Cargando…

The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies

Background: In recent years pre-clinical stroke research has shown increased interest in the development of biomaterial-based therapies to promote tissue repair and functional recovery. Such strategies utilize biomaterials as structural support for tissue regeneration or as delivery vehicles for the...

Descripción completa

Detalles Bibliográficos
Autores principales: Bolan, Faye, Louca, Irene, Heal, Calvin, Cunningham, Catriona J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718570/
https://www.ncbi.nlm.nih.gov/pubmed/31507524
http://dx.doi.org/10.3389/fneur.2019.00924
_version_ 1783447747234365440
author Bolan, Faye
Louca, Irene
Heal, Calvin
Cunningham, Catriona J.
author_facet Bolan, Faye
Louca, Irene
Heal, Calvin
Cunningham, Catriona J.
author_sort Bolan, Faye
collection PubMed
description Background: In recent years pre-clinical stroke research has shown increased interest in the development of biomaterial-based therapies to promote tissue repair and functional recovery. Such strategies utilize biomaterials as structural support for tissue regeneration or as delivery vehicles for therapeutic agents. While a range of biomaterials have been tested in stroke models, currently no overview is available for evaluating the benefit of these approaches. We therefore performed a systematic review and meta-analysis of studies investigating the use of biomaterials for the treatment of stroke in experimental animal models. Methods: Studies were identified by searching electronic databases (PubMed, Web of Science) and reference lists of relevant review articles. Studies reporting lesion volume and/or neurological score were included. Standardized mean difference (SMD) and 95% confidence intervals were calculated using DerSimonian and Laird random effects. Study quality and risk of bias was assessed using the CAMARADES checklist. Publication bias was visualized by funnel plots followed by trim and fill analysis of missing publications. Results: A total of 66 publications were included in the systematic review, of which 44 (86 comparisons) were assessed in the meta-analysis. Overall, biomaterial-based interventions improved both lesion volume (SMD: −2.98, 95% CI: −3.48, −2.48) and neurological score (SMD: −2.3, 95% CI: −2.85, −1.76). The median score on the CAMARADES checklist was 5.5/10 (IQR 4.25-6). Funnel plots of lesion volume and neurological score data revealed pronounced asymmetry and publication bias. Additionally, trim and fill analysis estimated 19 “missing” studies for the lesion volume outcome adjusting the effect size to −1.91 (95% CI: −2.44, −1.38). Conclusions: Biomaterials including scaffolds and particles exerted a positive effect on histological and neurological outcomes in pre-clinical stroke models. However, heterogeneity in the field, publication bias and study quality scores which may be another source of bias call for standardization of outcome measures and improved study reporting.
format Online
Article
Text
id pubmed-6718570
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-67185702019-09-10 The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies Bolan, Faye Louca, Irene Heal, Calvin Cunningham, Catriona J. Front Neurol Neurology Background: In recent years pre-clinical stroke research has shown increased interest in the development of biomaterial-based therapies to promote tissue repair and functional recovery. Such strategies utilize biomaterials as structural support for tissue regeneration or as delivery vehicles for therapeutic agents. While a range of biomaterials have been tested in stroke models, currently no overview is available for evaluating the benefit of these approaches. We therefore performed a systematic review and meta-analysis of studies investigating the use of biomaterials for the treatment of stroke in experimental animal models. Methods: Studies were identified by searching electronic databases (PubMed, Web of Science) and reference lists of relevant review articles. Studies reporting lesion volume and/or neurological score were included. Standardized mean difference (SMD) and 95% confidence intervals were calculated using DerSimonian and Laird random effects. Study quality and risk of bias was assessed using the CAMARADES checklist. Publication bias was visualized by funnel plots followed by trim and fill analysis of missing publications. Results: A total of 66 publications were included in the systematic review, of which 44 (86 comparisons) were assessed in the meta-analysis. Overall, biomaterial-based interventions improved both lesion volume (SMD: −2.98, 95% CI: −3.48, −2.48) and neurological score (SMD: −2.3, 95% CI: −2.85, −1.76). The median score on the CAMARADES checklist was 5.5/10 (IQR 4.25-6). Funnel plots of lesion volume and neurological score data revealed pronounced asymmetry and publication bias. Additionally, trim and fill analysis estimated 19 “missing” studies for the lesion volume outcome adjusting the effect size to −1.91 (95% CI: −2.44, −1.38). Conclusions: Biomaterials including scaffolds and particles exerted a positive effect on histological and neurological outcomes in pre-clinical stroke models. However, heterogeneity in the field, publication bias and study quality scores which may be another source of bias call for standardization of outcome measures and improved study reporting. Frontiers Media S.A. 2019-08-27 /pmc/articles/PMC6718570/ /pubmed/31507524 http://dx.doi.org/10.3389/fneur.2019.00924 Text en Copyright © 2019 Bolan, Louca, Heal and Cunningham. http://creativecommons.org/licenses/by/4.0/ 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) and the copyright owner(s) 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.
spellingShingle Neurology
Bolan, Faye
Louca, Irene
Heal, Calvin
Cunningham, Catriona J.
The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title_full The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title_fullStr The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title_full_unstemmed The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title_short The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies
title_sort potential of biomaterial-based approaches as therapies for ischemic stroke: a systematic review and meta-analysis of pre-clinical studies
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718570/
https://www.ncbi.nlm.nih.gov/pubmed/31507524
http://dx.doi.org/10.3389/fneur.2019.00924
work_keys_str_mv AT bolanfaye thepotentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT loucairene thepotentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT healcalvin thepotentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT cunninghamcatrionaj thepotentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT bolanfaye potentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT loucairene potentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT healcalvin potentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies
AT cunninghamcatrionaj potentialofbiomaterialbasedapproachesastherapiesforischemicstrokeasystematicreviewandmetaanalysisofpreclinicalstudies