Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse ...Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.展开更多
Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their...Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge.However,to date,no attempt has been made to collate and synthesize literature in this area.Objective:This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.Search strategy:A systematic search of MEDLINE/PubMed,CINAHL,Scopus and medRxiv was conducted to identify articles published up to March 2022.Inclusion criteria:This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity,exercise,or breathing training to enhance or restore functional capacity,pulmonary function,quality of life,and mental health or function.Data extraction and analysis:Selection of included articles,data extraction,and methodological quality assessments were conducted by two review authors respectively,and consensus was reached through discussion and consultation with a third reviewer.Finally,we review the outcomes of studies based on four categories including:(1)functional capacity,(2)pulmonary function,(3)quality of life,and(4)mental health status.Results:A total of 7534 titles and abstracts were screened;10 cohort studies,4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review.Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity,pulmonary function,quality of life and mental health status.Conclusion:Physical rehabilitation interventions may be safe,feasible and effective in COVID-19 patients discharged from the hospital,and can improve a variety of clinically relevant outcomes.Further studies are warranted to determine the underlying mechanisms.展开更多
文摘Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.
文摘Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge.However,to date,no attempt has been made to collate and synthesize literature in this area.Objective:This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.Search strategy:A systematic search of MEDLINE/PubMed,CINAHL,Scopus and medRxiv was conducted to identify articles published up to March 2022.Inclusion criteria:This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity,exercise,or breathing training to enhance or restore functional capacity,pulmonary function,quality of life,and mental health or function.Data extraction and analysis:Selection of included articles,data extraction,and methodological quality assessments were conducted by two review authors respectively,and consensus was reached through discussion and consultation with a third reviewer.Finally,we review the outcomes of studies based on four categories including:(1)functional capacity,(2)pulmonary function,(3)quality of life,and(4)mental health status.Results:A total of 7534 titles and abstracts were screened;10 cohort studies,4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review.Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity,pulmonary function,quality of life and mental health status.Conclusion:Physical rehabilitation interventions may be safe,feasible and effective in COVID-19 patients discharged from the hospital,and can improve a variety of clinically relevant outcomes.Further studies are warranted to determine the underlying mechanisms.
