scholarly journals Current Evidence of Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review, Meta-analysis, and Meta-regression of Prospective Clinical Studies

2020 ◽  
Author(s):  
Woo Sup Cho ◽  
Sun Gun Chung ◽  
Won Kim ◽  
Chris H. Jo ◽  
Shi-Uk Lee ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Mean Difference ◽  
Efficacy And Safety ◽  
Cell Dose ◽  
Human Tendon ◽  
Meta Regression ◽  
Standardized Mean Difference

Abstract Purpose: Although several studies with animals have reported the effects of mesenchymal stem cells (MSCs) for tendon regeneration, little is known about the efficacy and safety of MSCs in human tendon disorders. We performed this meta-analysis to evaluate the efficacy and safety of MSC therapy in patients with tendon disorders enrolled in prospective clinical studies.Methods: We systematically searched prospective clinical studies investigating the effects of MSCs administration on human tendon disorders with at least a 6-month follow-up period on PubMed-Medline, Embase, and Cochrane Library databases. The primary outcome of interest was the change in pain on motion related to tendon disorders. We performed a pairwise meta-analysis using the fixed-effects model to assess treatment response, which was calculated by the standardized mean difference. Meta-regression analyses were performed to assess the relationship between MSCs dose and pooled effect sizes in each cell dose.Results: Four prospective clinical trials investigating the effect of MSCs on tendon disorders were retrieved. MSCs showed significant pooled effect size (overall Hedge’s g pooled standardized mean difference (SMD) = 1.868; 95% confidence interval [CI], 1.274–2.462; P < 0.001). The treatment with MSCs improved all the aspects analyzed, i.e. pain, functional scores, radiologic parameters (magnetic resonance image or ultrasonography), and arthroscopic findings. In the meta-regression analysis, there was a significant cell dose-dependent response in pain relief (Q = 9.06, P = 0.029). While three studies reported mild adverse events after MSCs injection, these were not severe and relieved spontaneously.Conclusions: Our meta-analysis revealed that MSC therapy may improve pain, function, radiologic, and arthroscopic parameters in patients with tendon disorders. Due to the small number of studies in this meta-analysis and considering the increasing MSCs applications, there is a strong need for large-scale randomized controlled trials to confirm the long-term functional improvement as well as the adverse effects of MSC therapies in tendon disorders.

scholarly journals Current Evidence of Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review, Meta-analysis, and Meta-regression of Prospective Clinical Studies

2020 ◽  
Author(s):  
Woo Sup Cho ◽  
Sun Gun Chung ◽  
Won Kim ◽  
Chris H. Jo ◽  
Shi-Uk Lee ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Mean Difference ◽  
Efficacy And Safety ◽  
Cell Dose ◽  
Human Tendon ◽  
Meta Regression ◽  
Standardized Mean Difference

Abstract Purpose Although several studies with animals have reported the effects of mesenchymal stem cells (MSCs) for tendon regeneration, little is known about the efficacy and safety of MSCs in human tendon disorders. We performed this meta-analysis to evaluate the efficacy and safety of MSC therapy in patients with tendon disorders enrolled in prospective clinical studies. Methods We systematically searched prospective clinical studies investigating the effects of MSCs administration on human tendon disorders with at least a 6-month follow-up period on PubMed-Medline, Embase, and Cochrane Library databases. The primary outcome of interest was the change in pain on motion related to tendon disorders. We performed a pairwise meta-analysis using the fixed-effects model to assess treatment response, which was calculated by the standardized mean difference. Meta-regression analyses were performed to assess the relationship between MSCs dose and pooled effect sizes in each cell dose. Results Four prospective clinical trials investigating the effect of MSCs on tendon disorders were retrieved. MSCs showed significant pooled effect size (overall Hedge’s g pooled standardized mean difference (SMD) = 1.868; 95% confidence interval [CI], 1.274–2.462; P < 0.001). The treatment with MSCs improved all the aspects analyzed, i.e. pain, functional scores, radiologic parameters (magnetic resonance image or ultrasonography), and arthroscopic findings. In the meta-regression analysis, there was a significant cell dose-dependent response in pain relief (Q = 9.06, P = 0.029). While three studies reported mild adverse events after MSCs injection, these were not severe and relieved spontaneously. Conclusions Our meta-analysis revealed that MSC therapy may improve pain, function, radiologic, and arthroscopic parameters in patients with tendon disorders. Due to the small number of studies in this meta-analysis and considering the increasing MSCs applications, there is a strong need for large-scale randomized controlled trials to confirm the long-term functional improvement as well as the adverse effects of MSC therapies in tendon disorders.

scholarly journals Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review and Meta-Analysis of Prospective Clinical Studies

2021 ◽  
Vol 45 (4) ◽  
pp. 274-283
Author(s):  
Woo Sup Cho ◽  
Sun Gun Chung ◽  
Won Kim ◽  
Chris H. Jo ◽  
Shi-Uk Lee ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Clinical Studies ◽  
Large Scale ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Cochrane Library ◽  
Functional Scores ◽  
Meta Regression ◽  
Meta Regression Analysis

Objective To evaluate the efficacy and safety of mesenchymal stem cells (MSCs) therapy in patients with tendon disorders enrolled in prospective clinical studies.Methods We systematically searched prospective clinical studies that investigated the effects of MSC administration on human tendon disorders with at least a 6-month follow-up period in the PubMed-MEDLINE, EMBASE, and Cochrane Library databases. The primary outcome of interest was the change in pain on motion related to tendon disorders. Meta-regression analyses were performed to assess the relationship between MSC dose and pooled effect sizes in each cell dose.Results Four prospective clinical trials that investigated the effect of MSCs on tendon disorders were retrieved. MSCs showed a significant pooled effect size (overall Hedges’ g pooled standardized mean difference=1.868; 95% confidence interval, 1.274–2.462; p<0.001). The treatment with MSCs improved all the aspects analyzed, namely pain, functional scores, radiological parameters (magnetic resonance image or ultrasonography), and arthroscopic findings. In the meta-regression analysis, a significant cell dose-dependent response in pain relief (Q=9.06, p=0.029) was observed.Conclusion Our meta-analysis revealed that MSC therapy may improve pain, function, radiological, and arthroscopic parameters in patients with tendon disorders. A strong need for large-scale randomized controlled trials has emerged to confirm the long-term functional improvement and adverse effects of MSC therapies in tendon disorders.

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.

The effectiveness of virtual reality-based technology on anatomy teaching: a meta-analysis of randomized controlled studies

2020 ◽  
Author(s):  
jingjie zhao ◽  
xinliang xu ◽  
Hualin Jiang ◽  
yi ding
Keyword(s):  
Virtual Reality ◽  
Meta Analysis ◽  
Mean Difference ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Subgroup Analyses ◽  
Degree Of Satisfaction ◽  
Meta Regression ◽  
Standardized Mean Difference ◽  
Anatomy Teaching

Abstract Virtual reality (VR) is an innovation that permits the individual to discover and operate three-dimensional (3D) environment to gain practical understanding instantly. Recently, VR has been advanced as an encouraging tool in the course of clinical college. This research aimed to examine the general efficiency of VR for teaching medical anatomy. We executed a meta-analysis of randomized regulated studies of the performance of VR anatomy education. We browsed 5 databases from the year 1990 to 2019. Ultimately, 15 randomized controlled trials with a teaching outcome measure analysis were included. Tow authors separately chosen studies, extracted information, and examined the risk of bias. The primary outcomes were examination scores of the students. Secondary outcomes were the degree of satisfaction of the students. Random-effects models were used for the pooled evaluations. Standardized mean difference (SMD) was applied to assess the systematic results. The heterogeneity was determined by I2 statistics, and then was investigated by meta-regression and subgroup analyses. In this review, we screened and included fifteen randomized controlled researches (816 students). The pooled analysis of primary outcomes showed that VR improves test scores comparing with other approaches (standardized mean difference [SMD]= 0.53; 95% CI 0.09–0.97; I2= 87.8%). The high homogeneity indicated that the studies were different from each other. Therefore, we carried out meta-regression as well as subgroup analyses using 7 variables (year, country, learners, course, intervention, comparator, and duration). We found that VR improves postintervention test score of anatomy comparing with other types of teaching methods. Although the findings have high internal validity and limited, because of that anatomy teaching in medical universities appears to becoming a dilemma, VR may act as an efficient way to improve the learners’ level of anatomy knowledge. Future research should assess other factors like degree of satisfaction, cost-effectiveness, and adverse reactions when evaluating the teaching effectiveness of VR in anatomy.

scholarly journals Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
S. Tsabouri ◽  
G. Ntritsos ◽  
F. Koskeridis ◽  
E. Evangelou ◽  
P. Olsson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Symptom Severity ◽  
Meta Analysis ◽  
Mean Difference ◽  
Efficacy And Safety ◽  
Symptom Severity Score ◽  
Large Heterogeneity ◽  
Standardized Mean Difference

Background: Allergic rhinitis (AR), an IgE mediated inflammatory disease, significantly impacts quality of life of a considerable proportion of the general population. Omalizumab, a humanized monoclonal antibody against IgE, has been evaluated for both seasonal and perennial AR. We aimed to assess the efficacy and safety of omalizumab in randomized controlled trials (RCTs) in inadequately controlled AR. Methods: We conducted a systematic literature search of RCTs evaluating the safety and efficacy of omalizumab in AR. We synthesized evidence for clinical improvement of AR symptoms, quality of life, reduction of the use of rescue medication, and adverse events. Results: The systematic search returned 289 articles, of which 12 RCTs were eligible for data extraction and meta-analysis. Omalizumab reduced the Daily Nasal Symptom Severity Score (DNSSS) by a summary standardized mean difference of -0.41 points with large heterogeneity; omalizumab significantly reduced the DNSSS both in the 3 cedar pollen-induced AR trials by -0.97 points and to a lower extent in the remaining five non-cedar trials by -0.19 points. Omalizumab also improved the Daily Ocular Symptom Severity Score (DOSSS) by a summary standardized mean difference of -0.30 points with large heterogeneity; the Rhino-conjunctivitis Quality of Life Questionnaire by a summary standardized mean difference of -0.45 points with no heterogeneity and the mean daily consumption of rescue antihistamines by a summary standardized mean difference of -0.21 with large heterogeneity. No statistically significant difference in the occurrence of adverse events was observed between omalizumab and placebo. Conclusion: Our findings further support the efficacy and safety of omalizumab in the management of patients with allergic rhinitis inadequately controlled with a conventional treatment.

scholarly journals Mesenchymal Stem Cells for the Treatment of Intestinal Ischemia-reperfusion Injury: a Protocol of Systematic Review and Meta-analysis of Animal Models

2021 ◽  
Author(s):  
Guangru Zhang ◽  
Shenghong Suo ◽  
Zhenzhen Liu ◽  
Disheng Liu ◽  
Zhiyu Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Animal Models ◽  
Intestinal Ischemia ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Mean Difference ◽  
Clinical Event ◽  
Intestinal Ischemia Reperfusion

Abstract Introduction: Intestinal ischemia-reperfusion (I/R) injury is a common clinical event. Mesenchymal stem cells (MSCs) have been widely used to repair intestinal injury in animal models. However, the effects of MSCs on intestinal I/R injury therapy remain unclear. Thus, we will perform a systematic review and meta-analysis of controlled trials to evaluate the efficacy of MSCs in animal models of intestinal I/R injury.Methods and analysis: We will search PubMed, Web of Science, Embase, Cochrane Library, Science Citation Index, China National Knowledge Information database, Wanfang Database, and the Chinese Scientific and Technological Journal Database in May 2021. We will include studies that evaluate the two different interventions for target MSCs to be maintained for the degree of histopathologic changes, mortality rate of rats, tumour necrosis factor α, and diamine oxidase. Two reviewers will independently screen titles and abstracts, perform a full article review, and extract study data. We will also use the SYRCLE tool to assess the risk of bias in the included studies. Furthermore, a random-effects meta-analysis will be conducted. Dichotomous and continuous outcomes will be analysed using risk ratios with 95% confidence intervals (CIs) and weighted mean difference with 95% CIs, respectively. For outcomes where different scales or different measurement methods have been used, the standardised mean difference will be applied. Subgroup and sensitivity analyses will be performed to explore the heterogeneity. Stata (version 12.0, Stata Corp, College Station, Texas, USA) will be used to analyse and pool the individual research results.Ethics and dissemination: This systematic review and meta-analysis does not require an ethical approval because no human beings are involved. We aim to publish this systematic review in a peer-reviewed journal.PROSPERO registration number: CRD42021231826

scholarly journals Mesenchymal stem cells and COVID-19

2020 ◽  
Vol 61 (2) ◽  
pp. 78-82
Author(s):  
Dragana Vujić ◽  
Marija Simić
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Clinical Picture ◽  
Clinical Studies ◽  
Organ Damage ◽  
Host Immune System ◽  
Cytokine Storm ◽  
Efficacy And Safety ◽  
Severe Clinical Picture ◽  
The Subject

With the appearance of the first cases of COVID-19 infection, which had a severe clinical picture accompanied by respiratory insufficiency, as well as multiorgan dysfunction, mesenchymal stem cells became the subject of intensive research. The main cause of tissue and organ damage in patients with COVID-19 infection is thought to be a cytokine storm, which is the result of an imbalance in the regulation of the host immune system. Previous studies have shown that mesenchymal stem cells have an immunomodulatory effect and can prevent and reduce the cytokine storm triggered by the SARS-Cov-2 virus. Numerous clinical studies on the use of mesenchymal stem cells in patients with a severe clinical picture of COVID-19 are underway. Undoubtedly, cell therapy could be of great importance in the treatment of patients with a severe clinical picture of COVID-19, but it takes time to consider the efficacy and safety of such therapy, which is possible only through controlled multicenter clinical studies.

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