scholarly journals The safety and efficacy of mesenchymal stem cells in the treatment of COVID-19-associated pneumonia: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Junwu Wang ◽  
Pengzhi Shi ◽  
Dong Chen ◽  
Shuguang Wang ◽  
Pingchuan Wang ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adverse Events ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Safe Method ◽  
Radiographic Outcomes ◽  
The Difference

Mesenchymal stem cells (MSCs) therapy is considered one of the most promising treatments in the context of the coronavirus disease 2019 (COVID-19) pandemic. However, the safety and effectiveness of MSCs in the treatment of COVID-19-associated pneumonia patients need to be systematically reviewed and analyzed. Two independent researchers searched for the relevant studies published between October 2019 and April 2021 in PubMed, Embase, Cochrane Library, WAN FANG, and CNKI databases. A total of 22 studies involving 371 patients were included in the present study. MSCs were administered in 247 participants, and MSCs were allogeneic from umbilical cord, adipose tissue, menstrual blood, placenta, Wharton's jelly, or unreported sources. Combined results found that MSCs group significantly reduced the incidence of adverse events (OR = 0.43, 95%CI. = 0.22~0.84, P = 0.01) and mortality (OR = 0.17, 95%CI. = 0.06~0.49, P < 0.01), and the difference compared with control group was statistically significant. No MSCs treat-related serious adverse events were reported. The lung function and radiographic outcomes, and biomarker levels of inflammation and immunity all showed improvement trends. Therefore, MSCs therapy is an effective and safe method in the treatment of COVID-19-associated pneumonia and shows advantages in less adverse events and mortality. However, a standard and effective MSCs treatment program needs to be developed.

scholarly journals Clinical efficacy on glycemic control and safety of mesenchymal stem cells in patients with diabetes mellitus: Systematic review and meta-analysis of RCT data

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247662
Author(s):  
Jingjing He ◽  
Desheng Kong ◽  
Zhifen Yang ◽  
Ruiyun Guo ◽  
Asiamah Ernest Amponsah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Treatment Group ◽  
Random Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Significant Difference

Background Diabetes mellitus as a chronic metabolic disease is threatening human health seriously. Although numerous clinical trials have been registered for the treatment of diabetes with stem cells, no articles have been published to summarize the efficacy and safety of mesenchymal stem cells (MSCs) in randomized controlled trials (RCTs). Methods and findings The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to provide a reliable numerical summary and the most comprehensive assessment of therapeutic efficacy and safety with MSCs in diabetes. PubMed, Web of Science, Ovid, the Cochrane Library and CNKI were searched. The retrieval time was from establishment of these databases to January 4, 2020. Seven RCTs were eligible for analysis, including 413 participants. Meta-analysis results showed that there were no significant differences in the reduction of fasting plasma glucose (FPG) compared to the baseline [mean difference (MD) = -1.05, 95% confidence interval (CI) (-2.26,0.16), P<0.01, I2 = 94%] and the control group [MD = -0.62, 95%CI (-1.46,0.23), P<0.01, I2 = 87%]. The MSCs treatment group showed a significant decrease in hemoglobin (Hb) A1c [random-effects, MD = -1.32, 95%CI (-2.06, -0.57), P<0.01, I2 = 90%] after treatment. Additionally, HbA1c reduced more significantly in MSC treatment group than in control group [random-effects, MD = -0.87, 95%CI (-1.53, -0.22), P<0.01, I2 = 82%] at the end of follow-up. However, as for fasting C-peptide levels, the estimated pooled MD showed that there was no significant increase [MD = -0.07, 95%CI (-0.30, 0.16), P<0.01, I2 = 94%] in MSCs treatment group compared with that in control group. Notably, there was no significant difference in the incidence of adverse events between MSCs treatment group and control group [relative risk (RR) = 0.98, 95%CI (0.72, 1.32), P = 0.02, I2 = 70%]. The most commonly observed adverse reaction in the MSC treatment group was hypoglycemia (29.95%). Conclusions This meta-analysis revealed MSCs therapy may be an effective and safe intervention in subjects with diabetes. However, due to the limited studies, a number of high-quality as well as large-scale RCTs should be performed to confirm these conclusions.

scholarly journals Nephroprotective Effect of Mesenchymal Stem Cells in Therapy of Kidney Disease Induced by Toxicant

2020 ◽  
Author(s):  
Shujun Lin ◽  
Wenshan Lin ◽  
Chunling Liao ◽  
Tianbiao Zhou
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Treatment Group ◽  
Kidney Disease ◽  
Drug Toxicity ◽  
Meta Analysis ◽  
Control Group ◽  
The Difference ◽  
And Control ◽  
Nephroprotective Effect

Abstract Background: Renal damage caused by drug toxicity is becoming more and more common in clinic. How to avoid and treat kidney damage caused by drug toxicity is essential to maintain patient health and reduce social economic burden. In this study, we performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in therapy of kidney disease induced by toxicant. Methods: Cochrane Library, Embase, ISI Web of Science and PubMed databases were searched up to Dec 31, 2019 to identify the studies and extract the data to assess the efficacy of MSCs for kidney disease induced by toxicant using Cochrane Review Manager Version 5.3. 27 studies were eligible and recruited for this meta-analysis. Results: The results showed that the difference of Scr between MSCs treatment group and control group was notable for 2 days, 4 days, 5 days, 6-8 days, 10-15 days, ≥42 days (2 days: WMD =-0.88, 95%CI: -1.34, -0.42, P=0.0002; 4 days: WMD=-0.69, 95%CI: -0.99, -0.39, P<0.00001; 5 days: WMD=-0.46, 95%CI: -0.67, -0.25, P<0.0001; 6-8 days: WMD=-0.51, 95%CI: -0.79, -0.22, P=0.0005; 10-15 days: WMD =-0.38, 95%CI: -0.56, -0.20, P<0.0001; ≥42 days: WMD =-0.22, 95%CI: -0.39, -0.06, P=0.007). Furthermore, the difference of BUN between MSCs treatment group and control group was notable for 2-3 days, 4-5 days, 6-8 days, ≥28 days. The results also indicated that MSCs treatment can alleviate the inflammatory cells, necrotic tubule, regenerative tubules, renal interstitial fibrosis in kidney disease induced by toxicant. Conclusion: MSCs might be a promising therapeutic agent for kidney disease induced by toxicant.

scholarly journals Nephroprotective effect of mesenchymal stem cells in therapy of kidney disease induced by toxicant

2020 ◽  
Author(s):  
Tianbiao Zhou ◽  
Shujun Lin ◽  
Chunling Liao ◽  
Wenshan Lin ◽  
Hongzhen Zhong
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Treatment Group ◽  
Kidney Disease ◽  
Drug Toxicity ◽  
Meta Analysis ◽  
Control Group ◽  
The Difference ◽  
And Control ◽  
Nephroprotective Effect

Abstract Background Renal damage caused by drug toxicity is becoming more and more common in clinic. How to avoid and treat kidney damage caused by drug toxicity is essential to maintain patient health and reduce social economic burden. In this study, we performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in therapy of kidney disease induced by toxicant. Methods Cochrane Library, Embase, ISI Web of Science and PubMed databases were searched up to Dec 31, 2019 to identify the studies and extract the data to assess the efficacy of MSCs for kidney disease induced by toxicant using Cochrane Review Manager Version 5.3. Results 27 studies were eligible and recruited for this meta-analysis. The results showed that the difference of Scr between MSCs treatment group and control group was notable for 2 days, 4 days, 5 days, 6-8 days, 10-15 days, ≥42 days (2 days: WMD =-0.88, 95%CI: -1.34, -0.42, P=0.0002; 4 days: WMD=-0.69, 95%CI: -0.99, -0.39, P<0.00001; 5 days: WMD=-0.46, 95%CI: -0.67, -0.25, P<0.0001; 6-8 days: WMD=-0.51, 95%CI: -0.79, -0.22, P=0.0005; 10-15 days: WMD =-0.38, 95%CI: -0.56, -0.20, P<0.0001; ≥42 days: WMD =-0.22, 95%CI: -0.39, -0.06, P=0.007). Furthermore, the difference of BUN between MSCs treatment group and control group was notable for 2-3 days, 4-5 days, 6-8 days, ≥28 days. The results also indicated that MSCs treatment can alleviate the inflammatory cells, necrotic tubule, regenerative tubules, renal interstitial fibrosis in kidney disease induced by toxicant. Conclusion: MSCs might be a promising therapeutic agent for kidney disease induced by toxicant.

scholarly journals Nephroprotective effect of mesenchymal stem cells in therapy of kidney disease induced by toxicant

2020 ◽  
Author(s):  
Tianbiao Zhou ◽  
Shujun Lin ◽  
Chunling Liao ◽  
Wenshan Lin ◽  
Hongzhen Zhong
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Treatment Group ◽  
Kidney Disease ◽  
Drug Toxicity ◽  
Meta Analysis ◽  
Control Group ◽  
The Difference ◽  
And Control ◽  
Nephroprotective Effect

Abstract Background Renal damage caused by drug toxicity is becoming more and more common in clinic. How to avoid and treat kidney damage caused by drug toxicity is essential to maintain patient health and reduce social economic burden. In this study, we performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in therapy of kidney disease induced by toxicant. Methods Cochrane Library, Embase, ISI Web of Science and PubMed databases were searched up to Dec 31, 2019 to identify the studies and extract the data to assess the efficacy of MSCs for kidney disease induced by toxicant using Cochrane Review Manager Version 5.3. Results 27 studies were eligible and recruited for this meta-analysis. The results showed that the difference of Scr between MSCs treatment group and control group was notable for 2 days, 4 days, 5 days, 6–8 days, 10–15 days, ≥ 42 days (2 days: WMD =-0.88, 95%CI: -1.34, -0.42, P = 0.0002; 4 days: WMD=-0.69, 95%CI: -0.99, -0.39, P < 0.00001; 5 days: WMD=-0.46, 95%CI: -0.67, -0.25, P < 0.0001; 6–8 days: WMD=-0.51, 95%CI: -0.79, -0.22, P = 0.0005; 10–15 days: WMD =-0.38, 95%CI: -0.56, -0.20, P < 0.0001; ≥42 days: WMD =-0.22, 95%CI: -0.39, -0.06, P = 0.007). Furthermore, the difference of BUN between MSCs treatment group and control group was notable for 2–3 days, 4–5 days, 6–8 days, ≥ 28 days. The results also indicated that MSCs treatment can alleviate the inflammatory cells, necrotic tubule, regenerative tubules, renal interstitial fibrosis in kidney disease induced by toxicant. Conclusion MSCs might be a promising therapeutic agent for kidney disease induced by toxicant.

scholarly journals Safety and Efficacy of Remdesivir for the Treatment of COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 24 ◽  
pp. 237-245
Author(s):  
Mohammad Tasavon Gholamhoseini ◽  
Vahid Yazdi-Feyzabadi ◽  
Reza Goudarzi ◽  
Mohammad Hossein Mehrolhassani
Keyword(s):  
Adverse Events ◽  
Clinical Improvement ◽  
Meta Analysis ◽  
Qualitative Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Placebo Control ◽  
Serious Adverse Events ◽  
Safety And Efficacy ◽  
Positive Effects

Purpose: To evaluate the safety and efficacy of remdesivir in adult patients with COVID-19. Methods: PubMed, Embase, Scopus, Web of Science, Cochrane Library, ClinicalTrials.gov, and medRxiv databases were searched using a search strategy tailored to each database. The Consolidated Standards of Reporting Trials (CONSORT) and Strengthening the reporting of observational studies in epidemiology (STROBE) checklists were used for the studies' qualitative assessment. The outcomes studied were mortality, all adverse events, serious adverse events, and clinical improvement. The quantitative synthesis was conducted using fixed and random effects models in the CMA 2.2. Heterogeneity was tested using the I-squared (I2) measure. Results: In general, six studies, including five randomized controlled trials and one cohort study were found eligible. Comparison of the findings related to both groups receiving remdesivir (10-day remdesivir group) and placebo/control group showed that remdesivir treatment had no significant effect on mortality at day 14 of the treatment (RR=0.769; 95% CI :0.563-1.050; p=0.098), and all adverse events (RR= 1.078; 95% CI: 0.908-1.279; p= 0.392). However, remdesivir had a significant effect on clinical improvement at day 14 compared to placebo/control (OR= 1.447; 95% CI: 1.005-2.085; p= 0.047) and reduced serious adverse events (RR= 0.736; 95% CI: 0.611-0.887; p= 0.001). Conclusion: Remdesivir has positive effects on clinical improvement, and reduction of the risk of serious adverse events. However, it does not influence the mortality at day 14 of treatment.

scholarly journals The Efficacy of Mesenchymal Stem Cells for Cardiomyopathy: A Meta-analysis of Randomized Controlled Trials

2019 ◽  
Vol 22 (3) ◽  
pp. E256-E261 ◽  
Author(s):  
Yu Li ◽  
Linglong Chen ◽  
Sheng Li ◽  
Ya-Jing Pan ◽  
Peiyun Peng ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Randomized Controlled Trials ◽  
Treatment Efficacy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Nyha Classification

Introduction: The efficacy of mesenchymal stem cells (MSCs) for cardiomyopathy remains controversial. We conducted a systematic review and meta-analysis to explore the influence of MSCs versus placebo on the treatment efficacy of cardiomyopathy. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through November 2018 for randomized controlled trials (RCTs) assessing the treatment efficacy of MSCs versus placebo for cardiomyopathy. This meta-analysis was performed using the random-effect model. Results: Five RCTs were included in the meta-analysis. Overall, compared with the control group for cardiomyopathy, MSCs treatment showed significantly positive effect on LVEF (MD = 5.85; 95% CI = 3.88 to 7.83; P < .00001), NYHA classification (MD = -1.11; 95% CI = -1.45 to -0.77; P < .00001), LVEDd (MD = -3.00; 95% CI = -5.37 to -0.64; P = .01), and the proportion of fixed defects (MD = -4.22; 95% CI = -6.91 to -1.52; P = .002), but had no obvious influence on death (RR = 0.42; 95% CI = 0.12 to 1.50; P = 0.18) or adverse events (RR = 1.14; 95% CI = 0.70 to 1.86; P = .59). Conclusion: MSCs treatment showed favorable impact on LVEF, NYHA classification, LVEDd, and the proportion of fixed defects for cardiomyopathy patients.

scholarly journals Clinical Efficacy and Safety of Mesenchymal Stem Cells for Systemic Lupus Erythematosus

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Tianbiao Zhou ◽  
Hong-Yan Li ◽  
Chunling Liao ◽  
Wenshan Lin ◽  
Shujun Lin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adverse Events ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Case Series ◽  
Control Group ◽  
Efficacy And Safety ◽  
Systemic Lupus

Systemic lupus erythematosus (SLE) is a polymorphic, multisystemic autoimmune disease that causes multiorgan damage in which cellular communication occurs through the involvement of autoantibodies directed against autoantigen production. Mesenchymal stem cells (MSCs), which have strong protective and immunomodulatory abilities, are obtained not only from bone marrow but also from medical waste such as adipose tissue and umbilical cord tissue and have been recognized as a promising tool for the treatment of various autoimmune diseases and inflammatory disorders. This meta-analysis is aimed at assessing whether MSCs can become a new treatment for SLE with good efficacy and safety. Based on predetermined criteria, a bibliographical search was performed from January 1, 2000, to July 31, 2019, by searching the following databases: ISI Web of Science, Embase, PubMed, the Cochrane Library, and the Chinese Biomedical Literature Database (CBM). Eligible studies and data were identified. Statistical analysis was conducted to assess the efficacy (proteinuria, systemic lupus erythematosus disease activity index (SLEDAI), Scr, BUN, albumin, C3, and C4) and safety (rate of adverse events) of MSCs for SLE using Cochrane Review Manager Version 5.3. Ten studies fulfilled the inclusion criteria and were eligible for this meta-analysis, which comprised 8 prospective or retrospective case series and four randomized controlled trails (RCTs) studies. In the RCT, the results indicated that the MSC group had lower proteinuria than the control group at 3 months and 6 months and the MSC group displayed a lower SLEDAI than the control group at 2 months and 6 months. Furthermore, the MSC group showed a lower rate of adverse events than the control group (OR=0.26, 95% CI: 0.07, 0.89, P=0.03). In the case series trials, the results indicated that the MSC group had lower proteinuria at 1 month, 2 months, 3 months, 4 months, 6 months, and 12 months. In conclusion, MSCs might be a promising therapeutic agent for patients with SLE.

Denosumab in the treatment on structural damage caused by rheumatoid arthritis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Shuang Cai ◽  
Anhang Zhang ◽  
Bokai Cheng ◽  
Qiligeer Bao ◽  
Shuxia Wang
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Structural Damage ◽  
Bone Erosion ◽  
Meta Analysis ◽  
Joint Space ◽  
Joint Disease ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events

Abstract Background: Rheumatoid arthritis (RA) is a chronic inflammatory joint disease, which can cause cartilage and bone damage as well as disability. The effects of denosumab in patients with RA have been analyzed in several clinical studies. These results provide strong evidence to suggest that denosumab significantly inhibited the progression of bone erosion, increased BMD in patients with RA. We undertook a meta-analysis to summarize the efficacy and safety of denosumab in the treatment on structural damage caused by rheumatoid arthritis.Methods: We searched PubMed, Embase, Medline, The Cochrane Library, and collected randomized controlled trials of denosumab in patients with rheumatoid arthritis from the database was established until January 19, 2021.Literature was screened according to inclusion and exclusion criteria, and RevMan 5.3 software was used for Meta-analysis after quality assessment.Results: Five eligible studies were included in the primary meta-analysis. Denosumab significantly inhibited the increase of the modified Sharp erosion score(MD=-0.62, 95%CI＝-0.91～-0.33,P＜0.0001)、modified total Sharp score(MD=-0.78, 95%CI＝1.23～-0.33,P=0.0007)compared to placebo groups at 12 months. In addition, denosumab also significantly increased lumbar spine BMD (3.73, 95% CI 2.00, 5.46, P<0.0001) compared to placebo or bisphosphonates. There was no evidence of an effect of denosumab on joint space narrowing. Adverse events, serious adverse events were similar between denosumab and placebo arms.Conclusion: Results suggest that denosumab inhibits the progression of structural damage caused by rheumatoid arthritis, with no increase in the rates of adverse events as compared with control group. Preliminary research suggests that denosumab is reasonable and promising options for preventing and treating structural destruction in rheumatoid arthritis.Trial registration: We registered our study with PROSPERO (registration number CRD42021239783); no other meta-analysis focusing on denosumab use for structural damage caused by rheumatoid arthritis were found in the PROSPERO database.

Can platelet-rich plasma enhance the effect of meniscus repair?:a meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Yulei Xie ◽  
Shan Wang ◽  
Ju Yang ◽  
Anli Hu ◽  
Qing Wu
Keyword(s):  
Adverse Events ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Meniscus Repair ◽  
Lysholm Score ◽  
Cochrane Library ◽  
Control Group ◽  
Cure Rate ◽  
Serious Adverse Events ◽  
Meniscus Injury

Abstract Background: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP.Purpose: To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury.Methods: By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov, and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events. The risk of bias is assessed using Cochrane’s collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed.Results: The meta-analysis included eight RCTs and 431 patients. In general, compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P=0.002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 4.86, P=0.0009, 95%CI: 1.98–7.75) of patients with meniscus injury, but the PRP enhancement technique showed no benefit in improving the cure rate of meniscus repair (risk ratio [RR]: 1.22, P=0.06, 95%CI: 0.99–1.51). No serious adverse events were reported in any study. Conclusion: PRP deserves further consideration as an enhancement program for meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.

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