Umbilical cord mesenchymal stromal cell transplantations: A systemic analysis of clinical trials


CAN A., TOPAL ÇELİKKAN F., ÇINAR Ö.

CYTOTHERAPY, cilt.19, sa.12, ss.1351-1382, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 19 Sayı: 12
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1016/j.jcyt.2017.08.004
  • Dergi Adı: CYTOTHERAPY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1351-1382
  • Anahtar Kelimeler: clinical trial, mesenchymal stem/stromal cell, regenerative medicine, systemic review, umbilical cord, Wharton's jelly, ACUTE MYOCARDIAL-INFARCTION, SEVERE APLASTIC-ANEMIA, DECOMPENSATED LIVER-CIRRHOSIS, TYPE-2 DIABETES-MELLITUS, VERSUS-HOST-DISEASE, STEM-CELLS, BONE-MARROW, LUPUS-ERYTHEMATOSUS, MONONUCLEAR-CELLS, DOUBLE-BLIND
  • Ankara Üniversitesi Adresli: Evet

Özet

The advances and success of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in experimental disease animal models have fueled the development of targeted therapies in humans. The therapeutic potential of allogeneic transplantation of UC-MSCs has been under examination since 2009. The purpose of this systematic analysis was to review the published results, limitations and obstacles for UC-MSC transplantation. An extensive search strategy was applied to the published literature, 93 peer-reviewed full-text articles and abstracts were found published by early August 2017 that investigated the safety, efficacy and feasibility of UC-MSCs in 2001 patients with 53 distinct pathologies including many systemic/local, acute/chronic conditions. Few data were extracted from the abstracts and/or Chinese-written articles (n = 7, 8%). Importantly, no long-term adverse effects, tumor formation or cell rejection were reported. All studies noted certain degrees of therapeutic benefit as evidenced by clinical symptoms and/or laboratory findings. Thirty-seven percent (n = 34) of studies were found published as a single case (n = 10; 11%) or 2-10 case reports (n = 24; 26%) with no control group. Due to the nature of many stem cell-based studies, the majority of patients also received conventional therapy regimens, which obscured the pure efficacy of the cells transplanted. Randomized, blind, phase 1/2 trials with control groups (placebocontrolled) showed more plausible results. Given that most UC-MSC trials are early phase, the internationally recognized cell isolation and preparation standards should be extended to future phase 2/3 trials to reach more convincing conclusions regarding the safety and efficacy of UC-MSC therapies.