Brain research bulletin · 2025
Stem cell derived extracellular vesicles therapy for perinatal brain injury: A systematic review & meta-analysis of preclinical studies and a potential path to clinic.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Guo Xiaolin, Peng Tingting, Zhong Mengru, Cai Simian, He Lu, Xu Kaishou
Аннотация
BACKGROUND: Perinatal brain injury (PBI) is a significant cause of neonatal death and childhood disability. Current treatments for PBI are limited and ineffective. Stem cell derived extracellular vesicles (SC-EVs) have shown promising therapeutic potential in addressing PBI. We aimed to assess the effectiveness and potential mechanisms of SC-EVs therapy on behavioral and pathological outcomes in animal models of PBI.
METHODS: We searched six databases (MEDLINE, Embase, Scopus, PubMed, ProQuest, and Web of Science) for articles on the therapeutic effects of SC-EVs in animal models of PBI. We extracted neurobehavioral and pathological results related to brain injury and used a random-effects model to calculate the standardized mean difference and confidence interval.
RESULTS: Twenty-five articles met the inclusion criteria. Treatment with SC-EVs improved cerebral infarct size and tissue edema, as well as the recovery of cognition and motor function. The mechanism of action may be related to the inhibition of apoptosis, microglia activation, astrogliosis, and pro-inflammatory factor release, further promoting neuronal protection, remyelination, and angiogenesis. Study quality assessment found no studies to be at high risk, and there was significant heterogeneity among studies. Sensitivity analysis and subgroup analysis did not identify the source of heterogeneity.
CONCLUSION: SC-EVs might improve cognitive and motor functions, as well as brain microstructure, by exerting anti-apoptotic and anti-neuroinflammatory effects. This provides a theoretical basis for using cell-free therapies to prevent and treat PBI and supports the translation of SC-EVs from preclinical models to human applications.
METHODS: We searched six databases (MEDLINE, Embase, Scopus, PubMed, ProQuest, and Web of Science) for articles on the therapeutic effects of SC-EVs in animal models of PBI. We extracted neurobehavioral and pathological results related to brain injury and used a random-effects model to calculate the standardized mean difference and confidence interval.
RESULTS: Twenty-five articles met the inclusion criteria. Treatment with SC-EVs improved cerebral infarct size and tissue edema, as well as the recovery of cognition and motor function. The mechanism of action may be related to the inhibition of apoptosis, microglia activation, astrogliosis, and pro-inflammatory factor release, further promoting neuronal protection, remyelination, and angiogenesis. Study quality assessment found no studies to be at high risk, and there was significant heterogeneity among studies. Sensitivity analysis and subgroup analysis did not identify the source of heterogeneity.
CONCLUSION: SC-EVs might improve cognitive and motor functions, as well as brain microstructure, by exerting anti-apoptotic and anti-neuroinflammatory effects. This provides a theoretical basis for using cell-free therapies to prevent and treat PBI and supports the translation of SC-EVs from preclinical models to human applications.