间充质干细胞来源外泌体治疗动物急性肝衰竭的Meta分析  

Exosomes derived from mesenchymal stem cells in treatment of animals with acute liver failure:a meta-analysis

作　　者：马树微 何生[2] 韩冰 张缭云[1] Ma Shuwei;He Sheng;Han Bing;Zhang Liaoyun(Department of Infectious Diseases,First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Department of Imaging,First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;School of Public Health,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第一医院,感染病科,山西省太原市030001 [2]山西医科大学第一医院,影像科,山西省太原市030001 [3]山西医科大学公共卫生学院,山西省太原市030001

出　　处：《中国组织工程研究》2024年第7期1137-1142,共6页Chinese Journal of Tissue Engineering Research

基　　金：山西省科技厅项目(201903D421064),项目负责人:张缭云。

摘　　要：目的:评价间充质干细胞来源外泌体治疗急性肝衰竭动物模型的效果。方法:检索PubMed、Web of Science、Embase、The Cochrane Library、CBM、CNKI、万方、维普数据库,收集各数据库建库至2023-01-16期间有关间充质干细胞外泌体治疗急性肝衰竭的动物实验。由2名研究人员独立筛选文献并提取数据,应用SYRCLE工具评估偏倚风险。提取的数据由Revman 5.4.1软件和Stata 17.0软件进行分析。结果:共检索出241篇相关文献,筛选9篇动物实验纳入分析,共219只动物:模型组110只,外泌体组109只。研究结果显示外泌体组动物生存率较模型组显著提高[RR=9.34,95%CI(3.91,22.29),P<0.001],血清丙氨酸氨基转移酶水平[SMD=-5.31,95%CI(-7.43,-3.19),P<0.001]及天门冬氨酸氨基转移酶水平[SMD=-4.47,95%CI(-5.85,-3.10),P<0.001]明显降低,白细胞介素1β[SMD=-11.54,95%CI(-18.12,-4.95),P=0.0006]、白细胞介素6[SMD=-5.75,95%CI(-8.08,-3.41),P<0.001]、肿瘤坏死因子α[SMD=-4.46,95%CI(-6.83,-2.09),P=0.0002]等促炎因子的表达水平明显降低。结论:间充质干细胞外泌体有助于抑制炎症反应,改善急性肝衰竭动物的肝功能,并提高其生存率。亚组分析结果提示,动物生存时间较短(≤24 h)、外泌体移植剂量较小(<1 mg/kg)及外泌体来源(脂肪间充质干细胞)可能会影响间充质干细胞外泌体治疗急性肝衰竭动物模型的疗效。该结论及临床转化仍需大样本量、高质量的随机对照研究予以证实。OBJECTIVE:To evaluate the efficacy of exosomes derived from mesenchymal stem cells on animal models of acute liver failure.METHODS:PubMed,Web of Science,Embase,The Cochrane Library,CBM,CNKI,WanFang,and VIP databases were retrieved from inception to January 16,2023.A series of animal experiments on the treatment of acute liver failure animal models by exosomes derived from mesenchymal stem cells were collected.Two evaluators screened the literature and extracted the data independently.The bias risk was evaluated by the SYRCLE tool.The extracted data were analyzed by Revmen 5.4.1 software and Stata 17.0 software.RESULTS:A total of 241 articles were retrieved and 9 animal experiments were included,with 219 animals:110 animals in the model group and 109 animals in the exosome group.The results showed that the survival rate of animals in the exosome group improved significantly[RR=9.34,95%CI(3.91,22.29),P<0.001],the levels of serum alanine transaminase[SMD=-5.31,95%CI(-7.43,-3.19),P<0.001]and aspartate aminotransferase[SMD=-4.47,95%CI(-5.85,-3.10),P<0.001]were reduced obviously.The expressions of interleukin-1β[SMD=-11.54,95%CI(-18.12,-4.95),P=0.0006],interleukin-6[SMD=-5.75,95%CI(-8.08,-3.41),P<0.001]and tumor necrosis factor-α[SMD=-4.46,95%CI(-6.83,-2.09),P=0.0002],were suppressed obviously.CONCLUSION:Exosomes derived from mesenchymal stem cells effectively inhibit the inflammatory response,ameliorate liver function of animals with acute liver failure,and improve their survival rate.The results of subgroup analysis showed that the shorter survival time of animals(≤24 hours),the lower dose of transplanted exosomes(<1 mg/kg)and the source of exosomes(adipose-derived mesenchymal stem cells)may affect the efficacy of the exosomes derived from mesenchymal stem cells in the animal model of acute liver failure.This conclusion and its clinical transformation still need to be confirmed by randomized controlled studies with large sample sizes and high quality.

关 键 词：间充质干细胞 外泌体 急性肝衰竭 动物 生存率 肝功能 系统评价 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R575.3