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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neurotrauma
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1447414

Stem cell-derived exosome treatment for acute spinal cord injury: a systematic review and meta-analysis based on preclinical evidence

Provisionally accepted
Chunlin Mou Chunlin Mou 1*Ziyao Xia Ziyao Xia 2Xiujuan Wang Xiujuan Wang 1*Xunan Dai Xunan Dai 2*Jiaxian Wang Jiaxian Wang 3*Chun Zhang Chun Zhang 2*Yongsheng Xu Yongsheng Xu 1*
  • 1 Tianjin Everunion Biotechnology Co., Ltd., Beijing, China
  • 2 Peking University Third Hospital, Beijing, China
  • 3 Other, Nanjing, China

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

    Background: The study aims were to systematically review and analyze preclinical research on the efficacy of exosomes derived from various mesenchymal stem cell sources (MSC-exos) for the treatment of spinal cord contusion injury (SCI) in small animal models. Methods: We conducted a systematic search of PubMed, Embase and Google Scholar databases from their inception through February 29, 2024, to identify eligible English-language studies based on predefined inclusion and exclusion criteria. Two independent investigators performed literature screening, data extraction and bias assessment. Results: A total of 235 rats were used to assess locomotor recovery at the initial assessment, and exhibited significant improvement in hind limb movement in those treated with exosomes, as indicated by a statistically significant increase in Basso-Beattie-Bresnahan (BBB) scores (MD: 1.26, 95% CI: 1.14–1.38, P < 0.01) compared to the controls. This trend persisted in final assessment data across 21 studies, with pooled analysis confirming similar results (MD: 1.56, 95% CI: 1.43–1.68, P < 0.01). Funnel plot analysis indicated asymmetry in the pooled BBB scores at both baseline and endpoint assessments, suggesting potential publication bias. Exosomes were derived from bone marrow, adipose tissue, umbilical cord or human placental MSCs. Meta-analysis results showed no statistically significant differences in therapeutic efficacy among these MSC-exos sources at various treatment time points. Conclusions: MSC-exos demonstrated considerable promise in improving motor function in SCI-affected rats, with bone marrow MSC-derived exosomes having particularly notable effectiveness.

    Keywords: Mesenchymal stem cells,, Exosomes,, spinal cord injury, , Locomotor function,, Basso-Beattie-Bresnahan scores,, Meta-analysis,, Spinal contusion,, Spinal fixation

    Received: 13 Jun 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Mou, Xia, Wang, Dai, Wang, Zhang and Xu. 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:
    Chunlin Mou, Tianjin Everunion Biotechnology Co., Ltd., Beijing, China
    Xiujuan Wang, Tianjin Everunion Biotechnology Co., Ltd., Beijing, China
    Xunan Dai, Peking University Third Hospital, Beijing, China
    Jiaxian Wang, Other, Nanjing, China
    Chun Zhang, Peking University Third Hospital, Beijing, China
    Yongsheng Xu, Tianjin Everunion Biotechnology Co., Ltd., Beijing, 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.