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Meta-Analysis
. 2022 Nov 4:13:972247.
doi: 10.3389/fimmu.2022.972247. eCollection 2022.

Mesenchymal stromal cell extracellular vesicles for multiple sclerosis in preclinical rodent models: A meta-analysis

Chengfeng Xun  1   2   3 , Huiyin Deng  4 , Jing Zhao  1 , Lite Ge  1   2   3 , Zhiping Hu  1
Affiliations
Meta-Analysis

Mesenchymal stromal cell extracellular vesicles for multiple sclerosis in preclinical rodent models: A meta-analysis

Chengfeng Xun et al. Front Immunol. .

Abstract

Introduction: Extracellular vesicles (EVs), especially mesenchymal stem (stromal) cell-derived EVs (MSC-EVs), have gained attention as potential novel treatments for multiple sclerosis (MS). However, their effects remain incompletely understood. Thus, the purpose of this meta-analysis was to systematically review the efficacy of MSC-EVs in preclinical rodent models of MS.

Methods: We searched PubMed, EMBASE, and the Web of Science databases up to August 2021 for studies that reported the treatment effects of MSC-EVs in rodent MS models. The clinical score was extracted as an outcome. Articles were peer-reviewed by two authors based on the inclusion and exclusion criteria. This meta-analysis was conducted using Stata 15.1 and R.

Results: A total of twelve animal studies met the inclusion criteria. In our study, the MSC-EVs had a positive overall effect on the clinical score with a standardized mean difference (SMD) of -2.17 (95% confidence interval (CI)):-3.99 to -0.34, P = 0.01). A significant amount of heterogeneity was observed among the studies.

Conclusions: This meta-analysis suggests that transplantation of MSC-EVs in MS rodent models improved functional recovery. Additionally, we identified several critical knowledge gaps, such as insufficient standardized dosage units and uncertainty regarding the optimal dose of MSC-EVs transplantation in MS. These gaps must be addressed before clinical trials can begin with MSC-EVs.

Keywords: animal model; exosomes; extracellular vesicles; meta-analysis; multiple sclerosis; stem cells; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISM Aflow diagram for review and selection process of studies included in meta-analysis of MSC-EVs in rodent models of MS.
Figure 2
Figure 2
Forest plot shows the mean effect size and 95% confidence interval (CI) for clinical score.
Figure 3
Figure 3
Sensitivity analysis of the studies included in clinical score.
Figure 4
Figure 4
The evaluation of publication bias. (A) Funnel plots for clinical score, with the y-axis signifying study quality and the x-axis showing the study results. (B) Trim-and-fill method was used to evaluate the missing studies in clinical score. SMD, standardized mean difference.
Figure 5
Figure 5
Clinical challenges of MSC-EVs therapy for MS.
See this image and copyright information in PMC

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