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Meta-Analysis
. 2025 Apr;31(4):e70357.
doi: 10.1111/cns.70357.

Efficacy and Potential Mechanisms of Umbilical Cord-Derived Mesenchymal Stem Cells in the Treatment of Ischemic Stroke in Animal Models: A Meta-Analysis

Renli Wei  1   2 , Minguang Yang  3 , Yue Cao  4 , Shuqian Qiu  1 , Xu Fan  1   2 , Muxuan Fang  1   2 , Li Chen  5 , Shaojie Cheng  5 , Jianhong Li  1   2   5 , Shenghang Zhang  1   5
Affiliations
Meta-Analysis

Efficacy and Potential Mechanisms of Umbilical Cord-Derived Mesenchymal Stem Cells in the Treatment of Ischemic Stroke in Animal Models: A Meta-Analysis

Renli Wei et al. CNS Neurosci Ther. 2025 Apr.

Abstract

Background: Umbilical cord-derived mesenchymal stem cells (UCMSCs) have emerged as a promising treatment for ischemic stroke. This study aimed to evaluate the therapeutic efficacy and potential mechanisms of UCMSCs in treating ischemic stroke.

Methods: A systematic search of PubMed, Web of Science, and Embase was conducted up to April 25, 2024. Literature was screened based on the PICOS principle, with predefined inclusion and exclusion criteria. Relevant data were extracted and analyzed using Review Manager 5.4.

Results: Out of 1390 retrieved articles, 30 were included in the meta-analysis. UCMSCs significantly reduced infarct size and volume, improved neurological deficit scores, and facilitated neurobehavioral recovery. UCMSCs treatment also modulated inflammatory cytokine levels in brain tissue and serum, promoted microglial polarization, inhibited apoptosis, and increased vessel density in the peri-infarct tissue.

Conclusions: UCMSCs administration significantly promoted the neurological function recovery after ischemic stroke. Their mechanisms of action may be related to immune response regulation, inhibition of apoptosis, and promotion of angiogenesis. These findings provide theoretical guidance for improving the quality of basic research and clinical translation.

Keywords: animal study; ischemic stroke; meta‐analysis; umbilical cord‐derived mesenchymal stem cells.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
SYRCLE risk of bias assessment for included studies. (A) Risk of bias graph. (B) Risk of bias summary.
FIGURE 3
FIGURE 3
Forest plot demonstrating the efficacy of UCMSCs on cerebral infarct size and edema in IS animals. (A) Percentage of cerebral infarction area. (B) Percentage of cerebral infarction volume. (C) Infarct volume size. (D) Brain water content.
FIGURE 4
FIGURE 4
Forest plot illustrating the efficacy of UCMSCs on neurological scores in IS animals. (A) mNSS. (B) Longa.
FIGURE 5
FIGURE 5
Forest plot depicting the efficacy of UCMSCs on neurological behaviors in IS animals. (A) Rotarod test. (B) Retention time. (C) Adhesive removal test. (D) Cylinder test. (E) Morris water maze test. (F) Body asymmetry test. (G) Vertical activity. (H) Vertical movement time. (I) Number of vertical movements.
FIGURE 6
FIGURE 6
Forest plot showing the efficacy of UCMSCs on levels in brain tissue or serum of IS animals. (A) IL‐1β in brain. (B) IL‐6 in brain. (C) TNF‐α in brain. (D) IL‐10 in brain. (E) IL‐4 in brain. (F) TGF‐β in brain. (G) IL‐1β in serum. (H) IL‐6 in serum. (I) TNF‐α in serum.
FIGURE 7
FIGURE 7
Forest plot demonstrating the efficacy of UCMSCs on microglial polarization in IS animals. (A) Iba1+ (%). (B) ED1+ (%). (C) Proportion of iNOS+/ED1+ cells. (D) Proportion of CD206+/ED1+ cells.
FIGURE 8
FIGURE 8
Forest plot showing the efficacy of UCMSCs on apoptosis and proliferation in IS animals. (A) Apoptosis rate. (B) Proliferation of neuroblasts. (C) BrdU‐labeled cells proliferating.
FIGURE 9
FIGURE 9
Forest plot illustrating the efficacy of UCMSCs on vessel density in IS animals. (A) Vessel density. (B) Percentage of vessel density.
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