Acute liver failure: A systematic review and network meta-analysis of optimal type of stem cells in animal models

BACKGROUND

The therapeutic effects of various stem cells in acute liver failure (ALF) have been demonstrated in preclinical studies. However, the specific type of stem cells with the highest therapeutic potential has not been determined.

AIM

To validate the efficacy of stem cells in ALF model and to identify the most promising stem cells.

METHODS

A search was conducted on the PubMed, Web of Science, Embase, Scopus, and Cochrane databases from inception to May 3, 2022, and updated on November 16, 2022 to identify relevant studies. Two independent reviewers performed the literature search, identification, screening, quality assessment, and data extraction.

RESULTS

A total of 89 animal studies were included in the analysis. The results of traditional meta-analysis showed that stem cell therapy could significantly reduce the serum levels of alanine aminotransferase [weighted mean difference (WMD) = -181.05 (-191.71, -170.39)], aspartate aminotransferase [WMD = -309.04 (-328.45, -289.63)], tumor necrosis factor-alpha [WMD = -8.75 (-9.93, -7.56)], and interleukin-6 [WMD = -10.43 (-12.11, -8.76)] in animal models of ALF. Further subgroup analysis and network meta-analysis showed that although mesenchymal stem cells are the current research hotspot, the effect of liver stem cells (LSCs) on improving liver function is significantly better than that of the other five types of stem cells. In addition, the ranking results showed that the possibility of LSCs improving liver function ranked first. This fully proves the great therapeutic potential of LSCs, which needs to be paid more attention in the future.

CONCLUSION

LSCs may have a higher therapeutic potential. Further high-quality animal experiments are needed to explore the most effective stem cells for ALF.

Key Words: Acute liver failure, Stem cells, Animal model, Systematic review, Network meta-analysis

Core Tip: Determination of stem cells with the highest therapeutic potential in acute liver failure is crucial for future animal and clinical research. In this pioneer study, we conducted traditional meta-analysis and network meta-analysis to explore the efficacy of stem cells from four aspects: Alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor-alpha and interleukin-6. We found that although mesenchymal stem cells are the current research hotspot, liver stem cells may have higher therapeutic potential and should be the focus of future research. In addition, we point out the problems existing and the direction of improvement in the future through the quality evaluation.

• Citation: Ma JF, Gao JP, Shao ZW. Acute liver failure: A systematic review and network meta-analysis of optimal type of stem cells in animal models. World J Stem Cells 2023; 15(1): 1-15
• URL: https://www.wjgnet.com/1948-0210/full/v15/i1/1.htm
• DOI: https://dx.doi.org/10.4252/wjsc.v15.i1.1