Human studies of the efficacy and safety of stem cells in the treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis.

IF 7.1 2区 医学 Q1 CELL & TISSUE ENGINEERING Stem Cell Research & Therapy Pub Date : 2024-11-19 DOI:10.1186/s13287-024-04033-3
Seyed Danial Alizadeh, Shima Jahani, Mohammad Rezaei Zadeh Rukerd, Reza Tabrizi, Rasoul Masoomi, Seyedeh Zahra Banihashemian, Mahgol Sadat Hassan Zadeh Tabatabaei, Zahra Ghodsi, Ahmad Pour-Rashidi, James Harrop, Vafa Rahimi-Movaghar
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Abstract

Objective: To assess the efficacy and safety of stem cell therapy in human studies for diabetic peripheral neuropathy (DPN).

Methods: A comprehensive literature review was performed across multiple databases, including Ovid MEDLINE ALL, Embase via Ovid SP, Scopus, Web of Science Core Collection, and Cochrane CENTRAL, up to January 31, 2024. Keywords and controlled vocabularies related to diabetic neuropathy and stem cell therapy were used. Inclusion criteria encompassed all controlled trials examining stem cell therapy for DPN, excluding animal or in vitro studies, review papers, conference abstracts, and editor letters. Data extraction and risk of bias assessment were independently performed by multiple reviewers using standardized tools.

Results: Out of 5431 initial entries, seven were included. Stem cell therapies included bone marrow-derived mononuclear cells and umbilical cord-derived mesenchymal stem cells, administered mainly via intramuscular transplantation. Meta-analysis indicated significant improvements in motor nerve conduction velocity (weighted mean differences (WMD): 2.2, 95% CI 1.6-2.8) and sensory nerve conduction velocity (WMD: 1.9, 95% CI 1.1-2.6). Vibration perception threshold and Toronto Clinical Scoring System scores decreased significantly (WMD: - 2.9, 95% CI - 4.0, - 1.8, and WMD: - 3.6, 95% CI - 5.0, - 2.2, respectively). Sensitivity analysis and subgroup analysis confirmed the robustness and specificity of these findings. The complications were pain and swelling at the injection sites, which disappeared in a few days.

Conclusion: Stem cell therapy shows significant promise in improving clinical outcomes for DPN, with evident benefits in nerve conduction and sensory parameters. Further research is needed to consolidate these findings and optimize therapeutic protocols.

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干细胞治疗糖尿病周围神经病变的疗效和安全性人体研究:系统回顾和荟萃分析。
目的:评估干细胞疗法对糖尿病周围神经病变(DPN)的疗效和安全性:评估干细胞疗法在糖尿病周围神经病变(DPN)人体研究中的有效性和安全性:在多个数据库中进行了全面的文献综述,包括截至2024年1月31日的Ovid MEDLINE ALL、Embase via Ovid SP、Scopus、Web of Science Core Collection和Cochrane CENTRAL。使用了与糖尿病神经病变和干细胞疗法相关的关键词和控制词汇。纳入标准包括所有研究干细胞治疗DPN的对照试验,不包括动物或体外研究、综述论文、会议摘要和编辑信函。数据提取和偏倚风险评估由多名审稿人使用标准化工具独立完成:结果:在 5431 篇初始条目中,有 7 篇被收录。干细胞疗法包括骨髓来源的单核细胞和脐带来源的间充质干细胞,主要通过肌肉移植给药。元分析表明,运动神经传导速度(加权平均差(WMD):2.2,95% CI 1.6-2.8)和感觉神经传导速度(WMD:1.9,95% CI 1.1-2.6)均有显著改善。振动感知阈值和多伦多临床评分系统评分显著下降(WMD:- 2.9,95% CI - 4.0,- 1.8;WMD:- 3.6,95% CI - 5.0,- 2.2)。敏感性分析和亚组分析证实了这些结果的可靠性和特异性。并发症为注射部位疼痛和肿胀,几天后消失:干细胞疗法在改善 DPN 临床疗效方面前景广阔,在神经传导和感觉参数方面有明显的疗效。要巩固这些发现并优化治疗方案,还需要进一步的研究。
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来源期刊
Stem Cell Research & Therapy
Stem Cell Research & Therapy CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
13.20
自引率
8.00%
发文量
525
审稿时长
1 months
期刊介绍: Stem Cell Research & Therapy serves as a leading platform for translational research in stem cell therapies. This international, peer-reviewed journal publishes high-quality open-access research articles, with a focus on basic, translational, and clinical research in stem cell therapeutics and regenerative therapies. Coverage includes animal models and clinical trials. Additionally, the journal offers reviews, viewpoints, commentaries, and reports.
期刊最新文献
Exosome crosstalk between cancer stem cells and tumor microenvironment: cancer progression and therapeutic strategies. Reprogrammed human lateral ganglionic eminence precursors generate striatal neurons and restore motor function in a rat model of Huntington's disease. Rapid-acting pain relief in knee osteoarthritis: autologous-cultured adipose-derived mesenchymal stem cells outperform stromal vascular fraction: a systematic review and meta-analysis. Comparative analysis of regulations and studies on stem cell therapies: focusing on induced pluripotent stem cell (iPSC)-based treatments. Correction: Adipose stem cells regulate lipid metabolism by upregulating mitochondrial fatty acid β-oxidation in macrophages to improve the retention rate of transplanted fat.
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