Mesenchymal stem cell transplantation as an effective treatment strategy for ischemic stroke in Asia: A meta-analysis of controlled trials

Abstract

Objective: The aim of this study was to evaluate the efficacy and safety of the mesenchymal stem cell (MSC) therapy in patients with ischemic stroke (IS). Materials and methods: Clinical trials involved in this research were searched from PubMed, Web of Science, Cochrane Library, Embase, Wanfang and CNKI database. Therapeutic effects of MSC therapy were assessed according to National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), Fugl-Meyer Assessment (FMA) and Functional Independence Measure (FIM), and its safety was evaluated based on adverse events. Results: This research covered 23 trials including 1,279 IS patients. Based on our analysis, the overall condition of IS patients significantly improved after MSC therapy, indicated by decreased NIHSS and increased BI, FMA and FIM scores. Our analysis also showed that the treatment effects in the MSC transplantation group were superior to those in the control group (routine medication therapy) with statistical significance for NIHSS (1 month after therapy: odds ratio [OR]=−1.92, CI=−3.49 to −0.34, P=0.02; 3 months after therapy: OR=−2.65, CI=−3.40 to −1.90, P<0.00001), BI (1 month after therapy: OR=0.99, CI=0.19–1.79, P=0.02; 6 months after therapy: OR=10.10, CI=3.07–17.14, P=0.005), FMA (3 months after therapy: OR=10.20, CI=3.70–16.70, P=0.002; 6 months after therapy: OR=10.82, CI=6.45–15.18, P<0.00001) and FIM (1 month after therapy: OR=15.61, CI=−0.02 to 31.24, P=0.05; 6 months after therapy: OR=16.56, CI=9.06–24.06, P<0.0001). No serious adverse events were reported during MSC therapy. Conclusion: MSC therapy is safe and effective in treating IS by improving the neurological deficits, motor function and daily life quality of patients.