Abstract
Treatment of peripheral nerve regeneration with stem cells (SCs) alone has some limitations. For this reason, we evaluate the efficacy of neurotrophic factors combined with stem cell transplantation in the treatment of sciatic nerve injury (SNI) in rats. PubMed, Cochrane Library, Embase, WanFang, VIP and China National Knowledge Infrastructure databases were retrieved from inception to October 2021, and control experiments on neurotrophic factors combined with stem cells in the treatment of SNI in rats were searched. Nine articles and 551 rats were included in the meta-analysis. The results of meta-analysis confirmed that neurotrophic factor combined with stem cells for the treatment of SNI yielded more effective repair than normal rats with regard to sciatic nerve index, electrophysiological detection index, electron microscope observation index, and recovery rate of muscle wet weight. The conclusion is that neurotrophic factor combined with stem cells is more conducive to peripheral nerve regeneration and functional recovery than stem cells alone. However, due to the limitation of the quality of the included literature, the above conclusions need to be verified by randomized controlled experiments with higher quality and larger samples.
Highlights
Development and maintenance of the nervous system depends on proteins called neurotrophic factors [1]
Members of the neurotrophic factor family are widely expressed in the developing and mature central nervous system (CNS), especially during synaptogenesis, which involves the formation of synaptic structures, as well as signal transmission between presynaptic and postsynaptic neurons [3]
Meta-analysis using a fixed-effects model indicated that the Sciatic nerve function index (SNFI) of the combined treatment group was significantly better than that of the stem cell only group [standardized mean difference (SMD) = 1.35, 95% confidence interval (CI) (0.55, 2.15), P=0.0009] (Figure 2A)
Summary
Development and maintenance of the nervous system depends on proteins called neurotrophic factors [1]. The neurotrophic factor family originally included nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophic factor (NT)-3 (NT-3), and NT-4/5, as these proteins were identified as factors related to neuron survival [2]. Cholinergic neurotrophic factor (CNTF) and glial-derived neurotrophic factor (GDNF) were added to this family, as they were shown to promote survival and differentiation of multiple target neurons in central and peripheral regions. Members of the neurotrophic factor family are widely expressed in the developing and mature central nervous system (CNS), especially during synaptogenesis, which involves the formation of synaptic structures, as well as signal transmission between presynaptic and postsynaptic neurons [3]. NGF promotes cholinergic release to local motor axons and mediates the regeneration of primary sensory axons after injury; BDNF secretion promotes bone marrow stromal cell transplantation to affect neurons and sensory axon regeneration and NT-3 (expressed in a similar pattern to BDNF) promotes regeneration of dorsal root neurons and ascending sensory neurons in the spinal cord [4]
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