Title:A Bayesian Network Analysis of the Efficacy of Scaffolds and Stem Cells in
Spinal Cord Injury Treatment
Volume: 18
Issue: 4
Author(s): Yang Wang*Hanxiao Yi
Affiliation:
- Department of Orthopedics, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical
University; No. 250 Changgang East Road, Haizhu District, Guangzhou, Guangdong Province, China
Keywords:
Spinal cord injury, locomotor function, scaffold, stem cell, exosome, bayesian network meta-analysis.
Abstract:
Backgrond: Novel scaffolds and stem cells are alternatives for the treatment of spinal cord
injury (SCI), which causes life-long disability. However, there is a lack of synthesized evidence comparing
different therapies.
Aim: To examine the efficacy of various treatments in achieving locomotor recovery in SCI animals. The
PubMed, Scopus and Web of Science databases were searched from inception to 21st May 2021.
Methods: The data were extracted by one investigator under the surveillance of a referee according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and
stored in Microsoft Excel. All data were analysed using Bayesian network analysis with a consistency
model. The selection was performed in strict accordance with the participant, intervention, comparison,
outcome and study (PICOS) principle, as specifically stated in the methods section.
Results: A total of 387 eligible studies involving 11169 animals subjected to 5 different treatments were
evaluated. Compared to placebo or no treatment, scaffolds (mean difference (MD), 2.04; 95% credible
interval (CrI): 1.58 to 2.50), exosomes (MD, 3.46; 95% CrI: 3.07 to 3.86), stem cells (MD, 4.18; 95% CrI:
3.28 to 5.07), scaffolds in conjunction with stem cells (MD, 5.26; 95% CrI: 4.62 to 5.89), and scaffolds in
conjunction with non-cell agents (MD, 4.88; 95% CrI: 4.21 to 5.54) led to significant recovery of locomotor
function in SCI animals. No significant difference in the locomotor function score was observed between
animals treated with stem cells and those treated with exosomes (MD, 0.71; 95% CrI: -0.25 to
3.05), between animals treated with scaffolds in conjunction with stem cells and those treated with scaffolds
in conjunction with non-cell agents (MD, -0.38; 95% CrI: -1.24 to 0.49), or between animals treated
with scaffolds in conjunction with non-cell agents and those treated with stem cells (MD, 0.71; 95% CrI: -
0.38 to 1.80).
Conclusion: Significant differences in the efficacy of various therapies in SCI animals were observed,
and transplantation of scaffolds in conjunction with non-cell agents, scaffolds in conjunction with stem
cells, and stem cells should be considered over transplantation of exosomes or scaffolds alone. Even
though transplantation of scaffolds alone promoted locomotor function recovery in SCI animals, its use
should be discouraged.
