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The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials

Mesenchymal stromal cells (MSC) have shown potential efficacy in both animal and human trials of acute respiratory distress syndrome (ARDS). Especially during the COVID-19 pandemic, MSC was intensely studied for treating COVID-19-induced ARDS. The purpose of this study is to evaluate the safety and...

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Autores principales: Wang, Fengyun, Li, Yiming, Wang, Bingqing, Li, Jianguo, Peng, Zhiyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857915/
https://www.ncbi.nlm.nih.gov/pubmed/36670442
http://dx.doi.org/10.1186/s13054-022-04287-4
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author Wang, Fengyun
Li, Yiming
Wang, Bingqing
Li, Jianguo
Peng, Zhiyong
author_facet Wang, Fengyun
Li, Yiming
Wang, Bingqing
Li, Jianguo
Peng, Zhiyong
author_sort Wang, Fengyun
collection PubMed
description Mesenchymal stromal cells (MSC) have shown potential efficacy in both animal and human trials of acute respiratory distress syndrome (ARDS). Especially during the COVID-19 pandemic, MSC was intensely studied for treating COVID-19-induced ARDS. The purpose of this study is to evaluate the safety and efficacy of MSC in ARDS via a meta-analysis of randomized controlled trials (RCTs). Therefore, a meta-analysis of RCTs of MSC as a therapy for ARDS was conducted. The protocol of this review was registered on Open Science Framework. With no language restriction and according to the “PICOs” principle, searches were conducted on Pubmed and Embase to retrieve any clinical literature on MSC for ARDS. Any RCT, which compared MSC to controls for ARDS, where MSC and controls were intravenously infused, of any dosage, was eligible for inclusion. A total of 13 RCTs, which evaluated MSC versus control for treating ARDS, enrolling a total of 655 cases, met the inclusion criteria and appeared in this meta-analysis. A heterogeneity assessment was carried out using the χ(2) test, where a P value less than 0.05 was considered significant. The choice of a fixed-effect or a random-effect model was decided by the I(2) value in each of the analyses. This meta-analysis indicated that there was no significant difference in terms of adverse events between MSC and control for ARDS (OR = 0.64, 95% CI [0.34, 1.20], P = 0.17, and I(2) = 0%). In comparison with control, MSC could reduce the mortality of ARDS (OR = 0.66, 95% CI [0.46, 0.96], P = 0.03, and I(2) = 10%). Based on the results of our meta-analysis, the safety of MSC was demonstrated to be non-inferior to that of standard treatment, and MSC may reduce the mortality rate of ARDS. Though the heterogeneity in the main results was low (I(2) < 25%), more high-quality and large-scale clinical trials are needed to further confirm our findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-04287-4.
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spelling pubmed-98579152023-01-22 The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials Wang, Fengyun Li, Yiming Wang, Bingqing Li, Jianguo Peng, Zhiyong Crit Care Research Mesenchymal stromal cells (MSC) have shown potential efficacy in both animal and human trials of acute respiratory distress syndrome (ARDS). Especially during the COVID-19 pandemic, MSC was intensely studied for treating COVID-19-induced ARDS. The purpose of this study is to evaluate the safety and efficacy of MSC in ARDS via a meta-analysis of randomized controlled trials (RCTs). Therefore, a meta-analysis of RCTs of MSC as a therapy for ARDS was conducted. The protocol of this review was registered on Open Science Framework. With no language restriction and according to the “PICOs” principle, searches were conducted on Pubmed and Embase to retrieve any clinical literature on MSC for ARDS. Any RCT, which compared MSC to controls for ARDS, where MSC and controls were intravenously infused, of any dosage, was eligible for inclusion. A total of 13 RCTs, which evaluated MSC versus control for treating ARDS, enrolling a total of 655 cases, met the inclusion criteria and appeared in this meta-analysis. A heterogeneity assessment was carried out using the χ(2) test, where a P value less than 0.05 was considered significant. The choice of a fixed-effect or a random-effect model was decided by the I(2) value in each of the analyses. This meta-analysis indicated that there was no significant difference in terms of adverse events between MSC and control for ARDS (OR = 0.64, 95% CI [0.34, 1.20], P = 0.17, and I(2) = 0%). In comparison with control, MSC could reduce the mortality of ARDS (OR = 0.66, 95% CI [0.46, 0.96], P = 0.03, and I(2) = 10%). Based on the results of our meta-analysis, the safety of MSC was demonstrated to be non-inferior to that of standard treatment, and MSC may reduce the mortality rate of ARDS. Though the heterogeneity in the main results was low (I(2) < 25%), more high-quality and large-scale clinical trials are needed to further confirm our findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-04287-4. BioMed Central 2023-01-20 /pmc/articles/PMC9857915/ /pubmed/36670442 http://dx.doi.org/10.1186/s13054-022-04287-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wang, Fengyun
Li, Yiming
Wang, Bingqing
Li, Jianguo
Peng, Zhiyong
The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title_full The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title_fullStr The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title_full_unstemmed The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title_short The safety and efficacy of mesenchymal stromal cells in ARDS: a meta-analysis of randomized controlled trials
title_sort safety and efficacy of mesenchymal stromal cells in ards: a meta-analysis of randomized controlled trials
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857915/
https://www.ncbi.nlm.nih.gov/pubmed/36670442
http://dx.doi.org/10.1186/s13054-022-04287-4
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