Efficacy and Safety of Bone Mesenchymal Stem Cells Transplantation for Ischemic Stroke: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LIUChao ,  WUHai-qin , YANPu , ZHAOJia-xin , GAOZhen , LIPeng , ZHANGMeng

Department of Neurology, the Second Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710004, China;

Corresponding?author：

WUHai-qin, Email: eryuanwhq@126.com

Keywords：

Bone marrow mesenchymal stem cell; Transplantation; Ischemic stroke; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20150110

Video：

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Objective To systematically review the efficacy and safety of bone mesenchymal stem cells (BMSCs) transplantation for ischemic stroke. Methods We electronically searched PubMed, The Cochrane Library (Issue 12, 2014), EMbase, CBM, CNKI and WanFang Data from inception to December 2014, to collect randomized controlled trials (RCTs) of BMSCs transplantation for ischemic stroke. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 6 RCTs involving 332 patients were included. The results of meta-analysis showed that, the BMSCs transplantation group was superior to the routine treatment group with significant differences in the neurologic deficits score (NIHSS score)(MD=-2.09, 95%CI -2.88 to -1.29, P<0.000 01), motor function (Fugl-Meyer rating scale) (MD=15.25, 95%CI 13.51 to 16.99, P<0.000 01) and daily life ability (Barthel index) (MD=20.04, 95%CI 9.91 to 30.17, P=0.000 1) after 3 months treatment. Two trials reported the adverse events including fever and headache, but the patients relieved in a brief period. Conclusion Current evidence shows that BMSCs transplantation can improve the neurological deficits, motor function and daily life ability after ischemic stroke with less adverse effect. No serious adverse events are observed. However, more high quality studies are needed to confirm its effects for lowering rates of death and dependency of BMSC.

Citation： LIUChao, WUHai-qin, YANPu, ZHAOJia-xin, GAOZhen, LIPeng, ZHANGMeng. Efficacy and Safety of Bone Mesenchymal Stem Cells Transplantation for Ischemic Stroke: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(6): 659-663. doi: 10.7507/1672-2531.20150110 Copy

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13.	謝旭芳,劉詩英,金光華,等.自體骨髓間充質干細胞移植治療腦梗死的臨床分析.檢驗醫學與臨床,2014,(21):2955-2957.
14.	Friedenstein AJ,Petrakova KV,Kurolesova AI,et al.Heterotopic of bone marrow.Analysis of precursor cells for osteogenic and hematopoietic tissues.Transplantation,1968,6(2):230-247.
15.	Kopen GC,Prockop DJ,Phinney DG.Marrow stromal cells migrate throughout forebrain and cerebellum,and they differentiate into astrocytes after injection into neonatal mouse brains.Proc Natl Acad Sci USA,1999,96(19):10711-10716.
16.	Li Y,Chopp M,Chen J,et al.Intrastriatal transplantation of bone marrow nonhematopoietic cells improves functional recovery after stroke in adult mice.J Cereb Blood Flow Metab,2000,20(9):1311-1319.
17.	Mochizuki N,Moriyama Y,Takagi N,et al.Intravenous injection of neural progenitor cells improves cerebral ischemia-induced learning dysfunction.Biol Pharm Bull,2011,34(2):260-265.
18.	Rossini PM,Dal Forno G.Neuronal post-stroke plasticity in the adult.Restor Neurol Neurosci,2004,22(3-5):193-206.
19.	Iihoshi S,Honmou O,Houkin K,et al.A therapeutic window for intravenous administration of autologous bone marrow after cerebral ischemia in adult rats.Brain Res,2004,1007(1-2):1-9.
20.	周紅青,王德任,張燦飛,等.通心絡膠囊治療急性缺血性腦卒中療效與安全性的系統評價.中國循證醫學雜志,2013,13(7):844-851.
21.	吳波,劉鳴,張世洪.丹參類藥物治療急性缺血性腦卒中的系統評價.中國循證醫學雜志,2005,5(2):101-105.

1. Leys D,Goldstein P.Primary emergencies:management of acute ischemic stroke.Bull Acad Natl Med,2012,196(4-5):909-925.
2. Adams HP Jr,del Zoppo G,Alberts MJ,et al.Guidelines for the early management of adults with ischemic stroke.Stroke,2007,38(5):1655-1711.
3. Rombouts WJC,Ploemacher RE.Primary murine MSC show highly efficient homing to the bone marrow but lose homing ability following culture.Leukemia,2003,17(1):160-170.
4. Woodbury D,Reynolds K,Black IB.Adult bone marrow stromal stem cells express germline,ectodermal,endodermal,and mesodermal genes prior to neurogenesis.Journal of Neuroscience Research,2002,69(6):908-917.
5. 中華醫學會第四次腦血管病學術會議組.各類腦血管疾病診斷要點.中華神經科雜志,1996,29(6):379-380.
6. Hatano S.Experience from a multicentre stroke register:a preliminary report.Bull World Health Organ,1976,54(5):541-553.
7. 王丹,翟俊霞,牟振云,等.Meta分析中的異質性及其處理方法.中國循證醫學雜志,2009,9(10):1115-1118.
8. Bang OY,Lee JS,Lee PH,et al.Autologous mesenchymal stem cell transplantation in stroke patients.Ann Neurol,2005,57(6):874-882.
9. 陳文斗,李江濤,張效北,等.骨髓間充質干細胞移植治療腦梗死臨床分析.吉林醫學,2012,33(21):4522-4522.
10. 何振東.骨髓間充質干細胞移植改善腦梗死患者神經功能機制研究.亞太傳統醫藥,2012,8(12):126-127.
11. 劉定華,韓伯軍,洪珊珊,等.自體骨髓間充質神經干細胞移植治療腦梗死的療效觀察.中華物理醫學與康復雜志,2014,36(6):425-428.
12. 孟憲國,朱士文,高華,等.自體骨髓間充質干細胞移植治療腦梗死:6個月隨訪.中國組織工程研究與臨床康復,2009,13(32):6374-6378.
13. 謝旭芳,劉詩英,金光華,等.自體骨髓間充質干細胞移植治療腦梗死的臨床分析.檢驗醫學與臨床,2014,(21):2955-2957.
14. Friedenstein AJ,Petrakova KV,Kurolesova AI,et al.Heterotopic of bone marrow.Analysis of precursor cells for osteogenic and hematopoietic tissues.Transplantation,1968,6(2):230-247.
15. Kopen GC,Prockop DJ,Phinney DG.Marrow stromal cells migrate throughout forebrain and cerebellum,and they differentiate into astrocytes after injection into neonatal mouse brains.Proc Natl Acad Sci USA,1999,96(19):10711-10716.
16. Li Y,Chopp M,Chen J,et al.Intrastriatal transplantation of bone marrow nonhematopoietic cells improves functional recovery after stroke in adult mice.J Cereb Blood Flow Metab,2000,20(9):1311-1319.
17. Mochizuki N,Moriyama Y,Takagi N,et al.Intravenous injection of neural progenitor cells improves cerebral ischemia-induced learning dysfunction.Biol Pharm Bull,2011,34(2):260-265.
18. Rossini PM,Dal Forno G.Neuronal post-stroke plasticity in the adult.Restor Neurol Neurosci,2004,22(3-5):193-206.
19. Iihoshi S,Honmou O,Houkin K,et al.A therapeutic window for intravenous administration of autologous bone marrow after cerebral ischemia in adult rats.Brain Res,2004,1007(1-2):1-9.
20. 周紅青,王德任,張燦飛,等.通心絡膠囊治療急性缺血性腦卒中療效與安全性的系統評價.中國循證醫學雜志,2013,13(7):844-851.
21. 吳波,劉鳴,張世洪.丹參類藥物治療急性缺血性腦卒中的系統評價.中國循證醫學雜志,2005,5(2):101-105.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Bone Mesenchymal Stem Cells Transplantation for Ischemic Stroke: A Systematic Review

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