中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (2): 299-305.doi: 10.4103/1673-5374.347941

• 综述:脊髓损伤修复保护与再生 • 上一篇    下一篇

基因疗法修复脊髓损伤:临床前研究的系统综述和meta分析

  

  • 出版日期:2023-02-15 发布日期:2022-08-05

The potential of gene therapies for spinal cord injury repair: a systematic review and meta-analysis of pre-clinical studies

Catriona J. Cunningham1, *, Mindaugas Viskontas1, Krzysztof Janowicz1, Yasmin Sani1, Malin E. Håkansson1, Anastasia Heidari1, Wenlong Huang1, #, Xuenong Bo2, #   

  1. 1Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK; 2Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  • Online:2023-02-15 Published:2022-08-05
  • Contact: Catriona J. Cunningham, PhD, catriona.cunningham@abdn.ac.uk.
  • Supported by:
    This study was supported by Scottish Rugby Union, Graham and Pam Dixon, Medical Research Scotland, and University of Aberdeen HOTSTART Scholarship Programme (to WH). 

摘要: https://orcid.org/0000-0002-9216-9414 (Catriona J. Cunningham)

Abstract: Currently, there is no cure for traumatic spinal cord injury but one therapeutic approach showing promise is gene therapy. In this systematic review and meta-analysis, we aim to assess the efficacy of gene therapies in pre-clinical models of spinal cord injury and the risk of bias. In this meta-analysis, registered at PROSPERO (Registration ID: CRD42020185008), we identified relevant controlled in vivo studies published in English by searching the PubMed, Web of Science, and Embase databases. No restrictions of the year of publication were applied and the last literature search was conducted on August 3, 2020. We then conducted a random-effects meta-analysis using the restricted maximum likelihood estimator. A total of 71 studies met our inclusion criteria and were included in the systematic review. Our results showed that overall, gene therapies were associated with improvements in locomotor score (standardized mean difference [SMD]: 2.07, 95% confidence interval [CI]: 1.68–2.47, Tau2 = 2.13, I2 = 83.6%) and axonal regrowth (SMD: 2.78, 95% CI: 1.92–3.65, Tau2 = 4.13, I2 = 85.5%). There was significant asymmetry in the funnel plots of both outcome measures indicating the presence of publication bias. We used a modified CAMARADES (Collaborative Approach to Meta-Analysis and Review of Animal Data in Experimental Studies) checklist to assess the risk of bias, finding that the median score was 4 (IQR: 3–5). In particular, reports of allocation concealment and sample size calculations were lacking. In conclusion, gene therapies are showing promise as therapies for spinal cord injury repair, but there is no consensus on which gene or genes should be targeted.

Key words: animal models, gene delivery, meta-analysis, regenerative medicine, spinal cord injury, systematic review, viral vectors