Human umbilical cord derived mesenchymal stem cells in peripheral nerve regeneration

Christine Bojanic; Kendrick To; Bridget Zhang; Christopher Mak; Wasim S Khan

doi:10.4252/wjsc.v12.i4.288

Human umbilical cord derived mesenchymal stem cells in peripheral nerve regeneration

World J Stem Cells. 2020 Apr 26;12(4):288-302. doi: 10.4252/wjsc.v12.i4.288.

Authors

Christine Bojanic¹, Kendrick To², Bridget Zhang³, Christopher Mak³, Wasim S Khan⁴

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, United Kingdom.
² Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, United Kingdom.
³ School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom.
⁴ Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, United Kingdom. wasimkhan@doctors.org.uk.

Abstract

Background: Peripheral nerve injury can occur as a result of trauma or disease and carries significant morbidity including sensory and motor loss. The body has limited ability for nerve regeneration and functional recovery. Left untreated, nerve lesions can cause lifelong disability. Traditional treatment options such as neurorrhaphy and neurolysis have high failure rates. Surgical reconstruction with autograft carries donor site morbidity and often provide suboptimal results. Mesenchymal stem cells (MSCs) are known to have promising regenerative potential and have gained attention as a treatment option for nerve lesions. It is however, unclear whether it can be effectively used for nerve regeneration.

Aim: To evaluate the evidence for the use of human umbilical cord derived MSCs (UCMSCs) in peripheral nerve regeneration.

Methods: We carried out a systematic literature review in accordance with the PRISMA protocol. A literature search was performed from conception to September 2019 using PubMed, EMBASE and Web of Science. The results of eligible studies were appraised. A risk of bias analysis was carried out using Cochrane's RoB 2.0 tool.

Results: Fourteen studies were included in this review. A total of 279 subjects, including both human and animal were treated with UCMSCs. Four studies obtained UCMSCs from a third-party source and the remainder were harvested by the investigators. Out of the 14 studies, thirteen conducted xenogenic transplantation into nerve injury models. All studies reported significant improvement in nerve regeneration in the UCMSC treated groups compared with the various different controls and untreated groups.

Conclusion: The evidence summarised in this PRISMA systematic review of in vivo studies supports the notion that human UCMSC transplantation is an effective treatment option for peripheral nerve injury.

Keywords: Mesenchymal stem cells; Peripheral nerve regeneration; Transplantation; Umbilical cord.