Mesenchymal Stem Cell Therapy for Acetaminophen-related Liver Injury: A Systematic Review and Meta-analysis of Experimental Studies In Vivo
Objective: The efficacy of mesenchymal stem cell (MSC) therapy in acetaminophen-induced
liver injury has been investigated in animal experiments, but individual studies with a small
sample size cannot be used to draw a clear conclusion. Therefore, we conducted a systematic review
and meta-analysis of preclinical studies to explore the potential of using MSCs in acetaminophen-
induced liver injury.
Methods: Eight databases were searched for studies reporting the effects of MSCs on acetaminophen
hepatoxicity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses
(PRISMA) guidelines were used. SYRCLE’s risk of bias tool for animal studies was applied to
assess the methodological quality. A meta-analysis was performed by using RevMan 5.4 and STATA/
SE 16.0 software.
Results: Eleven studies involving 159 animals were included according to PRISMA statement
guidelines. Significant associations were found for MSCs with the levels of alanine transaminase
(ALT) (standardized mean difference (SMD) - 2.58, p < 0.0001), aspartate aminotransferase (AST)
(SMD - 1.75, p = 0.001), glutathione (GSH) (SMD 3.7, p < 0.0001), superoxide dismutase (SOD)
(SMD 1.86, p = 0.022), interleukin 10 (IL-10) (SMD 5.14, p = 0.0002) and tumor necrosis factor-α
(TNF-α) (SMD - 4.48, p = 0.011) compared with those in the control group. The subgroup analysis
showed that the tissue source of MSCs significantly affected the therapeutic efficacy (p < 0.05).
Conclusion: Our meta-analysis results demonstrate that MSCs could be a potential treatment for acetaminophen-
related liver injury. The protocol for this meta-analysis was prospectively registered
in PROSPERO (Number: CRD42020212677).
Journal Title: Current Stem Cell Research & Therapy