Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2024; 30(32): 3766-3782
Published online Aug 28, 2024. doi: 10.3748/wjg.v30.i32.3766
Mesenchymal stem cell therapy for liver fibrosis need “partner”: Results based on a meta-analysis of preclinical studies
Yan Xu, Xue-Song Wang, Xiao-Lei Zhou, Wen-Ming Lu, Xing-Kun Tang, Yu Jin, Jun-Song Ye
Yan Xu, Xue-Song Wang, Wen-Ming Lu, Jun-Song Ye, Subcenter for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Yan Xu, Xue-Song Wang, Xiao-Lei Zhou, Wen-Ming Lu, Xing-Kun Tang, Yu Jin, School of Rehabilitation Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Yan Xu, Xue-Song Wang, Wen-Ming Lu, Jun-Song Ye, Ganzhou Key Laboratory of Stem Cell and Regenerative Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Xing-Kun Tang, Department of Medical Genetics, School of Medicine, Tongji University, Shanghai 200092, China
Jun-Song Ye, Key Laboratory of Prevention and Treatment of Cardiovascular and Cere-brovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Jun-Song Ye, Jiangxi Provincal Key Laboratory of Tissue Engineering, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Co-first authors: Yan Xu and Xue-Song Wang.
Author contributions: Xu Y, Wang XS, Zhou XL, Lu WM, Tang XK, Jin Y, and Ye JS designed the research study; Xu Y, Wang XS, Zhou XL, and Ye JS performed the research; Lu WM, Tang XK, and Jin Y contributed new reagents and analytic tools; Xu Y and Wang XS analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 32060232; and Jiangxi Provincial Natural Science Foundation, No. 20212BAB206075.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Song Ye, PhD, Professor, Teacher, Subcenter for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, No. 23 Qingnian Road, Ganzhou 341000, Jiangxi Province, China. yjs1211@163.com
Received: May 3, 2024
Revised: June 22, 2024
Accepted: August 6, 2024
Published online: August 28, 2024
Processing time: 115 Days and 16.3 Hours
Abstract
BACKGROUND

The efficacy of mesenchymal stem cells (MSCs) in treating liver fibrosis has been demonstrated in several clinical studies. However, their low survival and liver implantation rates remain problematic. In recent years, a large number of studies in animal models of liver fibrosis have shown that MSCs combined with drugs can improve the efficacy of MSCs in the treatment of liver fibrosis alone and inhibit its progression to end-stage liver disease. This has inspired new ways of thinking about treating liver fibrosis.

AIM

To investigate the effectiveness and mechanisms of MSCs combined with drugs in treating liver fibrosis.

METHODS

Data sources included four electronic databases and were constructed until January 2024. The subjects, interventions, comparators, outcomes, and study design principle were used to screen the literature, and the quality of the literature was evaluated to assess the risk of bias. Relevant randomised controlled trials were selected, and the final 13 studies were included in the final study.

RESULTS

A total of 13 studies were included after screening. Pooled analysis showed that MSCs combined with drug therapy significantly improved liver function, promoted the repair of damaged liver tissues, reduced the level of liver fibrosis-related indexes, and effectively ameliorated hepatic fibrosis by modulating the hepatic inflammatory microenvironment, promoting the homing of MSCs, and regulating the relevant signaling pathways, and the treatment efficacy was superior to MSCs alone. However, the combined treatment statistics showed no ame-lioration in serum albumin levels (standardized mean difference = 0.77, 95% confidence interval: -0.13 to 1.68, P = 0.09).

CONCLUSION

In conclusion, MSCs combined with drugs for treating liver fibrosis effectively make up for the shortcomings of MSCs in their therapeutic effects. However, due to the different drugs, the treatment mechanism and effect also differ. Therefore, more randomized controlled trials are needed to compare the therapeutic efficacy of different drugs in combination with MSCs, aiming to select the “best companion” of MSCs in treating hepatic fibrosis.

Keywords: Mesenchymal stem cell; Stem cell therapy; Liver fibrosis; Combination of drugs; Cirrhosis; Meta-analysis

Core Tip: The efficacy of mesenchymal stem cells (MSCs) therapy for hepatic fibrosis is affected by liver colonization rate and low survival rate. In recent years, an increasing number of studies have shown that the combination of MSCs and drugs can improve the efficacy of MSCs alone in treating liver fibrosis. Our Meta-analysis summarizing the current studies and systematically assessed the efficacy of this combined strategy to ameliorate liver fibrosis.