title: Bone marrow stromal cell therapy for ischemic stroke: A meta-analysis of randomized control animal trials.
abstract: Background Results of animal studies assessing efficacy of bone marrow stromal cell therapy for ischemic stroke remain inconsistent. Aims The aims are to assess efficacy of bone marrow stromal cell therapy for ischemic stroke in animal studies. Methods Randomized controlled animal trials assessing efficacy of bone marrow stromal cell therapy were eligible. Stroke therapy academic industry round table was used to assess methodologic quality of included studies. Primary outcomes were total infarction volume and modified Neurological Severity Score. Multiple prespecified sensitivity analyses and subgroup analyses were conducted. Random effects models were used for meta-analysis. Results Thirty-three randomized animal trials were included with a total of 796 animals. The median quality score was 6 (interquartile range, 5-7). Bone marrow stromal cell therapy decreased total infarction volume (standardized mean difference, 0.897; 95% confidence interval, 0.553-1.241; P < .001) at follow-up. Overall standardized mean difference between animals treated with bone marrow stromal cell and controls was 2.47 (95% confidence interval, 1.84-3.11; P < .001) for modified Neurological Severity Score; 1.27 (95% confidence interval, 0.72-1.82; P < .001) for adhesive removal test; and 2.13 (95% confidence interval, 0.65-3.61; P < .001) for rotarod test. Significant heterogeneity among studies was observed. Effect of all outcomes stayed significant in various sensitivity analyses and subgroup analyses, except in a few subgroup analyses with small sample size or with short time follow-up. No significant difference between groups was observed except for study location, in which significantly larger estimates were found in Asian countries. On the basis of this meta-analysis, larger sample sizes are warranted for future animal studies. Conclusions Bone marrow stromal cell therapy significantly decreased total infarction volume and increased neural functional recovery in randomized controlled animal models of ischemic stroke.
authors: 1 Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, Nevada USA.|2 Department of Environmental & Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas, Nevada USA.
authors: Qing
authors: Q
authors: Wu
authors: 3 Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota USA.
authors: Yuexiang
authors: Y
authors: Wang
authors: 4 Department of Neurology, Mayo Clinic Hospital, Phoenix, Arizona USA.
authors: Bart M
authors: BM
authors: Demaerschalk
authors: 1 Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, Nevada USA.
authors: Saruna
authors: S
authors: Ghimire
authors: 5 Division of Education Administration, Mayo Clinic, Scottsdale, Arizona USA.
authors: Kay E
authors: KE
authors: Wellik
authors: 3 Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota USA.|6 Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota USA.
authors: Wenchun
authors: W
authors: Qu
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation; D002545:Brain Ischemia / Q000628:therapy*; D045164:Mesenchymal Stem Cell Transplantation; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000628:therapy*
keywords: Bone marrow stromal cell; modified Neurological Severity Score; pooled analysis; review; stem cell therapy efficacy; stroke repair; subgroup analysis; total infarction volume