Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LUTeng ¹ , LIUChao ² , DONGJun ¹ , LUMeng ¹ , KANGJian ¹ ,  HEXi-jing ¹

1. Department of Orthopaedic, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;
2. Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;

Corresponding author：

HEXi-jing, Email: xijing_h@vip.tom.com

Keywords：

Spinal-cord injury; Schwann cells; Transplantation; Basso, Beattie and Bresnahan scale; Rats; Meta-analysis

DOI：

10.7507/1672-2531.20150117

Video：

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Objective To systemically review the efficacy and safety of Schwann cells (SCs) or activated Schwann cells (ASCs) transplantation in the treatment of traumatic spinal-cord injury (TSCI) in rats models. Methods Randomized controlled trials (RCTs) about the effects of SCs and ASCs transplantation for TSCI in rats were searched in PubMed, EMbase, The Cochrane Library (Issue 12, 2014), CBM, CNKI, WanFang Data and VIP from inception to December 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results A total of 14 RCTs involving 510 rats were included. The results of meta-analysis showed that:compared with the control group, the Basso, Beattie and Bresnahan (BBB) scores in the SCs or ASCs transplantation group were superior in 4 weeks (SMD=2.31, 95%CI 1.48 to 3.13, P<0.000 01), 8 weeks (SMD=3.93, 95%CI 3.06 to 4.81, P<0.000 01) and 12 weeks (SMD=6.15, 95%CI 4.30 to 8.00, P<0.000 01) after surgery. The BBB scores in the SCs or ASCs transplantation combined with other therapies group were also better in 4 weeks (SMD=1.06, 95%CI 0.44 to 1.68, P=0.000 8), 8 weeks (SMD=2.26, 95%CI 1.57 to 2.96, P<0.000 01) and 12 weeks (SMD=1.49, 95%CI 0.72 to 2.25, P<0.000 01) after surgery. Compared with the SCs group, the BBB score in the ASCs transplantation group were superior in 4 weeks (SMD=4.31, 95%CI 3.50 to 5.13, P<0.000 01) and 12 weeks (SMD=5.44, 95%CI 3.99 to 6.89, P<0.000 01) after surgery. No significant difference was found in mortality between the transplantation group and the control group. Conclusion Current evidence indicates that SCs and ASCs can promote the recovery of motor function in the rats with TSCI. More functional recoveries can be obtained in ASCs transplantation compared with SCs transplantation. Due to limited quality of the included studies, the above conclusion should be verified by conducting more large-scale, high quality RCTs.

Citation： LUTeng, LIUChao, DONGJun, LUMeng, KANGJian, HEXi-jing. Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(6): 705-712. doi: 10.7507/1672-2531.20150117 Copy

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2.	李建军,周红俊,洪毅,等.2002年北京市脊髓损伤发病率调查.中国康复理论与实践,2004,10(7):412-413.
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6.	劳杰,蒋良福,顾玉东.激活态雪旺细胞生长相关蛋白43 mRNA表达的研究.中华骨科杂志,2005,25(6):372-374.
7.	Basso DM,Beattie MS,Bresnahan JC.A sensitive and reliable locomotor rating scale for open field testing in rats.J Neurotrauma,1995,12(1):1-21.
8.	陈匡阳,马彬,王亚楠,等.SYRCLE动物实验偏倚风险评估工具简介.中国循证医学杂志,2014,14(10):1281-1285.
9.	牛军强,王亚楠,朱芊各,等.动物实验方法学和报告质量评估工具的横断面研究.中国循证医学杂志,2015,15(2):223-229.
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11.	Chen G,Hu YR,Wan H,et al.Functional recovery following traumatic spinal cord injury mediated by a unique polymer scaffold seeded with neural stem cells and Schwann cells.Chinese Medical Journal,2010,123(17):2424-2431.
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13.	Pourheydar B,Joghataei MT,Bakhtiari M,et al.Co-transplantation of bone marrow stromal cells with schwann cells evokes mechanical allodynia in the contusion model of spinal cord injury in rats.Cell Journal,2012,13(4):213-222.
14.	曹富江.自体激活雪旺细胞联合脐带间充质干细胞修复脊髓损伤的实验研究:天津医科大学,2008.
15.	冯世庆,周先虎,孔晓红,等.自体激活雪旺细胞移植治疗急性脊髓损伤的实验研究.中华骨科杂志,2006,26(8):553-557.
16.	郭涛.CD34~+细胞联合雪旺细胞移植对脊髓全横断大鼠后肢功能及移植细胞分化的研究:昆明医学院,2009.
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18.	李辉.C3转移酶联合雪旺细胞修复脊髓损伤的实验研究:天津医科大学,2010.
19.	李伟,冯世庆,李健辉,等.硫酸镁联合自体激活雪旺细胞移植治疗脊髓损伤.天津医药,2009,18(6):485-488.
20.	宁广智,冯世庆,班德翔,等.人脐血单个核细胞联合雪旺细胞修复脊髓损伤的实验研究.中华骨科杂志,2009,29(11):1057-1062.
21.	王春源,冯世庆,刘洋,等.蛛网膜下腔移植自体激活许旺细胞治疗大鼠脊髓损伤.中国组织工程研究与临床康复,2010,14(14):2533-2538.
22.	徐云强,冯世庆,王沛,等.软骨素酶联合雪旺细胞移植促进脊髓损伤修复的研究.中华实验外科杂志,2010,20(7):972-975.
23.	朱玉海,冯世庆,孔晓红,等.人脐带间充质干细胞与自体激活雪旺细胞联合移植修复脊髓损伤的实验研究.中华创伤骨科杂志,2009,11(8):747-751.
24.	Shi R,Pryor JD.Pathological changes of isolated spinal cord axons in response to mechanical stretch.Neuroscience,2002,110(4):765-777.
25.	Xu P,Gong WM,Li Y,et al.Destructive pathological changes in the rat spinal cord due to chronic mechanical compression.Laboratory investigation.J Neurosurg Spine,2008,8(3):279-285.
26.	Feng SQ,Zhou XF,Rush RA,et al.Graft of pre-injured sural nerve promotes regeneration of corticospinal tract and functional recovery in rats with chronic spinal cord injury.Brain Res,2008,1209:40-48.

1. Center NSCIS.Spinal cord injury facts and figures at a glance.J Spinal Cord Med,2013,36(6):715-716.
2. 李建军,周红俊,洪毅,等.2002年北京市脊髓损伤发病率调查.中国康复理论与实践,2004,10(7):412-413.
3. Liu WL,Lee YH,Tsai SY,et al.Methylprednisolone inhibits the expression of glial fibrillary acidic protein and chondroitin sulfate proteoglycans in reactivated astrocytes.Glia,2008,56(13):1390-1400.
4. Short DJ,El Masry WS,Jones PW.High dose methylprednisolone in the management of acute spinal cord injury-a systematic review from a clinical perspective.Spinal Cord,2000,38(5):273-286.
5. Lee HJ,Shin YK,Park HT.Mitogen Activated Protein Kinase Family Proteins and c-jun Signaling in Injury-induced Schwann Cell Plasticity.Exp Neurobiol,2014,23(2):130-137.
6. 劳杰,蒋良福,顾玉东.激活态雪旺细胞生长相关蛋白43 mRNA表达的研究.中华骨科杂志,2005,25(6):372-374.
7. Basso DM,Beattie MS,Bresnahan JC.A sensitive and reliable locomotor rating scale for open field testing in rats.J Neurotrauma,1995,12(1):1-21.
8. 陈匡阳,马彬,王亚楠,等.SYRCLE动物实验偏倚风险评估工具简介.中国循证医学杂志,2014,14(10):1281-1285.
9. 牛军强,王亚楠,朱芊各,等.动物实验方法学和报告质量评估工具的横断面研究.中国循证医学杂志,2015,15(2):223-229.
10. Ban DX,Ning GZ,Feng SQ,et al.Combination of activated Schwann cells with bone mesenchymal stem cells:The best cell strategy for repair after spinal cord injury in rats.Regenerative Medicine,2011,6(6):707-720.
11. Chen G,Hu YR,Wan H,et al.Functional recovery following traumatic spinal cord injury mediated by a unique polymer scaffold seeded with neural stem cells and Schwann cells.Chinese Medical Journal,2010,123(17):2424-2431.
12. Hui L,Feng SQ,Chen JT,et al.Repair of spinal cord injury using Schwann cells in rats:Feasibility and superiority of intravenous transplantation.Journal of Clinical Rehabilitative Tissue Engineering Research,2010,14(18):3305-3309.
13. Pourheydar B,Joghataei MT,Bakhtiari M,et al.Co-transplantation of bone marrow stromal cells with schwann cells evokes mechanical allodynia in the contusion model of spinal cord injury in rats.Cell Journal,2012,13(4):213-222.
14. 曹富江.自体激活雪旺细胞联合脐带间充质干细胞修复脊髓损伤的实验研究:天津医科大学,2008.
15. 冯世庆,周先虎,孔晓红,等.自体激活雪旺细胞移植治疗急性脊髓损伤的实验研究.中华骨科杂志,2006,26(8):553-557.
16. 郭涛.CD34~+细胞联合雪旺细胞移植对脊髓全横断大鼠后肢功能及移植细胞分化的研究:昆明医学院,2009.
17. 纪江峰.氯化锂联合自体激活雪旺细胞治疗脊髓损伤的研究:天津医科大学,2007.
18. 李辉.C3转移酶联合雪旺细胞修复脊髓损伤的实验研究:天津医科大学,2010.
19. 李伟,冯世庆,李健辉,等.硫酸镁联合自体激活雪旺细胞移植治疗脊髓损伤.天津医药,2009,18(6):485-488.
20. 宁广智,冯世庆,班德翔,等.人脐血单个核细胞联合雪旺细胞修复脊髓损伤的实验研究.中华骨科杂志,2009,29(11):1057-1062.
21. 王春源,冯世庆,刘洋,等.蛛网膜下腔移植自体激活许旺细胞治疗大鼠脊髓损伤.中国组织工程研究与临床康复,2010,14(14):2533-2538.
22. 徐云强,冯世庆,王沛,等.软骨素酶联合雪旺细胞移植促进脊髓损伤修复的研究.中华实验外科杂志,2010,20(7):972-975.
23. 朱玉海,冯世庆,孔晓红,等.人脐带间充质干细胞与自体激活雪旺细胞联合移植修复脊髓损伤的实验研究.中华创伤骨科杂志,2009,11(8):747-751.
24. Shi R,Pryor JD.Pathological changes of isolated spinal cord axons in response to mechanical stretch.Neuroscience,2002,110(4):765-777.
25. Xu P,Gong WM,Li Y,et al.Destructive pathological changes in the rat spinal cord due to chronic mechanical compression.Laboratory investigation.J Neurosurg Spine,2008,8(3):279-285.
26. Feng SQ,Zhou XF,Rush RA,et al.Graft of pre-injured sural nerve promotes regeneration of corticospinal tract and functional recovery in rats with chronic spinal cord injury.Brain Res,2008,1209:40-48.

Chinese Journal of Evidence-Based Medicine

Effect of Schwann Cells Transplantation in the Treatment of Traumatic Spinal-cord Injury in Rats: A Meta-Analysis

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