Clinical translation of stem cell therapy for spinal cord injury still premature

Major Points and Findings:

Methods:

The researchers conducted a comprehensive literature search across databases like PubMed, Ovid-Embase, Web of Science, and Cochrane up to February 10, 2022. They included 62 studies involving 2439 patients in their meta-analysis.

Results:

• Efficacy: The meta-analysis revealed that stem cells improved the ASIA impairment scale score by at least one grade in 48.9% of patients with SCI. Additionally, the rate of improvement in urinary and gastrointestinal system function was 42.1% and 52.0%, respectively.
• Adverse Effects: The study identified 28 types of adverse effects due to stem cells and transplantation procedures. The most common were neuropathic pain, abnormal feeling, muscle spasms, vomiting, and urinary tract infection, with an incidence of >20%. No serious adverse effects like tumorigenesis were reported, but the authors caution that this could be due to insufficient follow-up.

Conclusions:

While the efficacy of stem cell therapy appears encouraging, the study highlights several concerns:

1. Adverse effects remain a significant issue.
2. Many clinical trials had methodological problems like small sample sizes, poor design, and lack of controls and blinding.
3. The current evidence is not strong enough to support the clinical translation of stem cell therapy for SCI.