临床前文献的系统评价和荟萃分析。
为了评估基于生物材料的组合(BMC)策略对脊髓损伤(SCI)的治疗效果,在BMC策略的背景下,个体生物材料的影响,以及影响其疗效的因素。评估BMC策略中不同临床前测试范例的效果。
我们对Embase进行了系统的文献检索,WebofScience和PubMed。所有对照临床前研究描述了SCI的体内或体外模型,该模型与至少一种其他再生策略(细胞,毒品,或两者)都包括在内。两位综述作者独立进行了研究选择,独立提取研究特征,并使用修改后的CAMARADES检查表评估研究质量。使用随机效应模型组合效应大小测量值,并使用tau2,I2和R2统计量的meta回归探索异质性。我们使用基于漏斗图的方法测试了小研究效果。
包括134种出版物,测试超过100种不同的BMC策略。总的来说,与仅损伤对照组相比,BMC治疗的运动恢复改善25.3%(95%CI,20.3-30.3;n=102),体内轴突再生改善1.6SD(95%CI1.2-2SD;n=117).
BMC策略可改善实验性SCI后的运动结果。我们的全面研究突出了当前知识的差距,并为未来的实验设计提供了基础。
Systematic
review and meta-analysis of preclinical literature.
To assess the effects of biomaterial-based combination (BMC) strategies for the treatment of Spinal Cord Injury (SCI), the effects of individual biomaterials in the context of BMC strategies, and the factors influencing their efficacy. To assess the effects of different preclinical testing paradigms in BMC strategies.
We performed a systematic literature search of Embase, Web of Science and PubMed. All controlled preclinical studies describing an in vivo or in vitro model of SCI that tested a biomaterial in combination with at least one other regenerative strategy (cells, drugs, or both) were included. Two
review authors conducted the study selection independently, extracted study characteristics independently and assessed study quality using a modified CAMARADES checklist. Effect size measures were combined using random-effects models and heterogeneity was explored using meta-regression with tau2, I2 and R2 statistics. We tested for small-study effects using funnel plot-based methods.
134 publications were included, testing over 100 different BMC strategies. Overall, treatment with BMC therapies improved locomotor recovery by 25.3% (95% CI, 20.3-30.3; n = 102) and in vivo axonal regeneration by 1.6 SD (95% CI 1.2-2 SD; n = 117) in comparison with injury only controls.
BMC strategies improve locomotor outcomes after experimental SCI. Our comprehensive study highlights gaps in current knowledge and provides a foundation for the design of future experiments.