The efficacy of mesenchymal stromal cell-derived therapies for acute respiratory distress syndrome-a meta-analysis of preclinical trials.

Abstract:

BACKGROUND:The investigation of mesenchymal stromal cell (MSC)-conditioned medium or extracellular vesicles (exosomes or microvesicles) as a remedy for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) has become a fast-growing field in recent years. Our purpose was to conduct a meta-analysis to investigate the efficacy of MSC-derived therapies (MDTs) for ALI/ARDS in animal models. METHODS:A meta-analysis of MDTs for ALI/ARDS in animal trials was performed. PubMed and EMBASE were searched to screen relevant preclinical trials with a predetermined search strategy. RESULTS:A total of 17 studies that compared MDT with the ALI control group were included in our study. The pooled result derived from the comparison of the two groups suggested that MDT could significantly reduce the lung injury score (standardized mean difference (SMD) = - 4.02, 95% CI [- 5.28, - 2.23], P < 0.0001) and improve animal survival (OR = - 6.45, 95% CI [2.78, 14.97], P < 0.0001). MDT mitigated the infiltration of neutrophils in alveoli (SMD = - 3.38, 95% CI [- 4.58, - 2.18], P < 0.00001). MDT also reduced the wet-dry weight ratio of the lung (SMD = - 2.34, 95% CI [- 3.42, - 1.26], P < 0.0001) and the total protein in BALF (SMD = - 2.23, 95% CI [- 3.07, - 1.40], P < 0.00001). Furthermore, MDT was found to downregulate proinflammatory mediators such as IL-1, IL-6 and TNF-a and to upregulate anti-inflammatory mediators such as IL-10. CONCLUSION:MDT reduces lung injury and improves survival in animal ARDS models since it can ameliorate lung permeability, decrease inflammatory cell infiltration, downregulate proinflammatory mediators, and upregulate anti-inflammatory mediators. However, more animal studies and human trials are needed for further investigation.

journal_name

Respir Res

journal_title

Respiratory research

authors

Wang F,Fang B,Qiang X,Shao J,Zhou L

doi

10.1186/s12931-020-01574-y

subject

Has Abstract

pub_date

2020-11-20 00:00:00

pages

307

issue

1

eissn

1465-9921

issn

1465-993X

pii

10.1186/s12931-020-01574-y

journal_volume

21

pub_type

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