Abstract：
Spinal cord injury (SCI) is associated with substantial healthcare challenges, frequently resulting in enduring sensory and motor deficits alongside various chronic complications. While advanced regenerative therapies have shown promise in preclinical research, their translation into clinical application has been limited. In response, this study utilized a comprehensive network meta-analysis to evaluate the effectiveness of neural stem/progenitor cell (NSPC) transplantation across animal models of SCI. We analyzed 363 outcomes from 55 distinct studies, categorizing the treatments into NSPCs alone (cell only), NSPCs with scaffolds (cell + scaffold), NSPCs with hydrogels (cell + hydrogel), standalone scaffolds (scaffold), standalone hydrogels (hydrogel), and control groups. Our analysis demonstrated significant enhancements in motor recovery, especially in gait function, within the NSPC treatment groups. Notably, the cell only group showed considerable improvements (standardized mean difference [SMD], 2.05; 95 % credible interval [CrI]: 1.08 to 3.10, p < 0.01), as did the cell + scaffold group (SMD, 3.73; 95 % CrI: 2.26 to 5.22, p < 0.001) and the cell + hydrogel group (SMD, 3.37; 95 % CrI: 1.02 to 5.78, p < 0.05) compared to controls. These therapeutic combinations not only reduced lesion cavity size but also enhanced neuronal regeneration, outperforming the cell only treatments. By integrating NSPCs with supportive biomaterials, our findings pave the way for refining these regenerative strategies to optimize their potential in clinical SCI treatment. Although there is no overall violation of consistency, the comparison of effect sizes between individual treatments should be interpreted in light of the inconsistency. STATEMENT OF SIGNIFICANCE: This study presents a comprehensive network meta-analysis exploring the efficacy of neural stem cell (NSC) transplantation, with and without biomaterials, in animal models of spinal cord injury (SCI). We demonstrate that NSCs, particularly when combined with biomaterials like scaffolds or hydrogels, significantly enhance motor and histological recovery post-SCI. These findings underscore the potential of NSC-based therapies, augmented with biomaterials, to advance SCI treatment, offering new insights into regenerative strategies that could significantly impact clinical practices.
摘要：
脊髓损伤（SCI）与重大的医疗保健挑战有关。经常导致持久的感觉和运动缺陷以及各种慢性并发症。虽然先进的再生疗法在临床前研究中显示出希望，它们转化为临床应用受到限制。作为回应,这项研究利用综合的网络荟萃分析来评估SCI动物模型中神经干/祖细胞(NSPC)移植的有效性.我们分析了来自55项不同研究的363项结果，将治疗分类为单独的NSPC(仅细胞)，NSPC与支架（细胞+支架），NSPC与水凝胶（细胞+水凝胶），独立脚手架（脚手架），独立水凝胶（水凝胶），和对照组。我们的分析表明，在运动恢复方面有了显著的提高，尤其是在步态功能方面，在NSPC治疗组中。值得注意的是,仅细胞组显示出相当大的改善(标准化平均差[SMD]，2.05;95%可信区间[CrI]:1.08~3.10,p<0.01),细胞+支架组(SMD，3.73；95％CrI：2.26至5.22，p<0.001）和细胞水凝胶组（SMD，3.37；与对照组相比，95％CrI：1.02至5.78，p<0.05）。这些治疗组合不仅减少了病变腔大小，而且增强了神经元再生，优于仅细胞治疗。通过将NSPC与支持性生物材料集成，我们的研究结果为完善这些再生策略以优化其在临床SCI治疗中的潜力铺平了道路.虽然没有全面违反一致性，各个治疗之间的效应大小的比较应根据不一致来解释.重要声明：本研究提出了一个全面的网络荟萃分析，探索神经干细胞（NSC）移植的功效，有和没有生物材料，在脊髓损伤（SCI）动物模型中。我们证明了NSC，特别是当与生物材料如支架或水凝胶结合时，显着增强SCI后的运动和组织学恢复。这些发现强调了基于NSC的疗法的潜力，用生物材料增强，为了推进SCI治疗，提供对再生策略的新见解，这些策略可能会对临床实践产生重大影响。
