Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12003
Title: Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies.
Authors: Antonic, Ana;Sena, Emily S;Lees, Jennifer S;Wills, Taryn E;Skeers, Peta;Batchelor, Peter Egerton;Macleod, Malcolm R;Howells, David William
Affiliation: Department of Medicine, University of Melbourne Lance Townsend Building, Austin Hospital, Heidelberg, Victoria, Australia.
Florey Institute of Neuroscience and Mental Health, Victoria, Australia ; Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
Department of Medicine, University of Melbourne Lance Townsend Building, Austin Hospital, Heidelberg, Victoria, Australia ; Florey Institute of Neuroscience and Mental Health, Victoria, Australia.
Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
Florey Institute of Neuroscience and Mental Health, Victoria, Australia.
Issue Date: 17-Dec-2013
Citation: Plos Biology 2013; 11(12): e1001738
Abstract: Spinal cord injury (SCI) is a devastating condition that causes substantial morbidity and mortality and for which no treatments are available. Stem cells offer some promise in the restoration of neurological function. We used systematic review, meta-analysis, and meta-regression to study the impact of stem cell biology and experimental design on motor and sensory outcomes following stem cell treatments in animal models of SCI. One hundred and fifty-six publications using 45 different stem cell preparations met our prespecified inclusion criteria. Only one publication used autologous stem cells. Overall, allogeneic stem cell treatment appears to improve both motor (effect size, 27.2%; 95% Confidence Interval [CI], 25.0%-29.4%; 312 comparisons in 5,628 animals) and sensory (effect size, 26.3%; 95% CI, 7.9%-44.7%; 23 comparisons in 473 animals) outcome. For sensory outcome, most heterogeneity between experiments was accounted for by facets of stem cell biology. Differentiation before implantation and intravenous route of delivery favoured better outcome. Stem cell implantation did not appear to improve sensory outcome in female animals and appeared to be enhanced by isoflurane anaesthesia. Biological plausibility was supported by the presence of a dose-response relationship. For motor outcome, facets of stem cell biology had little detectable effect. Instead most heterogeneity could be explained by the experimental modelling and the outcome measure used. The location of injury, method of injury induction, and presence of immunosuppression all had an impact. Reporting of measures to reduce bias was higher than has been seen in other neuroscience domains but were still suboptimal. Motor outcomes studies that did not report the blinded assessment of outcome gave inflated estimates of efficacy. Extensive recent preclinical literature suggests that stem-cell-based therapies may offer promise, however the impact of compromised internal validity and publication bias mean that efficacy is likely to be somewhat lower than reported here.
Internal ID Number: 24358022
URI: http://ahro.austin.org.au/austinjspui/handle/1/12003
DOI: 10.1371/journal.pbio.1001738
URL: http://www.ncbi.nlm.nih.gov/pubmed/24358022
Type: Journal Article
Subjects: Animals
Disease Models, Animal
Spinal Cord Injuries.surgery
Stem Cell Transplantation
Treatment Outcome
Appears in Collections:Journal articles

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