Systematic review and meta-analysis of mesenchymal stem/stromal cells therapy for impaired renal function in small animal models

Abstract

Aim: The meta-analysis of recent small animal experiments of mesenchymal stem/stromal cells (MSC) therapy for impaired kidney could provide significant clues to design large animal experiments as well as human clinical trials.

Method: A total of 21 studies was analyzed. These, were indexed from PubMed and Embase databases. All data were analyzed by RevMan 5.1 and SPSS 17.0. Pooled analysis and multivariable meta-regression were calculated by random effects models. Heterogeneity and publication bias across the studies were also explored.

Results: Pooled analysis showed elevated serum creatinine (Scr) reduction in the animal models of renal failure following MSC therapy. By exploratory multivariable meta-regression, significant influence factors of Scr reduction were the time point of Scr measurement (early measurement showed greater reduction than the late (P = 0.005)) and the route of MSC delivery (arterial delivery of MSCs caused greater reduction in elevated Scr, when compared with the intra-renal delivery and intravenous injection (P = 0.040)). Subgroup analysis showed there tended to be greater reduction in Scr with higher MSC number (>10(6)), the renal ischemia-reperfusion injury (IRI) model, and late administration (>1 day) after injury.

Conclusion: The present meta-analysis confirmed that MSC therapy could improve impaired renal function. MSCs might get obvious effect in the early stage of renal injuries after arterial delivery. Further, this meta-analysis may provide important clues for animal experiments even for human clinical trials in MSC studies.