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Combined application of neural stem/progenitor cells and scaffolds on locomotion recovery following spinal cord injury in rodents: a systematic review and meta-analysis

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Abstract

Background

This present study evaluates the pre-clinical evidence on the efficacy of NS/PC and scaffold (NS/PC + scaffold) transplantation on locomotor recovery after traumatic spinal cord injury (SCI).

Method

Two independent reviewers screened the records gathered through a systematic search in MEDLINE, Embase, Scopus, and Web of Sciences databases. Studies on rats/mice evaluating the efficacy of simultaneous transplantation of NS/PCs and scaffold in the treatment of SCI were included. The results were reported as standardized mean difference (SMD) and 95% confidence interval (95% CI).

Results

Forty-seven articles were retrieved. Analyses showed that NS/PC + scaffold transplantation significantly improved locomotion in animals with SCI compared to that of the non-treatment group (SMD = 2.71, 95% CI: 1.89 to 3.54; I2 = 95.15%, p < 0.0001), scaffold alone (SMD = 2.28; 95% CI: 1.56 to 3.00; I2 = 94.38%; p < 0.0001), and NS/PCs alone (SMD = 1.74, 95% CI: 0.64 to 2.83; I2 = 92.02%, p < 0.0001). Moreover, the effectiveness of the treatment significantly increases when PLGA-based scaffolds and antibiotics are used. In addition, the NS/PC + scaffold transplantation during the first week after injury led to a significant improvement in locomotion, while concomitant transplantation of NS/PC + scaffold did not improve locomotion in cervical lesions.

Conclusion

The findings showed that using NS/PCs with scaffold not only improves locomotion recovery, but also is superior to NS/PCs alone and scaffold alone. Future experiments and translational clinical studies are recommended to focus on the assessment of the safety and efficacy of the application of NS/PC + scaffold on SCI recovery.

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Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Code availability

Not applicable.

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Funding

This research has been supported by the Tehran University of Medical Sciences and Health Services and the Iran Ministry of Health and Medical Education (Grant number: 96-04-159-36946).

Author information

Authors and Affiliations

  1. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran

    Mahmoud Yousefifard, Solmaz Nasseri Maleki, Seyedeh Niloufar Rafiei Alavi & Arian Madani Neishaboori

  2. Institute de Biologie Structurale (IBS), University of Grenoble Alpes, CEA, CNRS, 71 Avenue des Martyrs, 38000, Grenoble, France

    Shaghayegh Askarian-Amiri

  3. School of Medicine, International Campus, Tehran University of Medical Science, Tehran, Iran

    Leila Haghani

  4. Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA

    Alexander R. Vaccaro

  5. Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA

    James S. Harrop

  6. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Yi Lu

  7. Department of Neurosurgery, Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Vafa Rahimi-Movaghar

  8. Brain and Spinal Injuries Research Center (BASIR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Vafa Rahimi-Movaghar

  9. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., Tehran, Iran

    Mostafa Hosseini

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  1. Mahmoud Yousefifard
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Contributions

MY, VR, and MH designed the study. MY, SA, SNM, and LH gathered the data. MH analyzed the data. VR, MY, ARV, JSH, and YL interpreted the findings. MY wrote the first draft, and other authors critically revised the manuscript.

Corresponding authors

Correspondence to Vafa Rahimi-Movaghar or Mostafa Hosseini.

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The current study was approved by the Tehran University of Medical Sciences and Health Services and the Iran Ministry of Health and Medical Education.

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Yousefifard, M., Askarian-Amiri, S., Nasseri Maleki, S. et al. Combined application of neural stem/progenitor cells and scaffolds on locomotion recovery following spinal cord injury in rodents: a systematic review and meta-analysis. Neurosurg Rev 45, 3469–3488 (2022). https://doi.org/10.1007/s10143-022-01859-4

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  • DOI: https://doi.org/10.1007/s10143-022-01859-4

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