Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LUTeng ¹ , LIUChao ² , DONGJun ¹ , LUMeng ¹ , KANGJian ¹ ,  HEXi-jing ¹

1. Department of Orthopaedic, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;
2. Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;

Corresponding?author：

HEXi-jing, Email: xijing_h@vip.tom.com

Keywords：

Spinal-cord injury; Schwann cells; Transplantation; Basso, Beattie and Bresnahan scale; Rats; Meta-analysis

DOI：

10.7507/1672-2531.20150117

Video：

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Objective To systemically review the efficacy and safety of Schwann cells (SCs) or activated Schwann cells (ASCs) transplantation in the treatment of traumatic spinal-cord injury (TSCI) in rats models. Methods Randomized controlled trials (RCTs) about the effects of SCs and ASCs transplantation for TSCI in rats were searched in PubMed, EMbase, The Cochrane Library (Issue 12, 2014), CBM, CNKI, WanFang Data and VIP from inception to December 2014. 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 14 RCTs involving 510 rats were included. The results of meta-analysis showed that:compared with the control group, the Basso, Beattie and Bresnahan (BBB) scores in the SCs or ASCs transplantation group were superior in 4 weeks (SMD=2.31, 95%CI 1.48 to 3.13, P<0.000 01), 8 weeks (SMD=3.93, 95%CI 3.06 to 4.81, P<0.000 01) and 12 weeks (SMD=6.15, 95%CI 4.30 to 8.00, P<0.000 01) after surgery. The BBB scores in the SCs or ASCs transplantation combined with other therapies group were also better in 4 weeks (SMD=1.06, 95%CI 0.44 to 1.68, P=0.000 8), 8 weeks (SMD=2.26, 95%CI 1.57 to 2.96, P<0.000 01) and 12 weeks (SMD=1.49, 95%CI 0.72 to 2.25, P<0.000 01) after surgery. Compared with the SCs group, the BBB score in the ASCs transplantation group were superior in 4 weeks (SMD=4.31, 95%CI 3.50 to 5.13, P<0.000 01) and 12 weeks (SMD=5.44, 95%CI 3.99 to 6.89, P<0.000 01) after surgery. No significant difference was found in mortality between the transplantation group and the control group. Conclusion Current evidence indicates that SCs and ASCs can promote the recovery of motor function in the rats with TSCI. More functional recoveries can be obtained in ASCs transplantation compared with SCs transplantation. Due to limited quality of the included studies, the above conclusion should be verified by conducting more large-scale, high quality RCTs.

Citation： LUTeng, LIUChao, DONGJun, LUMeng, KANGJian, HEXi-jing. Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(6): 705-712. doi: 10.7507/1672-2531.20150117 Copy

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2.	李建軍,周紅俊,洪毅,等.2002年北京市脊髓損傷發病率調查.中國康復理論與實踐,2004,10(7):412-413.
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12.	Hui L,Feng SQ,Chen JT,et al.Repair of spinal cord injury using Schwann cells in rats:Feasibility and superiority of intravenous transplantation.Journal of Clinical Rehabilitative Tissue Engineering Research,2010,14(18):3305-3309.
13.	Pourheydar B,Joghataei MT,Bakhtiari M,et al.Co-transplantation of bone marrow stromal cells with schwann cells evokes mechanical allodynia in the contusion model of spinal cord injury in rats.Cell Journal,2012,13(4):213-222.
14.	曹富江.自體激活雪旺細胞聯合臍帶間充質干細胞修復脊髓損傷的實驗研究:天津醫科大學,2008.
15.	馮世慶,周先虎,孔曉紅,等.自體激活雪旺細胞移植治療急性脊髓損傷的實驗研究.中華骨科雜志,2006,26(8):553-557.
16.	郭濤.CD34~+細胞聯合雪旺細胞移植對脊髓全橫斷大鼠后肢功能及移植細胞分化的研究:昆明醫學院,2009.
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18.	李輝.C3轉移酶聯合雪旺細胞修復脊髓損傷的實驗研究:天津醫科大學,2010.
19.	李偉,馮世慶,李健輝,等.硫酸鎂聯合自體激活雪旺細胞移植治療脊髓損傷.天津醫藥,2009,18(6):485-488.
20.	寧廣智,馮世慶,班德翔,等.人臍血單個核細胞聯合雪旺細胞修復脊髓損傷的實驗研究.中華骨科雜志,2009,29(11):1057-1062.
21.	王春源,馮世慶,劉洋,等.蛛網膜下腔移植自體激活許旺細胞治療大鼠脊髓損傷.中國組織工程研究與臨床康復,2010,14(14):2533-2538.
22.	徐云強,馮世慶,王沛,等.軟骨素酶聯合雪旺細胞移植促進脊髓損傷修復的研究.中華實驗外科雜志,2010,20(7):972-975.
23.	朱玉海,馮世慶,孔曉紅,等.人臍帶間充質干細胞與自體激活雪旺細胞聯合移植修復脊髓損傷的實驗研究.中華創傷骨科雜志,2009,11(8):747-751.
24.	Shi R,Pryor JD.Pathological changes of isolated spinal cord axons in response to mechanical stretch.Neuroscience,2002,110(4):765-777.
25.	Xu P,Gong WM,Li Y,et al.Destructive pathological changes in the rat spinal cord due to chronic mechanical compression.Laboratory investigation.J Neurosurg Spine,2008,8(3):279-285.
26.	Feng SQ,Zhou XF,Rush RA,et al.Graft of pre-injured sural nerve promotes regeneration of corticospinal tract and functional recovery in rats with chronic spinal cord injury.Brain Res,2008,1209:40-48.

1. Center NSCIS.Spinal cord injury facts and figures at a glance.J Spinal Cord Med,2013,36(6):715-716.
2. 李建軍,周紅俊,洪毅,等.2002年北京市脊髓損傷發病率調查.中國康復理論與實踐,2004,10(7):412-413.
3. Liu WL,Lee YH,Tsai SY,et al.Methylprednisolone inhibits the expression of glial fibrillary acidic protein and chondroitin sulfate proteoglycans in reactivated astrocytes.Glia,2008,56(13):1390-1400.
4. Short DJ,El Masry WS,Jones PW.High dose methylprednisolone in the management of acute spinal cord injury-a systematic review from a clinical perspective.Spinal Cord,2000,38(5):273-286.
5. Lee HJ,Shin YK,Park HT.Mitogen Activated Protein Kinase Family Proteins and c-jun Signaling in Injury-induced Schwann Cell Plasticity.Exp Neurobiol,2014,23(2):130-137.
6. 勞杰,蔣良福,顧玉東.激活態雪旺細胞生長相關蛋白43 mRNA表達的研究.中華骨科雜志,2005,25(6):372-374.
7. Basso DM,Beattie MS,Bresnahan JC.A sensitive and reliable locomotor rating scale for open field testing in rats.J Neurotrauma,1995,12(1):1-21.
8. 陳匡陽,馬彬,王亞楠,等.SYRCLE動物實驗偏倚風險評估工具簡介.中國循證醫學雜志,2014,14(10):1281-1285.
9. 牛軍強,王亞楠,朱芊各,等.動物實驗方法學和報告質量評估工具的橫斷面研究.中國循證醫學雜志,2015,15(2):223-229.
10. Ban DX,Ning GZ,Feng SQ,et al.Combination of activated Schwann cells with bone mesenchymal stem cells:The best cell strategy for repair after spinal cord injury in rats.Regenerative Medicine,2011,6(6):707-720.
11. Chen G,Hu YR,Wan H,et al.Functional recovery following traumatic spinal cord injury mediated by a unique polymer scaffold seeded with neural stem cells and Schwann cells.Chinese Medical Journal,2010,123(17):2424-2431.
12. Hui L,Feng SQ,Chen JT,et al.Repair of spinal cord injury using Schwann cells in rats:Feasibility and superiority of intravenous transplantation.Journal of Clinical Rehabilitative Tissue Engineering Research,2010,14(18):3305-3309.
13. Pourheydar B,Joghataei MT,Bakhtiari M,et al.Co-transplantation of bone marrow stromal cells with schwann cells evokes mechanical allodynia in the contusion model of spinal cord injury in rats.Cell Journal,2012,13(4):213-222.
14. 曹富江.自體激活雪旺細胞聯合臍帶間充質干細胞修復脊髓損傷的實驗研究:天津醫科大學,2008.
15. 馮世慶,周先虎,孔曉紅,等.自體激活雪旺細胞移植治療急性脊髓損傷的實驗研究.中華骨科雜志,2006,26(8):553-557.
16. 郭濤.CD34~+細胞聯合雪旺細胞移植對脊髓全橫斷大鼠后肢功能及移植細胞分化的研究:昆明醫學院,2009.
17. 紀江峰.氯化鋰聯合自體激活雪旺細胞治療脊髓損傷的研究:天津醫科大學,2007.
18. 李輝.C3轉移酶聯合雪旺細胞修復脊髓損傷的實驗研究:天津醫科大學,2010.
19. 李偉,馮世慶,李健輝,等.硫酸鎂聯合自體激活雪旺細胞移植治療脊髓損傷.天津醫藥,2009,18(6):485-488.
20. 寧廣智,馮世慶,班德翔,等.人臍血單個核細胞聯合雪旺細胞修復脊髓損傷的實驗研究.中華骨科雜志,2009,29(11):1057-1062.
21. 王春源,馮世慶,劉洋,等.蛛網膜下腔移植自體激活許旺細胞治療大鼠脊髓損傷.中國組織工程研究與臨床康復,2010,14(14):2533-2538.
22. 徐云強,馮世慶,王沛,等.軟骨素酶聯合雪旺細胞移植促進脊髓損傷修復的研究.中華實驗外科雜志,2010,20(7):972-975.
23. 朱玉海,馮世慶,孔曉紅,等.人臍帶間充質干細胞與自體激活雪旺細胞聯合移植修復脊髓損傷的實驗研究.中華創傷骨科雜志,2009,11(8):747-751.
24. Shi R,Pryor JD.Pathological changes of isolated spinal cord axons in response to mechanical stretch.Neuroscience,2002,110(4):765-777.
25. Xu P,Gong WM,Li Y,et al.Destructive pathological changes in the rat spinal cord due to chronic mechanical compression.Laboratory investigation.J Neurosurg Spine,2008,8(3):279-285.
26. Feng SQ,Zhou XF,Rush RA,et al.Graft of pre-injured sural nerve promotes regeneration of corticospinal tract and functional recovery in rats with chronic spinal cord injury.Brain Res,2008,1209:40-48.

Chinese Journal of Evidence-Based Medicine

Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis

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