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2018 ; 13
(5
): e0197658
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Use of human amniotic epithelial cells in mouse models of bleomycin-induced lung
fibrosis: A systematic review and meta-analysis
#MMPMID29772024
He F
; Zhou A
; Feng S
PLoS One
2018[]; 13
(5
): e0197658
PMID29772024
show ga
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) urgently requires effective
treatment. Bleomycin-induced lung injury models are characterized by initial
inflammation and secondary fibrosis, consistent with the pathological features of
IPF. Human amniotic epithelial cells (hAECs) exhibit good differentiation
potential and paracrine activity and are thus ideal for cell-based clinical
therapies. The therapeutic effects of hAECs on lung fibrosis are attributed to
many factors. We performed a systematic review of preclinical studies
investigating the treatment of pulmonary fibrosis with hAECs to provide
suggestions for their clinical use. METHODS: PubMed and EMBASE were searched for
original studies describing hAEC therapy in animal bleomycin-induced pulmonary
fibrosis models. After quality assessments, the number and species of
experimental animals, bleomycin dose, hAEC source and dosage, time and route of
administration of transplanted cells in animals, and time animals were euthanized
in nine controlled preclinical studies were summarized. Ashcroft scores, lung
collagen contents, inflammatory cells and cytokines were quantitatively and/or
qualitatively analyzed in this review. Publication bias was also assessed.
RESULTS: Each of the nine preclinical studies have unique characteristics
regarding hAEC use. Ashcroft scores and lung collagen contents were decreased
following hAEC transplantation in bleomycin-injured mice. Histopathology was also
improved in most studies following treatment with hAECs. hAECs modulated
macrophages, neutrophils, T cells, dendritic cells and the mRNA or protein levels
of cytokines associated with inflammatory reactions (tumor necrosis factor-?,
transforming growth factor-?, interferon-? and interleukin) in lung tissues of
bleomycin-injured mice. CONCLUSIONS: hAECs alleviate and reverse the progression
of bleomycin-induced lung fibrosis in mice and may represent a new clinical
treatment for IPF. hAECs exert anti-inflammatory and anti-fibrotic effects by
modulating macrophage, neutrophil, T cell, dendritic cell and related cytokine
levels in mice with bleomycin-induced lung fibrosis. Cell generation and the
route, source and timing of hAEC transplantation all determine the therapeutic
effectiveness of hAECs.