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Review
. 2022 Jun 13;6(5):433-442.
doi: 10.22603/ssrr.2022-0004. eCollection 2022 Sep 27.

Mesenchymal Stem Cell-Conditioned Medium Promotes Functional Recovery Following Spinal Cord Injury: A Systematic Review and Meta-analysis

Arash Sarveazad  1   2 , Amirmohammad Toloui  3 , Aida Moarrefzadeh  4 , Hanieh Ghasemian Nafchi  3   5 , Arian Madani Neishaboori  3 , Mahmoud Yousefifard  3
Affiliations
Review

Mesenchymal Stem Cell-Conditioned Medium Promotes Functional Recovery Following Spinal Cord Injury: A Systematic Review and Meta-analysis

Arash Sarveazad et al. Spine Surg Relat Res. .

Abstract

Background: Considering the limitations of cell therapy, in case of adequate treatment efficacy, conditioned media (CM) may be a desirable alternative to cell therapy. Hence, the present systematic review and meta-analysis aims to evaluate the efficacy of mesenchymal stem cell-derived conditioned media (MSC-CM) in movement resolution following spinal cord injury (SCI) in animal models.

Methods: A comprehensive search in the databases of Medline, Scopus, Web of Science, and Embase was completed until the end of March 2021. Animal studies that evaluate the efficacy of MSC-CM on movement resolution following SCI were defined as the inclusion criteria. Lack of an SCI-untreated group, CM derived from a source other than MSC, not assessing motor function, failure to report CM administered dose, a follow-up period of less than 4 weeks, duplicates, and review articles were counted as the exclusion criteria. Final results are presented as overall standardized mean difference (SMD) with a 95% confidence interval (CI).

Results: From the 361 nonduplicate articles, data from 11 articles were entered into the present meta-analysis. The analyses showed that MSC-CM administration in SCI animal models promotes motor recovery (SMD=2.32; 95% CI: 1.55, 3.09; p<0.0001). Subgroup analysis was performed because of the noticeable heterogeneity between the studies (I2=80.97%, p<0.0001), depicting that antibiotic administration, delivery amount, delivery type, and follow-up time were the possible sources of heterogeneity. Moreover, multiple meta-regression demonstrated that in cases of delivery amount of more than 120 μL, the efficacy of MSC-CM administration in motor recovery is more than that of delivery amount of less than 120 μL (regression coefficient=3.30; 95% CI: 0.72, 5.89; p=0.019).

Conclusions: Based on the results of the present study, it can be concluded that MSC-CM administration in SCI models improves motor recovery. The efficacy of this treatment strategy significantly increases at doses higher than 120 μL.

Keywords: Conditioned media; Mesenchymal stem cells; Motor function; Spinal cord injury; Systematic review.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of the present meta-analysis.
Figure 2.
Figure 2.
Forest plot for the effect of conditioned media on locomotor recovery after spinal cord injury. SMD: Standardized mean difference; CI: Confidence interval
Figure 3.
Figure 3.
Leave-one-out sensitivity analysis to explore single study’s effect on overall effect size.
Figure 4.
Figure 4.
Funnel plot for assessment of publication bias in the efficacy of conditioned media on locomotor recovery after spinal cord injury.
See this image and copyright information in PMC

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