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Stem Cell Res Ther. 2019 Mar 6;10(1):75. doi: 10.1186/s13287-019-1172-6.

Regenerative cell therapy for pulmonary arterial hypertension in animal models: a systematic review.

Suen CM1,2, Stewart DJ1,2,3, Montroy J4,5, Welsh C3, Levac B3, Wesch N4,5, Zhai A1, Fergusson D4,5,3,6,7, McIntyre L4,5, Lalu MM8,9,10,11,12.

Author information

1
Regenerative Medicine Program, The Ottawa Hospital Research Institute, 501 Smyth Road, PO Box 201B, Ottawa, ON, K1H 8L6, Canada.
2
Department of Cell and Molecular Medicine, University of Ottawa, Ottawa, Canada.
3
Department of Medicine, University of Ottawa, Ottawa, Canada.
4
Clinical Epidemiology Program, Ottawa, Canada.
5
Blueprint Translational Research Group, The Ottawa Hospital Research Institute, Ottawa, Canada.
6
Depatrment of Surgery, University of Ottawa, Ottawa, Canada.
7
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
8
Regenerative Medicine Program, The Ottawa Hospital Research Institute, 501 Smyth Road, PO Box 201B, Ottawa, ON, K1H 8L6, Canada. manojlalu@gmail.com.
9
Department of Cell and Molecular Medicine, University of Ottawa, Ottawa, Canada. manojlalu@gmail.com.
10
Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, Canada. manojlalu@gmail.com.
11
Clinical Epidemiology Program, Ottawa, Canada. manojlalu@gmail.com.
12
Blueprint Translational Research Group, The Ottawa Hospital Research Institute, Ottawa, Canada. manojlalu@gmail.com.

Abstract

BACKGROUND:

Pulmonary arterial hypertension (PAH) is a rare disease characterized by widespread loss of the pulmonary microcirculation and elevated pulmonary arterial pressures leading to pathological right ventricular remodeling and ultimately right heart failure. Regenerative cell therapies could potentially restore the effective lung microcirculation and provide a curative therapy for PAH. The objective of this systematic review was to compare the efficacy of regenerative cell therapies in preclinical models of PAH.

METHODS:

A systematic search strategy was developed and executed. We included preclinical animal studies using regenerative cell therapy in experimental models of PAH. Primary outcomes were right ventricular systolic pressure (RVSP) and mean pulmonary arterial pressure (mPAP). The secondary outcome was right ventricle/left ventricle + septum weight ratio (RV/LV+S). Pooled effect sizes were undertaken using random effects inverse variance models. Risk of bias and publication bias were assessed.

RESULTS:

The systematic search yielded 1285 studies, of which 44 met eligibility criteria. Treatment with regenerative cell therapy was associated with decreased RVSP (SMD - 2.10; 95% CI - 2.59 to - 1.60), mPAP (SMD - 2.16; 95% CI - 2.97 to - 1.35), and RV/LV+S (SMD - 1.31, 95% CI - 1.64 to - 0.97). Subgroup analysis demonstrated that cell modification resulted in greater reduction in RVSP. The effects on RVSP and mPAP remained statistically significant even after adjustment for publication bias. The majority of studies had an unclear risk of bias.

CONCLUSIONS:

Preclinical studies of regenerative cell therapy demonstrated efficacy in animal models of PAH; however, future studies should consider incorporating design elements to reduce the risk of bias.

SYSTEMATIC REVIEW REGISTRATION:

Suen CM, Zhai A, Lalu MM, Welsh C, Levac BM, Fergusson D, McIntyre L and Stewart DJ. Efficacy and safety of regenerative cell therapy for pulmonary arterial hypertension in animal models: a preclinical systematic review protocol. Syst Rev. 2016;5:89.

TRIAL REGISTRATION:

CAMARADES-NC3Rs Preclinical Systematic Review & Meta-analysis Facility (SyRF). http://syrf.org.uk/protocols/ . Syst Rev 5:89, 2016.

KEYWORDS:

Animal models of human disease; Cell therapy; Meta-analysis; Pulmonary hypertension

PMID:
30841915
DOI:
10.1186/s13287-019-1172-6
Free PMC Article

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