间充质干细胞源性胞外囊泡修复动物颅颌骨缺损荟萃分析△

A meta-analysis of mesenchymal stem cell-derived extracellular vesicles for repairing craniomaxillofacial bone defects in animals

摘要:

[目的] 采用荟萃分析评价间充质干细胞源性细胞外囊泡 （mesenchymal stem cell-derived extracellular vesicles, MSCEVs） 在颅颌骨缺损修复中的疗效。[方法] 检索 PubMed、Embase、Cochrane、Web of Science、中国知网、万方、维普和中国生物医学文献数据库建库至 2025 年 5 月，符合标准的文献资料，应用 SYRCLE 工具评估偏倚风险，使用 Revman 5.4.1 软件和 Getdata Graph Digitizer 软件提取数据并进行分析。[结果]共 12 篇文献符合纳入标准，均为动物实验。荟萃分析显示，MSC-EVs 组在骨体积与总体积比 （SMD=3.97, 95%CI 2.50~5.43, P＜0.001）、骨密度 （SMD=5.89, 95%CI 3.50~8.29, P＜0.001）、骨小梁数量 （SMD=3.01, 95%CI 0.42~5.60, P=0.02）、骨小梁分离度（SMD=-3.48, 95%CI -5.84~-1.12, P=0.004）、血管容积（SMD=4.69, 95%CI 3.03~6.36, P＜0.001） 均显著优于对照组，此外，未预处理的 MSC-EVs 组与预处理的 MSC-EVs 组之间的差异均无统计学意义 （P＞0.05）。[结论]MSC-EVs 疗法在加速颅颌骨缺损愈合方面具有显著疗效，未预处理的 MSC-EVs 组与预处理的 MSC-EVs 组之间无明显差异。

Abstract:

[Objective] To evaluate the efficacy of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) in the repair of cra-niomaxillofacial bone defects. [Methods] The literature data that met the criteria were retrieved in PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, VIP and the Chinese Biomedical Literature Database from the establishment until May 2025. The SYRCLE tool was applied to assess the risk of bias. Data were extracted and analyzed using Revman 5.4.1 software and Getdata Graph Digitizer software. [Results] A total of 12 literature met the inclusion criteria, and all of them involved animal experiment. As results of the meta-analysis, the MSC-EVs group proved significantly superior to the control group in terms of the ratio of bone volume to total volume (SMD=3.97, 95%CI 2.50~5.43, P＜0.00001), bone mineral density (SMD=5.89, 95%CI 3.50~8.29, P＜0.00001), trabecular bone number (SMD=3.01, 95%CI 0.42~5.60, P=0.02), trabecular separation (SMD=-3.48, 95%CI -5.84~-1.12, P=0.004) and vessel volume (SMD=4.69, 95%CI 3.03~6.36, P＜0.00001).However, there was no significant difference between the unpretreated MSC-EVs group and the pretreated MSC-EVs group in abovesaid parameters. [Conclusion] MSC-EVs therapy has a significant effect in accelerating the healing of craniomaxillofacial bone defects. There was no significant difference between the unpretreated MSC-EVs group and the pretreated MSC-EVs group.