Conditioned Medium Treatment for the Improvement of Functional Recovery after Spinal Cord Injury: A Meta-Analysis Study.

Razieh Hajisoltani, Mona Taghizadeh, Michael R Hamblin, Fatemeh Ramezani
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Abstract

Background: While there is no certain treatment for spinal cord injury (SCI), stem cellbased therapy may be an attractive alternative, but the survival and differentiation of cells in the host tissue are poor. Conditioned medium (CM) has several beneficial effects on cells.

Objective: In this meta-analysis study, we examined the effect of CM on SCI treatment.

Methods: After searching on MEDLINE, SCOPUS, EMBASE, and Web of Science, first and secondary screening were performed based on title, abstract, and full text. The data were extracted from the included studies, and meta-analysis was performed using STATA.14 software. A standardized mean difference (SMD) with a 95% confidence interval was used to report findings. Quality control and subgroup analysis were also performed.

Results: The results from 52 articles and 61 separate experiments showed that CM had a significantly strong effect on improving motor function after SCI (SMD = 2.58; 95% CI: 2.17 to 2.98; p < 0.001) and also analysis of data from 12 articles demonstrated that CM reduced the expression of GFAP marker (SMD = -4.16; p < 0.0001) compared to SCI group without any treatment. Subgroup analysis showed that treatment with CM of neural stem cells was better than CM of mesenchymal stem cells. It was more effective after a mild lesion than a moderate or severe one. The improvement was more pronounced with <4 weeks than >4 weeks follow-up.

Conclusion: CM had a significant effect in improving motor function after SCI, especially in cases of mild lesions. It has been observed that if CM originates from the neural stem cells, it has a more significant effect than mesenchymal cells.

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改善脊髓损伤后功能恢复的条件介质治疗:一项元分析研究。
背景:虽然脊髓损伤(SCI)尚无确定的治疗方法,但基于干细胞的疗法可能是一种有吸引力的替代疗法,但细胞在宿主组织中的存活率和分化率很低。条件培养基(CM)对细胞有多种有益作用:在这项荟萃分析研究中,我们考察了 CM 对 SCI 治疗的影响:方法:在 MEDLINE、SCOPUS、EMBASE 和 Web of Science 上检索后,根据标题、摘要和全文进行初筛和复筛。从纳入的研究中提取数据,并使用 STATA.14 软件进行荟萃分析。报告结果时使用了标准化平均差(SMD)和 95% 置信区间。此外,还进行了质量控制和亚组分析:来自 52 篇文章和 61 个独立实验的结果表明,CM 对改善 SCI 后的运动功能有显著的强效作用(SMD = 2.58;95% CI:2.17 至 2.98;p < 0.001),同时对 12 篇文章的数据进行的分析表明,与未接受任何治疗的 SCI 组相比,CM 可减少 GFAP 标记的表达(SMD = -4.16;p < 0.0001)。分组分析显示,神经干细胞CM治疗效果优于间充质干细胞CM。轻度病变比中度或重度病变更有效。结论:结论:CM对改善脊髓损伤后的运动功能有明显效果,尤其是对轻度损伤的病例。据观察,如果CM源自神经干细胞,其效果比间充质细胞更显著。
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