Highlights
- •We reviewed the effects of stem cell-based therapies on ischemic stroke.
- •We assessed all the trials using the error matrix approach.
- •A dose-response meta-analysis was performed in our research.
Abstract
Stroke
is a major cause of death and long-term disability worldwide.
Cell-based therapies improve neural functional recovery in pre-clinical
studies, but clinical results require evaluation. We aimed to assess the
effects of mesenchymal stem cells on ischemic stroke treatment.
We
searched the PubMed, Embase and Cochrane databases until July 2015 and
selected the controlled trials using mesenchymal stem cells for ischemic
stroke treatment compared with cell-free treatment. We assessed the
results by meta-analysis using the error matrix approach, and we
assessed the association of mesenchymal stem cell counts with treatment
effect by dose-response meta-analysis.
Seven trials were included.
Manhattan plots revealed no obvious advantage of the application of
stem cells to treat ischemic stroke. For the comprehensive evaluation
index, stem cell treatment did not significantly reduce the mortality of
ischemic stroke patients (relative risk (RR) 0.59, 95% confidence
interval (CI) 0.29–1.19; ln(RR) 0.54, 95% CI −0.18 to 1.25, p = 0.141).
The National Institutes of Health Stroke Scale was also not
significantly improved by stem cell treatment (standardized mean
difference (SMD) 0.94, 95% CI −0.13 to 2.01, p = 0.072). The European
Stroke Scale was significantly improved using the stem cell treatment
(SMD 1.15, 95% CI 0.37–1.92). The dose-response meta-analysis did not
reveal a significant linear regression relationship between the number
of stem cells and therapeutic effect, except regarding the National
Institutes of Health Stroke Scale index.
In conclusion, our
assessments indicated no significant difference between stem cell and
cell-free treatments. Further research is needed to discover more
effective stem cell-based therapies for ischemic stroke treatment.
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