Efficacy of decellularized extracellular matrix (dECM) for articular cartilage repair in osteoarthritis (OA): a systematic review and meta-analysis

脱细胞细胞外基质(dECM)在骨关节炎(OA)关节软骨修复中的疗效:系统评价和荟萃分析

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Abstract

BACKGROUND: Osteoarthritis (OA) is a common degenerative joint disease causing chronic pain, disability, and mobility limitations, severely affecting quality of life. Traditional treatments like physical therapy and surgery often have limited efficacy due to side effects, incomplete recovery, and disease progression, highlighting the need for innovative therapies. METHODS: We searched PubMed and Embase from January 1, 2010 to November 1, 2024, preliminary included studies involving animal experiments on the therapeutic effects of decellularized extracellular matrix (dECM) and its derived materials on cartilage defect. After removing duplicates, we conducted a bibliometric analysis. Following the exclusion and evaluation of literature, the random/fixed effects model was employed to perform meta-analysis and obtain Weighted Mean Difference (WMD) of Osteoarthritis Research Society International (OARSI) score and International Cartilage Repair Society (ICRS) score between the dECM treatment group and corresponding control group. We verify the robustness of the results through subgroup analysis and sensitivity analysis, with heterogeneity assessed by Q-test and quantified via I(2) values. RESULTS: We included a total of 10 studies, of which 7 were used for ICRS-based meta-analysis and 3 were used for OARSI-based meta-analysis. The combined mean ICRS of dECM treatment group/control group resulted in an WMD of 2.45 (95% CI: 1.07 to 3.84; I(2) = 97.4%); P-value < 0.001). Meanwhile, the combined mean OARSI of dECM treatment group/control group resulted in an WMD of -1.65 (95% CI: -3.63 to 0.34; I(2) = 97.3%). The subsequent funnel plot confirmed the low publication bias of the above results. CONCLUSIONS: Based on the dual-index meta-analysis, the dECM and relative derivatives have been proved to possess significant cartilage repair function in OA, which can be further explored in tissue regeneration filed.

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