Hanieh Salehi-Pourmehr1, Ozra Nouri1,2, Amirreza Naseri1,2, Leila Roshangar3, Reza Rahbarghazi3, Saeed Sadigh-Eteghad4, Javad Mahmoudi4, Hadi Mostafaei1,5, M Reza Roshandel6, Leila Hoseini4, Nasrin Abolhasanpour1, Ali Mostafaei1, Sakineh Hajebrahimi7,8, Hashim Hashim9. 1. Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Azadi, Golgasht Ave, Tabriz, East Azarbaijan, 5166/15731, Iran. 2. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. 3. Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 4. Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran. 5. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 6. Icahn School of Medicine at Mount Sinai, NYC, New York, NY, USA. 7. Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Azadi, Golgasht Ave, Tabriz, East Azarbaijan, 5166/15731, Iran. ebrahimis@tbzmed.ac.ir. 8. Urology Department of Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. ebrahimis@tbzmed.ac.ir. 9. Bristol Urological Institute, Bristol, UK.
Abstract
INTRODUCTION AND HYPOTHESIS: This review aims to investigate the effect of stem cell (SC) therapy on the management of neurogenic bladder (NGB) in four neurological diseases, including spinal cord injury (SCI), Parkinson's disease (PD), multiple sclerosis (MS), and stroke, in the clinical setting. METHODS: An electronic database search was conducted in the Cochrane Library, EMBASE, Proquest, Clinicaltrial.gov , WHO, Google Scholar, MEDLINE via PubMed, Ovid, Web of Science, Scopus, ongoing trial registers, and conference proceedings in June 2019 and updated by hand searching on 1 February 2021. All randomized controlled trials (RCTs), quasi RCTs, phase I/II clinical trials, case-control, retrospective cohorts, and comprehensive case series that evaluated the regenerative potential of SCs on the management of NGB were included. Cochrane appraisal risk of bias checklist and the standardized critical appraisal instrument from the JBI Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI) were used to appraise the studies. RESULTS: Twenty-six studies among 1282 relevant publications met our inclusion criteria. Only SC therapy was applied for SCI or MS patients. Phase I/II clinical trials (without control arm) were the most conducted studies, and only four were RCTs. Four studies with 153 participants were included in the meta-analysis. The main route of transplantation was via lumbar puncture. There were no serious adverse events. Only nine studies in SCI and one in MS have used urodynamics, and the others have reported improvement based on patient satisfaction. SC therapy did not significantly improve residual urine volume, detrusor pressure, and maximum bladder capacity. Also, the quality of these publications was low or unclear. CONCLUSION: Although most clinical trials provide evidence of the safety and effectiveness of MSCs on the management of NGB, the meta-analysis results did not show a significant improvement; however, the interpretation of study results is difficult because of the lack of placebo controls.
INTRODUCTION AND HYPOTHESIS: This review aims to investigate the effect of stem cell (SC) therapy on the management of neurogenic bladder (NGB) in four neurological diseases, including spinal cord injury (SCI), Parkinson's disease (PD), multiple sclerosis (MS), and stroke, in the clinical setting. METHODS: An electronic database search was conducted in the Cochrane Library, EMBASE, Proquest, Clinicaltrial.gov , WHO, Google Scholar, MEDLINE via PubMed, Ovid, Web of Science, Scopus, ongoing trial registers, and conference proceedings in June 2019 and updated by hand searching on 1 February 2021. All randomized controlled trials (RCTs), quasi RCTs, phase I/II clinical trials, case-control, retrospective cohorts, and comprehensive case series that evaluated the regenerative potential of SCs on the management of NGB were included. Cochrane appraisal risk of bias checklist and the standardized critical appraisal instrument from the JBI Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI) were used to appraise the studies. RESULTS: Twenty-six studies among 1282 relevant publications met our inclusion criteria. Only SC therapy was applied for SCI or MS patients. Phase I/II clinical trials (without control arm) were the most conducted studies, and only four were RCTs. Four studies with 153 participants were included in the meta-analysis. The main route of transplantation was via lumbar puncture. There were no serious adverse events. Only nine studies in SCI and one in MS have used urodynamics, and the others have reported improvement based on patient satisfaction. SC therapy did not significantly improve residual urine volume, detrusor pressure, and maximum bladder capacity. Also, the quality of these publications was low or unclear. CONCLUSION: Although most clinical trials provide evidence of the safety and effectiveness of MSCs on the management of NGB, the meta-analysis results did not show a significant improvement; however, the interpretation of study results is difficult because of the lack of placebo controls.
Authors: L Y Garcia-Arguello; J C O'Horo; A Farrell; R Blakney; M R Sohail; C T Evans; N Safdar Journal: Spinal Cord Date: 2016-12-06 Impact factor: 2.772
Authors: L F Geffner; P Santacruz; M Izurieta; L Flor; B Maldonado; A H Auad; X Montenegro; R Gonzalez; F Silva Journal: Cell Transplant Date: 2008 Impact factor: 4.064