Các túi ngoại bào được thiết kế cho đột quỵ thiếu máu: một đánh giá hệ thống và phân tích tổng hợp các nghiên cứu tiền lâm sàng

Journal of Nanobiotechnology - Tập 21 Số 1
Péngtāo Li1, Rui Yin1, Yi-Hao Chen1, Jianbo Chang1, Yang Ling1, Xiaoyu Liu1, Houshi Xu1, Xiao Zhang1, Shihua Wang2, Qunying Han2, Junji Wei1
1Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
2Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences / School of Basic Medicine, Peking Union Medical College, Beijing, China

Tóm tắt

Tóm tắt Nền tảng Đánh giá hệ thống và phân tích tổng hợp này nhằm mục đích đánh giá hiệu quả của các túi ngoại bào được thiết kế (EEVs) trong điều trị đột quỵ thiếu máu (IS) trong các nghiên cứu tiền lâm sàng và so sánh chúng với các túi ngoại bào tự nhiên (EVs). Đánh giá hệ thống cung cấp một cái nhìn cập nhật về tình trạng hiện tại của tài liệu về việc sử dụng EEVs cho IS và thông báo cho các nghiên cứu trong tương lai trong lĩnh vực này. Phương pháp Chúng tôi đã tìm kiếm trên các cơ sở dữ liệu PubMed, EMBASE, Web of Science, Cochrane Library, và Scopus cho các nghiên cứu tiền lâm sàng đã trải qua đánh giá đồng nghiệp về hiệu ứng điều trị của EEVs đối với IS. Các cơ sở dữ liệu này trải dài từ lúc bắt đầu đến ngày 1 tháng 8 năm 2023. Các chỉ số kết quả bao gồm thể tích nhồi máu, điểm số thần kinh, điểm số hành vi, tỷ lệ apoptosis, số lượng tế bào thần kinh, và mức độ của IL-1β, IL-6 và TNF-α. Bảng kiểm CAMARADES được sử dụng để đánh giá chất lượng và rủi ro thiên lệch của các nghiên cứu. Tất cả các phân tích thống kê được thực hiện bằng phần mềm RevMan 5.4. Kết quả Tổng cộng có 28 nghiên cứu với 1760 động vật đáp ứng tiêu chí đưa vào. Kết quả của phân tích tổng hợp cho thấy rằng so với các EVs tự nhiên, EEVs đã giảm thể tích nhồi máu (tỷ lệ: SMD = -2.33, 95% CI: -2.92, -1.73; kích thước: SMD = -2.36, 95% CI: -4.09, -0.63), cải thiện điểm số thần kinh (mNSS: SMD = -1.78, 95% CI: -2.39, -1.17; Zea Longa: SMD = -2.75, 95% CI: -3.79, -1.71), thúc đẩy phục hồi hành vi (thử nghiệm rotarod: SMD = 2.50, 95% CI: 1.81, 3.18; thử nghiệm đi trên lưới: SMD = -3.45, 95% CI: -5.15, -1.75; thử nghiệm gỡ bỏ keo dính: SMD = -2.60, 95% CI: -4.27, -0.93; thử nghiệm mê cung Morris: SMD = -3.91, 95% CI: -7.03, -0.79), và giảm sự phóng thích các yếu tố gây viêm (IL-1β: SMD = -2.02, 95% CI: -2.77, -1.27; IL-6: SMD = -3.01, 95% CI: -4.47, -1.55; TNF-α: SMD = -2.72, 95% CI: -4.30, -1.13), đồng thời tăng số lượng tế bào thần kinh (tỷ lệ apoptosis: SMD = -2.24, 95% CI: -3.32, -1.16; số lượng tế bào thần kinh: SMD = 3.70, 95% CI: 2.44, 4.96). Các biểu đồ phễu cho hai chỉ số kết quả chính là bất đối xứng, cho thấy sự thiên lệch về công bố. Điểm trung vị trên bảng kiểm CAMARADES là 7 điểm (IQR: 6–9). Kết luận Phân tích tổng hợp này cho thấy EEVs vượt trội hơn EVs tự nhiên trong điều trị IS. Tuy nhiên, nghiên cứu trong lĩnh vực này vẫn còn ở giai đoạn đầu, và cần nhiều nghiên cứu hơn để hiểu hoàn toàn cơ chế điều trị tiềm năng của EEVs và khả năng sử dụng của chúng trong điều trị IS. Số đăng ký PROSPERO CRD42022368744.

Từ khóa


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Journal of Nanobiotechnology

Tập 21 Số 1

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