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Cell-therapy for Parkinson’s disease : a systematic review and meta-analysis
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Wang, Fang, Sun, Zhengwu, Peng, Daoyong, Gianchandani, Shikha, Le, Weidong, Boltze, Johannes and Li, Shen (2023) Cell-therapy for Parkinson’s disease : a systematic review and meta-analysis. Journal of Translational Medicine, 21 (1). doi:10.1186/s12967-023-04484-x ISSN 1479-5876.
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Official URL: http://dx.doi.org/10.1186/s12967-023-04484-x
Abstract
Background:
Cell-based strategies focusing on replacement or protection of dopaminergic neurons have been considered as a potential approach to treat Parkinson’s disease (PD) for decades. However, despite promising preclinical results, clinical trials on cell-therapy for PD reported mixed outcomes and a thorough synthesis of these findings is lacking. We performed a systematic review and meta-analysis to evaluate cell-therapy for PD patients.
Methods:
We systematically identified all clinical trials investigating cell- or tissue-based therapies for PD published before July 2023. Out of those, studies reporting transplantation of homogenous cells (containing one cell type) were included in meta-analysis. The mean difference or standardized mean difference in quantitative neurological scale scores before and after cell-therapy was analyzed to evaluate treatment effects.
Results:
The systematic literature search revealed 106 articles. Eleven studies reporting data from 11 independent trials (210 patients) were eligible for meta-analysis. Disease severity and motor function evaluation indicated beneficial effects of homogenous cell-therapy in the ‘off’ state at 3-, 6-, 12-, or 24-month follow-ups, and for motor function even after 36 months. Most of the patients were levodopa responders (61.6–100% in different follow-ups). Cell-therapy was also effective in improving the daily living activities in the ‘off’ state of PD patients. Cells from diverse sources were used and multiple transplantation modes were applied. Autografts did not improve functional outcomes, while allografts exhibited beneficial effects. Encouragingly, both transplantation into basal ganglia and to areas outside the basal ganglia were effective to reduce disease severity. Some trials reported adverse events potentially related to the surgical procedure. One confirmed and four possible cases of graft-induced dyskinesia were reported in two trials included in this meta-analysis.
Conclusions:
This meta-analysis provides preliminary evidence for the beneficial effects of homogenous cell-therapy for PD, potentially to the levodopa responders. Allogeneic cells were superior to autologous cells, and the effective transplantation sites are not limited to the basal ganglia.
PROSPERO registration number: CRD42022369760
Item Type: | Journal Article | |||||||||
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Subjects: | R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology |
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | |||||||||
Library of Congress Subject Headings (LCSH): | Parkinson's disease, Parkinson's disease -- Treatment -- Research, Parkinson's disease -- Prevention -- Research, Cellular therapy, Meta-analysis | |||||||||
Journal or Publication Title: | Journal of Translational Medicine | |||||||||
Publisher: | BMC | |||||||||
ISSN: | 1479-5876 | |||||||||
Official Date: | 7 September 2023 | |||||||||
Dates: |
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Volume: | 21 | |||||||||
Number: | 1 | |||||||||
DOI: | 10.1186/s12967-023-04484-x | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 13 September 2023 | |||||||||
Date of first compliant Open Access: | 15 September 2023 | |||||||||
RIOXX Funder/Project Grant: |
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