facet	Ana Antonic Emily S Sena Jennifer S Lees Taryn E Wills Peta Skeers Peter E Batchelor Malcolm R Macleod David W Howells
author_sort	Ana Antonic
title	Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
title_short	Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
title_full	Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
title_fullStr	Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
title_full_unstemmed	Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
title_sort	stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/45f5956858734163946af93f4ac91320
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Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.

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