Human mesenchymal stem cells for the management of systemic sclerosis. Systematic review
| Autor: | Mario García-Carrasco, Carlos-Hugo Escobar-Soto, Juan Pablo Alzate-Granados, Rossana Mejia-Romero, Claudia Mendoza-Pinto, Socorro Méndez-Martínez, Pamela Munguía-Realpozo, Natalia Aguilera, Adriana Rojas-Villarraga |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Adolescent Immunology MEDLINE Scleroderma Autoimmune Diseases 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Epidemiology Skin Ulcer medicine Immunology and Allergy Animals Humans Aged 030203 arthritis & rheumatology Gangrene Scleroderma Systemic business.industry Mesenchymal stem cell Mesenchymal Stem Cells Guideline Evidence-based medicine Middle Aged medicine.disease 030104 developmental biology Systematic review Female business |
| Zdroj: | Autoimmunity reviews. 20(6) |
| ISSN: | 1873-0183 |
| Popis: | Introduction Sistemic Sclerosis (SSc) is a heterogeneous autoimmune disease with a high rate of progression and therapeutic failure, and treatment is a challenge, new therapeutic proposals being needed, being mesenchymal stem cells (MSCs) considered as alternative therapy for SSc for its immunomodulatory capacity. We evaluated the efficacy and safety of human MSC (hMSC) in patients with SSc through a systematic literature review (SLR). Methods SLR (PRISMA guideline) on MEDLINE/OVID, LILACS, EMBASE, and Cochrane/OVID bases (until July 2020, without limits). All types of clinical studies were considered: patients ≥18 years old with SSc and treatment with hMSC. Exclusion criteria: animal models, autologous/allogenic hematopoietic stem cell transplants, narrative reviews, letters to the editor. MeSH and “Key word” terms were used. The level of evidence and the quality rating were rated [Joanna Briggs Institute (JBI) lists]. Registration in PROSPERO repository (ID CRD42020185245) The Synthesis Without Meta-analysis (SWiM) guideline was followed. Results We initially identified 508 articles, of which 11 were finally included (8 case series and 3 case reports). The 11 articles included 101 patients (85 female, age range 18–75 years). The level of evidence was mostly 4 (JBI); the quality of evidence was met (≥50% of JBI items). SWiM showed that vascular skin involvement (digital ulcers, necrosis, and gangrene) and associated pain were the predominant outcomes, while improvements were found in almost all cases. One patient died in the first month, and the frequency of complications was low. Expanded hMSCs were used in 24 patients and other cell sources in the remaining patients. Conclusion There is too little reported data to reach definite conclusions about the use of hMSC in SSc. Further studies with better epidemiological designs are needed to evaluate the benefit of hMSCs in SSc patients. |
| Databáze: | OpenAIRE |
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