| 제목 |
Effects of Mesenchymal Stem Cells on Tendon Disorders: A Meta-Analysis of Clinical Studies |
| 소속 |
Seoul National University Hospital, Department of Rehabilitation Medicine1, Asan Medical Center, Department of Rehabilitation Medicine2, SMG-SNU Boramae Medical Center, Department of Orthopedic Surgery3, SMG-SNU Boramae Medical Center, Department of Rehabilitation Medicine4 |
| 저자 |
Woo Sup Cho1*, Sun Gun Chung1, Won Kim2, Chris H. Jo3, Shi-Uk Lee4, Sang Yoon Lee4† |
Objectives: Although several animal studies have reported the effects of mesenchymal stem cells (MSCs) for tendon regeneration, little is known about the efficacy and safety of MSCs in human tendon disorders. Furthermore, a number of clinical studies used not pure MSCs but bone marrow aspirates or stromal vascular fractions cells. Thus, we performed an update meta-analysis of prospective clinical studies to evaluate the efficacy and safety of MSCs therapy in patients with tendon disorders.
Methods: Four randomized controlled trials investigating the effect of MSCs on tendon disorders were retrieved (Table 1) from a PubMed, Embase, and Cochrane Library search. We performed a pairwise meta-analysis using fixed- or random-effects models.
Results: MSCs showed a significant overall effect size (overall Hedge’s g pooled standardized mean difference (SMD) = 1.868; 95% confidence interval [CI], 1.274–2.462; P < 0.001) (Figure 1). Pain, functional scores, radiologic parameters (magnetic resonance image or ultrasonography), and arthroscopic findings all improved with MSCs treatment. In meta-regression analysis, there was a significant cell dose-dependent responses in pain relief (Q=9.06, P = 0.029) (Figure 2). While three studies reported mild adverse events after MSCs injection, these were not severe and spontaneously relieved.
Conclusion: Our meta-analysis revealed that MSCs therapy can improve pain, functions, radiologic and arthroscopic parameters in patients with tendon disorder. Due to the small sample size in this meta-analysis and considering the increasing MSCs applications, there is a need for large-scale randomized controlled trials to confirm the long-term functional improvement and adverse effects of MSCs on tendon disorders. |
|
Table 1. Characteristics of included individual studies
Figure 1. Forest plot of the overall effect size of mesenchymal stem cells on tendon disorders determined by a fixed-effects meta-analysis. Effect sizes are indicated as Hedges’ g standardized mean differences and 95% confidence intervals.
Figure 2. Meta-regression of the standardized mean differences in means for cell dose. The area of the circles is proportional to the studies’ weights in the regression.
|
