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SYSTEMATIC REVIEW article

Front. Mol. Neurosci.
Sec. Molecular Signalling and Pathways
Volume 17 - 2024 | doi: 10.3389/fnmol.2024.1448777

Repair of Spinal Cord Injury by Bone Marrow Mesenchymal Stem Cell-Derived Exosomes: A Systematic Review and Meta-Analysis Based on Rat Models

Provisionally accepted
Zhongduo Ye Zhongduo Ye 1Yukun Zheng Yukun Zheng 1Ningning Li Ningning Li 2Huaibin Zhang Huaibin Zhang 1Qiangqiang Li Qiangqiang Li 1Xiong Wang Xiong Wang 1*
  • 1 First Hospital of Lanzhou University, Lanzhou, Gansu Province, China
  • 2 Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi Zhuang Region, China

The final, formatted version of the article will be published soon.

    Objective: This study aims to systematically evaluate the efficacy of bone marrow mesenchymal stem cell-derived exosomes (BMSCs-Exo) in improving spinal cord injury (SCI) to mitigate the risk of translational discrepancies from animal experiments to clinical applications.We conducted a comprehensive literature search up to March 2024 using PubMed, Embase, Web of Science, and Scopus databases. Two researchers independently screened the literature, extracted data, and assessed the quality of the studies. Data analysis was performed using STATA16 software.Results: A total of 30 studies were included. The results indicated that BMSCs-Exo significantly improved the BBB score in SCI rats (WMD=3.47, 95%CI [3.31, 3.63]), inhibited the expression of the pro-inflammatory cytokine TNF-α (SMD=-3.12, 95%CI [-3.57, -2.67]), and promoted the expression of anti-inflammatory cytokines 95%CI [1.88, 3.63])and 95%CI [3.02, 4.76]). Additionally, BMSCs-Exo significantly reduced apoptosis levels (SMD=-4.52, 95%CI [-5.14, -3.89]), promoted the expression of axonal regeneration markers NeuN cells/field (SMD=3.54, 95%CI [2.65, 4.42]), NF200 (SMD=4.88, 95%CI [3.70, 6.05]), and the number of Nissl bodies (SMD=1.89, 95%CI [1.13, 2.65]), and decreased the expression of astrogliosis marker GFAP (SMD=-5.15, 95%CI [-6.47, -3.82]). The heterogeneity among studies was primarily due to variations in BMSCs-Exo transplantation doses, with efficacy increasing with higher doses.BMSCs-Exo significantly improved motor function in SCI rats by modulating inflammatory responses, reducing apoptosis, inhibiting astrogliosis, and promoting axonal regeneration. However, the presence of selection, performance, and detection biases in current 3 animal experiments may undermine the quality of evidence in this study.

    Keywords: spinal cord injury, Bone marrow mesenchymal stem cells, Exosomes, Rats, Systematic review

    Received: 15 Jun 2024; Accepted: 25 Jul 2024.

    Copyright: © 2024 Ye, Zheng, Li, Zhang, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xiong Wang, First Hospital of Lanzhou University, Lanzhou, Gansu Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.