Tissue & cell · 2026
Effects of decellularized biological scaffolds on motor function recovery following spinal cord injury: A systematic review and meta‑analysis.
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Khodaei Mohammad Mahdi, Behroozi Zahra, Haraj Alireza, Hamblin Michael R, Ramezani Fatemeh
Аннотация
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the efficacy of decellularized scaffolds (DCS) in improving motor function recovery in animal models of spinal cord injury (SCI).
METHODS: A comprehensive meta-analysis was conducted on 26 individual studies investigating DCS alone and 13 studies investigating DCS combined with cells. The standardized mean difference (SMD) with 95% confidence interval (CI) was calculated to assess the overall effect size. Subgroup analyses were performed to investigate sources of heterogeneity and the impact of variables such as gender, SCI model, scaffold source, implantation time, and follow-up duration.
RESULTS: The overall analysis revealed that implantation of DCS alone had a significant and large effect on motor function recovery compared to untreated controls (SMD = 2.6; 95% CI = 1.88-3.31; P < 0.0001). Subgroup analysis showed scaffolds derived from spinal cord tissue were significantly more effective (SMD=2.78, p < 0.0001) than those from other sources. Crucially, immediate implantation (within 30 min post-injury) yielded a strong significant effect (SMD=2.54, p < 0.0001), while a 24-hour delay abolished the significant benefit (SMD=0.903, p = 0.38). The effect was sustained over short (≤4 weeks), medium (4-8 weeks), and long-term (8 weeks) follow-ups. The combination of DCS with cell therapy showed a larger overall effect (SMD = 2.00; 95% CI = 1.21-2.79; P < 0.0001) compared with DCS alone.
CONCLUSION: The implantation of DCS is a highly effective intervention for promoting motor recovery after SCI in animal models, especially when derived from spinal cord tissue and implanted immediately after injury.
METHODS: A comprehensive meta-analysis was conducted on 26 individual studies investigating DCS alone and 13 studies investigating DCS combined with cells. The standardized mean difference (SMD) with 95% confidence interval (CI) was calculated to assess the overall effect size. Subgroup analyses were performed to investigate sources of heterogeneity and the impact of variables such as gender, SCI model, scaffold source, implantation time, and follow-up duration.
RESULTS: The overall analysis revealed that implantation of DCS alone had a significant and large effect on motor function recovery compared to untreated controls (SMD = 2.6; 95% CI = 1.88-3.31; P < 0.0001). Subgroup analysis showed scaffolds derived from spinal cord tissue were significantly more effective (SMD=2.78, p < 0.0001) than those from other sources. Crucially, immediate implantation (within 30 min post-injury) yielded a strong significant effect (SMD=2.54, p < 0.0001), while a 24-hour delay abolished the significant benefit (SMD=0.903, p = 0.38). The effect was sustained over short (≤4 weeks), medium (4-8 weeks), and long-term (8 weeks) follow-ups. The combination of DCS with cell therapy showed a larger overall effect (SMD = 2.00; 95% CI = 1.21-2.79; P < 0.0001) compared with DCS alone.
CONCLUSION: The implantation of DCS is a highly effective intervention for promoting motor recovery after SCI in animal models, especially when derived from spinal cord tissue and implanted immediately after injury.