The efficacy and safety of stem cell therapy for ischemic stroke: a systematic review and network meta-analysis study

Abstract

Background and aim

Using a network meta-analysis, this study evaluates the clinical efficacy and safety of different types of stem cell therapy in regard to the recovery of neurological function, motor function, and daily living ability in ischemic stroke patients.

Methods

A computerized search of the Cochrane Library, PubMed, Web of Science, Google Scholar, CNKI, and Wanfang Database was performed to collect randomized controlled clinical studies published from the time of library construction to December 2024, on the use of stem cells to improve function in patients with ischemic stroke.

Results

A total of 19 studies and 1055 patients were included, comprising five stem cell types: bone marrow mononuclear cells (BMMNC), bone marrow mesenchymal stem cells (BMSC), progenitor cells (PC), peripheral blood stem cells (PBSC), and umbilical cord blood mesenchymal stem cells (UBMSC). A network meta-analysis showed that, in terms of National Institute of Health Stroke Scale (NIHSS) scores, the ranked results of different stem cell transplants were: UBMSC [69.4%] > PBSC 29.2%] > BMSC [0.8%] > PC [0.6%] > BMMNC [0.0%] > CRT [0.0%]. In terms of Modified Rankin Scale (mRS) scores, the ranked results of different stem cell transplants were: BMMNC [66.8%] > PBSC [31.7%] > PC [1.3%] > BMSC [0.2%] > CRT [0%]. In terms of Modified Barthel Index (MBI) scores, the ranked results of different stem cell transplants were: BMMNC [56.3%] > PC [34.2%] > BMSC [9.5%] > CRT [0%]. In terms of Fugl-Meyer Assessment (FMA) scores, the results of the ranking of different stem cell transplants were: BMMNC [79.3%] > BMSC [17.3%] > UBMSC [3.4%] > CRT [0%].

Conclusion

UBMSC had the best efficacy in repairing neurological function in patients with ischemic stroke. BMMNC had the best efficacy in improving motor function and daily living ability in patients with ischemic stroke. BMMNC had a superior overall effect.