Objective: Although stem cell therapy for renal ischemia-reperfusion injury (RIRI) has made immense progress in animal studies, conflicting results have been reported by the investigators. Therefore, we aimed to systematically evaluate the effects of different stem cells on renal function of animals with ischemia-reperfusion injury and to compare the efficacies of stem cells from various sources. Methods: PubMed, Web of Science, Embase, Cochrane, CNKI, VIP, CBM, and WanFang Data were searched for records until April 2021. Two researchers independently conducted literature screening, data extraction, and literature quality evaluation. Results and conclusion: Seventy-two animal studies were included for data analysis. Different stem cells significantly reduced serum creatinine and blood urea nitrogen levels in the early and middle stages (1 and 7 days) compared to the negative control group, however there was no significant difference in the late stage among all groups (14 days); In the early stage (1 day), the renal histopathological score in the stem cell group was significantly lower than that in the negative control group, and there was no significant difference among these stem cells. In addition, there was no significant difference between stem cell and negative control in proliferation of resident cells, however, significantly less apoptosis of resident cells than negative control. In conclusion, the results showed that stem cells from diverse sources could improve the renal function of RIRI animals. ADMSCs and MDMSCs were the most-researched stem cells, and they possibly hold the highest therapeutic potential. However, the quality of evidence included in this study is low, and there are many risks of bias. The exact efficacy of the stem cells and the requirement for further clinical studies remain unclear.

/pdf/therapeutic-effects-of-stem-cells-from-different-source-on-2thkeui6uc.pdf

Therapeutic Effects of Stem Cells From Different Source on Renal Ischemia- Reperfusion Injury: A Systematic Review and Network Meta-analysis of Animal Studies.

目的 探讨外源性骨髓间充质干细胞(MSCs)移植对缺血再灌注肾损伤的可能保护作用.方法取SD雄性大鼠骨髓,梯度离心法分离MSCs,采用4,6-联脒-2-苯基吲哚(DAPI)标记.32只雌性SD大鼠建立缺血再灌注肾损伤模型后随机分为移植组和对照组,移植组于缺血45 min后经下腔静脉注入用DAPI标记的MSCs,对照组注入等量生理盐水.术后每天经腹腔注射5-溴脱氧尿苷嘧啶(BrdU),并分别于术后1、2、3、4 d处死大鼠,留取血标本,观察血清肌酐(Cr)和尿素氮(BUN)水平.留取肾组织,荧光显微镜及免疫组化染色方法观察移植MSCs在肾组织中的分布及肾细胞增殖状况,并采用蓖麻血凝素(RCA)对迁移入肾脏的MSCs分化状况进行鉴定.结果术后第1、2天,移植组大鼠血清BUN水平(31.93±1.49、19.58±1.58 mmol/L)明显低于对照组(41.03±2.14、26.45±1.74 mmol/L,P＜0.05);第3、4天2组间BUN水平差异无统计学意义(P＞0.05);第1、2、3天移植组大鼠血清Cr水平(77.47±4.77、57.45±2.41、44.93±3.97μmol/L)均显著低于对照组(102.37±3.59、67.50±2.92、53.25±2.73μmoL/L),差异有统计学意义(P＜0.05).细胞增殖状况:术后第1天偶见BrdU阳性细胞,第2天2组大鼠肾组织中均可见较多BrdU阳性细胞,并随时间延长阳性细胞逐渐增多,且移植组阳性细胞数(33.71±8.50、57.60±4.88、116.29±6.99)明显多于对照组(19.67±5.20、26.88±5.89、71.71±8.44),差异有统计学意义(P＜0.05).移植组术后第3天肾组织内可见DAPI标记细胞,第4天DAPI标记细胞明显增多,且多数标记细胞能结合RCA.结论移植的外源性骨髓MSCs能够迁移、定居于缺血再灌注损伤后的肾组织中并分化为肾小管上皮细胞;MSCs移植可促进损伤肾组织的细胞再生,对缺血再灌注肾损伤具有一定的保护作用。

Protective effects of bone marrow mesenchymal stem cells on renal ischemic injury in rats

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Protective effects of bone marrow mesenchymal stem cells on renal ischemic injury in rats