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Stem cell therapy for bone repair: a systematic review and meta‐analysis of preclinical studies with large animal models
Author(s) -
Liao Yun,
Zhang XiaoLong,
Li Ling,
Shen FuMing,
Zhong MingKang
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12382
Subject(s) - medicine , meta analysis , bone mineral , stem cell , stem cell therapy , confidence interval , surgery , transplantation , osteoporosis , biology , genetics
Aim Injury to bone is a significant clinical challenge, due to its limited regenerative capacity. The current methods of repairing bone defect are surgical, highly invasive and not always successful. A systematic review and meta‐analysis of preclinical studies involving large animals with bone defects were conducted to determine the treatment outcomes with stem cell therapies. Methods A random effects meta‐analysis of the available studies was conducted to assess the treatment outcomes including the rate of new bone formation and new bone mineral density ( BMD ). Stratified analyses were also conducted by separating studies based on each characteristic independently. Results Pooled analysis of 20 preclinical studies showed a significant beneficial effect of stem cell therapy in increasing new bone formation (17.79%, 95% confidence interval [ CI ], 10.54, 25.03; P < 0.001) and BMD (276.94 mg cm −2 , 95% CI , 62.71, 491.17; P < 0.001) for disease amelioration. Regarding new bone formation, a statistical improvement was similarly detected from randomized controlled trial groups (17.06%, 95% CI , 8.87, 25.24; P < 0.001) and cohort groups (17.43%, 95% CI , 10.79, 24.07; P < 0.001). Exploratory stratified analysis yielded significant predictors of new bone formation including cell number (<10 7 vs . ≥10 7 ; P = 0.048) and the route of cell delivery (combining with matrix scaffold showed more effect than direct cell injection, P = 0.041). The effect of stem cell therapy diminished after 12 weeks. Conclusion The study results suggest that stem cell therapy improves new bone formation and BMD in bone defect models. Future trials should focus on the transplantation of ≥10 7 stem cells, especially using slow release biodegradable scaffolds or repetitive cell injections.