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Abstract
BackgroundCombined cell implantation has been widely applied in tissue engineering in recent years. In this meta-analysis, we aimed to establish whether the combined transplantation of mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) promotes angiogenesis and tissue repair, compared with transplantation of a single cell type, following tissue injury or during tissue regeneration.MethodsThe electronic databases PubMed, EMBASE, MEDLINE, Chinese Biomedical Literature, and China National Knowledge Infrastructure were searched in this systematic review and meta-analysis. Eighteen controlled preclinical studies involving MSC and EPC transplantation in animal models of disease, or in coculture in vitro, were included in this review. The vessel density and other functional indexes, which were classified according to the organ source, were used to evaluate the efficiency of cotransplantation. Publication bias was assessed.ResultsThere was no obvious difference in angiogenesis following combined cell transplantation (EPCs and MSCs) and transplantation of EPCs alone; however, an improvement in the function of damaged organs was observed following cotransplantation. In addition, combined cell transplantation significantly promoted tissue recovery in cardiovascular disease, cerebrovascular disease, and during bone regeneration. Compared with combined transplantation (EPCs and MSCs) and transplantation of MSCs alone, cotransplantation significantly promoted angiogenesis and bone regeneration, as well as vessel revascularization and tissue repair in cerebrovascular disease; however, no obvious effects on cardiovascular disease were observed.ConclusionsAs an exploratory field in the discipline of tissue engineering, MSC and EPC cotransplantation offers advantages, although it is essential to assess the feasibility of this approach before clinical trials can be performed.
Highlights
Combined cell implantation has been widely applied in tissue engineering in recent years
Mesenchymal stem cells (MSCs) are a type of adult stem cells derived from the bone marrow with multidirectional differentiation potential, which differentiate into various cell types, according to their specific microenvironment, and participate in the regeneration of blood vessels and damaged tissues [3]
It is expected that transplantation of a combination of both types of cells should compensate for the limitations of transplantation of either endothelial progenitor cells (EPCs) or mesenchymal stem cells (MSCs) alone, because the former are unable to differentiate into cardiocytes in vivo [11], whereas the latter preferentially differentiate into tissue cells but fail to elicit an improvement in tissue function owing to a lack of specificity [5]
Summary
Combined cell implantation has been widely applied in tissue engineering in recent years In this meta-analysis, we aimed to establish whether the combined transplantation of mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) promotes angiogenesis and tissue repair, compared with transplantation of a single cell type, following tissue injury or during tissue regeneration. Endothelial progenitor cells (EPCs) are mononuclear cells that circulate in the blood and are derived from different tissues. They can participate in vascular repair by migrating to distant vessels, differentiating into mature endothelial cells (ECs), and replacing old and injured ECs [4]. The present systematic review and meta-analysis was conducted to assess the effectiveness of cotransplantation on the repair of damaged tissue and to provide novel insights into the potential utility of such therapies in regenerative medicine
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