Systematic Review and Meta-Analysis of Bone Marrow-Derived Mononuclear Cells in
Animal Models of Ischemic Stroke
#MMPMID27165959
Vahidy FS
; Rahbar MH
; Zhu H
; Rowan PJ
; Bambhroliya AB
; Savitz SI
Stroke
2016[Jun]; 47
(6
): 1632-9
PMID27165959
show ga
BACKGROUND AND PURPOSE: Bone marrow-derived mononuclear cells (BMMNCs) offer the
promise of augmenting poststroke recovery. There is mounting evidence of safety
and efficacy of BMMNCs from preclinical studies of ischemic stroke; however,
their pooled effects have not been described. METHODS: Using Preferred Reporting
Items for Systematic Review and Meta-Analysis guidelines, we conducted a
systematic review of preclinical literature for intravenous use of BMMNCs
followed by meta-analyses of histological and behavioral outcomes. Studies were
selected based on predefined criteria. Data were abstracted by 2 independent
investigators. After quality assessment, the pooled effects were generated using
mixed-effect models. Impact of possible biases on estimated effect size was
evaluated. RESULTS: Standardized mean difference and 95% confidence interval for
reduction in lesion volume was significantly beneficial for BMMNC treatment
(standardized mean difference: -3.3; 95% confidence interval, -4.3 to -2.3).
n=113 each for BMMNC and controls. BMMNC-treated animals (n=161) also had
improved function measured by cylinder test (standardized mean difference: -2.4;
95% confidence interval, -3.1 to -1.6), as compared with controls (n=205). A
trend for benefit was observed for adhesive removal test and neurological deficit
score. Study quality score (median: 6; Q1-Q3: 5-7) was correlated with year of
publication. There was funnel plot asymmetry; however, the pooled effects were
robust to the correction of this bias and remained significant in favor of BMMNC
treatment. CONCLUSIONS: BMMNCs demonstrate beneficial effects across histological
and behavioral outcomes in animal ischemic stroke models. Although study quality
has improved over time, considerable degree of heterogeneity calls for
standardization in the conduct and reporting of experimentation.
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