细胞疗法在阿尔茨海默病中的临床疗效和安全性系统回顾。

Q3 Medicine Dementia e Neuropsychologia Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI:10.1590/1980-5764-DN-2024-0147
Hamidreza Feizi, Mohammad-Salar Hosseini, Sepideh Seyedi-Sahebari, Hanie Karimi, Reza Mosaddeghi-Heris, Saeed Sadigh-Eteghad, Fatemeh Sadeghi-Ghyassi, Mahnaz Talebi, Amirreza Naseri, Hanieh Salehi-Pourmehr, Leila Roshangar
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引用次数: 0

摘要

阿尔茨海默病(AD)是导致痴呆症的最主要原因,目前尚无改变病情的疗法:本研究旨在评估细胞疗法对阿尔茨海默病的疗效和安全性:方法:根据乔安娜-布里格斯研究所(JBI)的方法和《系统综述与元分析首选报告项目》(PRISMA)声明,在PubMed、医学文献分析与检索系统在线(Medline,通过Ovid)、Embase、Cochrane和《护理与联合健康文献累积索引》--CINAHL(通过EBSCO)数据库(截至2023年6月)中进行了系统检索。纳入了利用细胞疗法治疗AD的相关临床研究。根据研究设计,使用 JBI 检查表对偏倚风险进行了评估:在1,014份筛选记录中,共纳入了5项研究,共70人(包括59名接受干细胞治疗的患者和11名安慰剂对照组)。在所有这些研究中,尽管干细胞来源、细胞密度和移植部位存在差异,但都达到了安全目标。根据所纳入的五项研究,脑室内注射脂肪源性基质血管组分(ADSVF)和脐带间充质干细胞(UC-MSCs)、静脉注射Lomecel-B、双侧海马和右侧楔前叶注射UC-MSCs与任何重大安全问题无关。研究还显示,生物标志物和临床结果的改善是次要结果。三项研究没有对照组,其他研究的对照组相似性也令人担忧。此外,结果评估量表也存在相当大的偏倚风险:基于细胞的疗法在AD患者中的耐受性良好,这强调了进一步开展精心策划的随机研究的必要性,以便在这方面获得循证临床建议。
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A systematic review of clinical efficacy and safety of cell-based therapies in Alzheimer's disease.

There is presently no disease-modifying therapy for Alzheimer's Disease (AD), which is the most prevalent cause of dementia.

Objective: This study aspires to estimate the efficacy and safety of cell-based treatments in AD.

Methods: Observing the Joanna Briggs Institute (JBI) methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic search was accomplished in PubMed, Medical Literature Analysis and Retrieval System Online (Medline, via Ovid), Embase; Cochrane, and Cumulative Index of Nursing and Allied Health Literature - CINAHL (via EBSCO) databases up to June 2023. The relevant clinical studies in which cell-based therapies were utilized to manage AD were included. The risk of bias was evaluated using the JBI checklists, based on the study designs.

Results: Out of 1,014 screened records, a total of five studies with 70 individuals (including 59 patients receiving stem cells and 11 placebo controls) were included. In all these studies, despite the discrepancy in the origin of stem cells, cell density, and transplant site, safety goals were obtained. The intracerebroventricular injection of adipose-derived stromal vascular fraction (ADSVF) and umbilical cord-derived mesenchymal stem cells (UC-MSCs), the intravenous injection of Lomecel-B, and the bilateral hippocampi and right precuneus injection of UC-MSCs are not linked to any significant safety concerns, according to the five included studies. Studies also revealed improvements in biomarkers and clinical outcomes as a secondary outcome. Three studies had no control groups and there are concerns regarding the similarity of the groups in others. Also, there is considerable risk of bias regarding the outcome assessment scales.

Conclusion: Cell-based therapies are well tolerated by AD patients, which emphasizes the need for further, carefully planned randomized studies to reach evidence-based clinical recommendations in this respect.

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来源期刊
Dementia e Neuropsychologia
Dementia e Neuropsychologia Medicine-Geriatrics and Gerontology
CiteScore
2.20
自引率
0.00%
发文量
58
审稿时长
8 weeks
期刊介绍: Dementia top Neuropsychologia the official scientific journal of the Cognitive Neurology and Ageing Department of the Brazilian Academy of Neurology and of the Brazilian Association of Geriatric Neuropsychiatry, is published by the "Associação Neurologia Cognitiva e do Comportamento", a nonprofit Brazilian association. Regularly published on March, June, September, and December since 2007.
期刊最新文献
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