-
European Spine Journal : Official... May 2015The debate on the effects and outcome of olfactory ensheathing cell (OEC) transplantation for the treatment of spinal cord injury (SCI) has remained unresolved for... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The debate on the effects and outcome of olfactory ensheathing cell (OEC) transplantation for the treatment of spinal cord injury (SCI) has remained unresolved for nearly 20 years. This study aimed to evaluate the safety and efficacy of OEC transplantation in chronic SCI patients.
METHOD
Electronic databases, including PubMed, the Cochrane Library, EMBASE, and MEDLINE, were searched to identify clinical therapeutic trials studying the use of OEC transplantation for SCI in humans. Each trial was analyzed in accordance with the criteria of the Cochrane Handbook 5.1.0 and MOOSE. Data were analyzed with Review Manager 5.2 and Meta-Analyst Beta 3.13 software.
RESULTS
Eleven articles concerning 10 studies of 1,193 patients with chronic SCI treated with OEC transplantation were selected for review. All the articles had low methodological quality. Studies reported their outcomes using the American Spinal Injury Association (ASIA) Impairment Scale; the AISA motor, light touch, pinprick score; the Functional Independence Measure and (or) other measure methods. According to the available relevant data, the incidences of total adverse events and mortality were 7.68% (n = 742) and 0.35% (n = 566), respectively. The most frequently reported adverse events were fever, mild anemia, and syringomyelia; however, the statistical adverse events occurring in different studies were cerebrospinal fluid leakage (7.00%, n = 586, 2 trials), sensory deterioration (0.70%, n = 573, 2 trials), and both motor and sensory deterioration (0.68%, n = 586, 2 trials).
CONCLUSIONS
Given the results from our study, we conclude that OEC transplantation appears to be safe, although the evidence for efficacy is modest and requires the support of prospective, randomized trials in larger cohorts of patients. Further randomized controlled trials utilizing strict therapy programs and implanted cell selections are needed to confirm these findings.
Topics: Cell Transplantation; Chronic Disease; Humans; Nerve Regeneration; Olfactory Mucosa; Prospective Studies; Spinal Cord Injuries
PubMed: 25001890
DOI: 10.1007/s00586-014-3416-6 -
Molecular Neurobiology Feb 2015Continuous renewal of neurons throughout life in the olfactory system is often thought to be partially attributable to specialized glial cells called olfactory... (Review)
Review
Continuous renewal of neurons throughout life in the olfactory system is often thought to be partially attributable to specialized glial cells called olfactory ensheathing cells (OECs). Hitherto, several studies have demonstrated that transplantation of OECs is one of the most promising strategies available to augment axonal regeneration and functional recovery following damage to the nervous system, including spinal cord injury (SCI). Based on these studies, a number of pre-clinical studies worldwide have been initiated using autologous transplantation of OECs into damaged central and peripheral nervous systems. Although OECs play a major role in promotion of neuron regeneration of the injured central nervous system (CNS), especially to SCI, limited valuable information is available regarding the beneficial characteristics of OECs in facilitating neural regeneration. Moreover, an increasing number of controversial issues related to the biology of OECs and their transplantation must be addressed. This step is important to better understand the cellular and molecular mechanisms modulated by transplanted OECs. To start shedding light into these controversial issues, this paper provides a systematic review regarding OECs' beneficial roles in neural regeneration, and the unique properties of these cells that may exert a potential advantage over other cellular transplants.
Topics: Animals; Cell Adhesion Molecules; Cell Movement; Humans; Nerve Growth Factors; Nerve Regeneration; Olfactory Bulb; Phagocytosis
PubMed: 24615159
DOI: 10.1007/s12035-014-8664-2