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Войти в исследования Equine veterinary journal · 2026
Antimicrobial effects of equine regenerative medicine products: A systematic review and meta-analysis of in vitro and in vivo studies.
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Chen Shuyao, Jia Yuchen, Yang Luo, Xie Yuxin, Zhu Yiping, Li Jing
Аннотация
BACKGROUND: Equine regenerative medicine products involving platelet-rich plasma (PRP), mesenchymal stromal cells (MSCs), and their derivatives are increasingly explored for antimicrobial and therapeutic roles, but their efficacy and between-study variability remain unclear.
OBJECTIVES: To systematically review and meta-analyse in vitro and in vivo evidence on antimicrobial effects of equine regenerative medicine products and to evaluate their efficacy against key pathogens.
STUDY DESIGN: Systematic review and meta-analysis: METHODS: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and searched studies (2010-2025) reporting PRP/MSC antimicrobial interventions in equine models. In vitro studies reporting colony-forming unit (CFU) outcomes were meta-analysed. Continuous outcomes were pooled as standardised mean differences (SMD; the mean difference divided by the pooled standard deviation with 95% confidence intervals [CI]), using a random-effects model. Heterogeneity was assessed by I2 and significance as p < 0.05. Predefined subgroup analyses by product class and pathogen were performed. Risk of bias was assessed with a predefined checklist. In vivo outcomes were synthesised narratively.
RESULTS: Twenty-four studies met inclusion criteria; 13/17 in vitro studies contributed CFU data for meta-analysis. Platelet-derived products showed a pooled SMD of 0.94 (95% CI 0.33-1.54; p = 0.003; I2 = 27%) against Staphylococcus aureus. Against Escherichia coli, regenerative products showed a non-significant effect (SMD 1.07; 95% CI 0.01-2.13; p = 0.05; I2 = 65%). MSC-based products produced a non-significant SMD of 0.55 (95% CI -0.46-1.55; p = 0.29; I2 = 38%) versus S. aureus. Seven in vivo studies reported clinical improvements, and combination therapies with antibiotics often enhanced bacterial clearance.
MAIN LIMITATIONS: Interpretation is limited by substantial methodological heterogeneity across studies and by potential risk of bias.
CONCLUSION: Platelet-derived regenerative products demonstrate in vitro antimicrobial activity against a representative Gram-positive bacterium, S. aureus; however, current heterogeneous and limited in vivo evidence provides only tentative support for their use as adjuncts, rather than standalone antimicrobial therapies. Well-designed, standardised in vitro and in vivo studies are needed.
OBJECTIVES: To systematically review and meta-analyse in vitro and in vivo evidence on antimicrobial effects of equine regenerative medicine products and to evaluate their efficacy against key pathogens.
STUDY DESIGN: Systematic review and meta-analysis: METHODS: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and searched studies (2010-2025) reporting PRP/MSC antimicrobial interventions in equine models. In vitro studies reporting colony-forming unit (CFU) outcomes were meta-analysed. Continuous outcomes were pooled as standardised mean differences (SMD; the mean difference divided by the pooled standard deviation with 95% confidence intervals [CI]), using a random-effects model. Heterogeneity was assessed by I2 and significance as p < 0.05. Predefined subgroup analyses by product class and pathogen were performed. Risk of bias was assessed with a predefined checklist. In vivo outcomes were synthesised narratively.
RESULTS: Twenty-four studies met inclusion criteria; 13/17 in vitro studies contributed CFU data for meta-analysis. Platelet-derived products showed a pooled SMD of 0.94 (95% CI 0.33-1.54; p = 0.003; I2 = 27%) against Staphylococcus aureus. Against Escherichia coli, regenerative products showed a non-significant effect (SMD 1.07; 95% CI 0.01-2.13; p = 0.05; I2 = 65%). MSC-based products produced a non-significant SMD of 0.55 (95% CI -0.46-1.55; p = 0.29; I2 = 38%) versus S. aureus. Seven in vivo studies reported clinical improvements, and combination therapies with antibiotics often enhanced bacterial clearance.
MAIN LIMITATIONS: Interpretation is limited by substantial methodological heterogeneity across studies and by potential risk of bias.
CONCLUSION: Platelet-derived regenerative products demonstrate in vitro antimicrobial activity against a representative Gram-positive bacterium, S. aureus; however, current heterogeneous and limited in vivo evidence provides only tentative support for their use as adjuncts, rather than standalone antimicrobial therapies. Well-designed, standardised in vitro and in vivo studies are needed.