Mesenchymal Stem Cells (MSCs) As Neuroregenerative and Locomotor Recovery-Promoting Agent for Spinal Cord Injury: A Systematic Review and Meta-Analysis
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Abstract
Introduction: Despite decades of extensive research, spinal cord injury (SCI) remains a complex health burden mainly affecting active patients and may cause a catastrophic permanent paralysis of the limbs (tetraplegia) and might even result in death. The current treatments are not sufficient to repair such damage. The development and discovery of the treatments that are capable of inducing the regeneration of axonal functions are hindered by the injured spinal cord’s limited neuroplasticity. Mesenchymal stem cells (MSCs) are ideal transplantable cells which have been shown to modulate the injury cascade of SCI mostly through paracrine effects.
Objective: This systematic review and meta-analysis aimed to investigate the association between the MSCs treatment and neuroregenerative effects in the SCI model-rodents by assessing the locomotor development based on Basso-Beattie-Bresnahan (BBB)/Basso Mice Scale (BMS) locomotor rating scale.
Materials and Methods: This meta-analysis was reported based on criteria from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted with multiple electronic databases, such as PubMed, ScienceDirect, Scopus, Google Scholar. Mean Difference (MD) and Standard Deviation (SD) with the confidence interval (CI) of 95% were used to determine the association between MSCs therapy and the increase in the BBB scale after SCI. Fixed and Random Effect Model was used based on heterogeneity level and p value<0.05 was considered statistically significant. Risk of biases were assessed for each study using Cochrane Risk of Bias (RoB) tool developed by the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE).
Results: Twenty studies were included in the qualitative synthesis, and eleven studies were included in the quantitative meta-analysis. The current study showed that MSCs therapy for SCI was very beneficial (pooled MD=4.71, 95% CI (3.86-5.55), p=0.006, I2=59%).
Conclusion: This systematic review and meta-analysis provide valuable evidence suggesting MSCs as a potential treatment for SCI.
Keywords: Spinal cord injury, MSCs, regenerative medicine, systematic review, meta-analysis
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