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A Combination of Mesenchymal Stem Cells and Scaffolds Promotes Motor Functional Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis Publisher Pubmed



Yousefifard M1 ; Maleki SN1 ; Askarianamiri S1 ; Vaccaro AR2 ; Chapman JR3 ; Fehlings MG4, 5, 6 ; Hosseini M7 ; Rahimimovaghar V8, 9
Authors
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Authors Affiliations
  1. 1. Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, United States
  3. 3. Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States
  4. 4. Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON, Canada
  5. 5. Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
  6. 6. Department of Surgery and Spine Program, University of Toronto, ON, Canada
  7. 7. Department of Epidemiology and Biostatistics, School of Public Health
  8. 8. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Brain and Spinal Injuries Research Center (BASIR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Neurosurgery: Spine Published:2020


Abstract

OBJECTIVE There is controversy about the role of scaffolds as an adjunctive therapy to mesenchymal stem cell (MSC) transplantation in spinal cord injury (SCI). Thus, the authors aimed to design a meta-analysis on preclinical evidence to evaluate the effectiveness of combination therapy of scaffold + MSC transplantation in comparison with scaffolds alone and MSCs alone in improving motor dysfunction in SCI. METHODS Electronic databases including Medline, Embase, Scopus, and Web of Science were searched from inception until the end of August 2018. Two independent reviewers screened related experimental studies. Animal studies that evaluated the effectiveness of scaffolds and/or MSCs on motor function recovery following experimental SCI were included. The findings were reported as standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS A total of 34 articles were included in the meta-analysis. Analyses show that combination therapy in comparison with the scaffold group alone (SMD 2.00, 95% CI 1.53–2.46, p < 0.0001), the MSCs alone (SMD 1.58, 95% CI 0.84–2.31, p < 0.0001), and the nontreated group (SMD 3.52, 95% CI 2.84–4.20, p < 0.0001) significantly improved motor function recovery. Co-administration of MSCs + scaffolds only in the acute phase of injury (during the first 3 days after injury) leads to a significant recovery compared to scaffold alone (SMD 2.18, p < 0.0001). In addition, the cotransplantation of scaffolds with bone marrow–derived MSCs (SMD 1.99, p < 0.0001) and umbilical cord–derived MSCs (SMD 1.50, p = 0.001) also improved motor function following SCI. CONCLUSIONS The findings showed that scaffolds + MSCs is more effective than scaffolds and MSCs alone in improving motor function following SCI in animal models, when used in the acute phase of injury. ©AANS 2020,
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