【摘要】 背景:干细胞是一种治疗慢性颞叶癫痫的新方法,且已广泛用于治疗各种癫痫动物模型,但各个实验研究中的疗效评价并不一致。目的:系统评价干细胞治疗慢性颞叶癫痫动物模型的有效性,为临床治疗提供实验依据和新思路。方法:计算机检索PubMed、Web of Science、EMBASE、中国期刊全文数据库(CNKI)、中国学术期刊数据库(万方),纳入国内外已发表的干细胞治疗慢性颞叶癫痫的动物实验,检索年限自各数据库建库至2018年5月。由2名研究者独立提取文献资料、进行文献质量评价,并采用CERQual工具对证据质量进行评估。结果与结论:最终纳入8篇动物实验,包括284个慢性颞叶癫痫动物。纳入研究之间存在较大的异质性,则进行定性系统评价。干细胞治疗使慢性颞叶癫痫动物在癫痫发作频率及持续时间方面有一定的改善,能促进大部分癫痫动物的恢复,其他研究指标包括对动物学习记忆功能的影响、干细胞的迁移、分化及融合,但由于纳入研究的实验设计缺乏严谨性、结果特征存在差异、证据质量不足等方面的局限性,尚不能确定干细胞治疗的确切疗效。因此,在临床试验施行之前,有必要进行高质量的临床前研究进一步评估干细胞移植对慢性颞叶癫痫的疗效及其向临床转化的可行性,以降低其结果向临床转化时的风险。更多还原

【Abstract】 BACKGROUND: Stem cell therapy has emerged as a novel treatment for chronic temporal lobe epilepsy that has been widely used in various animal models of epilepsy. However, there is yet no consensus in the therapeutic effect in existing experimental studies. OBJECTIVE: To systemically evaluate the therapeutic efficacy of stem cell therapy in animal models of chronic temporal lobe epilepsy, providing experimental evidence and new ideas for further clinical trials. METHODS: A systematic search of CNKI, WanFang, PubMed, Embase and Web of Science was performed for animal studies related to stem cell therapy for chronic temporal lobe epilepsy published from inception to May 2018. Two reviewers independently extracted data, assessed methodological quality and evaluated evidence quality by using CERQual tool. RESULTS AND CONCLUSION: Eight animal studies were eligible for inclusion, including 284 animals suffering chronic temporal lobe epilepsy. Between-study heterogeneity was substantial, so a qualitative description was performed. Stem cell therapy has some improvement in the seizure frequency and duration of chronic temporal lobe epilepsy in animals, which can promote the recovery from epilepsy in most animals. Other outcomes include memory and learning, stem cell migration, differentiation and integration. The exact efficacy of stem cells cannot be determined due to the lack of rigor, characterization, and evidence quality. We therefore do not have absolute confidence to recommend the clinical use of stem cell therapy for chronic temporal lobe epilepsy. Thus, it is necessary to conduct high-quality preclinical studies to further evaluate the efficacy of stem cell transplantation for chronic temporal lobe epilepsy and its clinical conversion risk before implementation of clinical trials.更多还原