Abstract
Purpose
In this systematic review and meta-analysis, the use of alginate for the repair of the damaged spinal cord was investigated.
Methods
After an extensive search of databases including MEDLINE, SCOPUS, EMBASE and Web of Science, an initial screening was performed based on inclusion and exclusion criteria. The full text of related articles was reviewed and data mining was performed. Data were analyzed by calculating the mean of ratios between treated and untreated groups using STATA software. Subgroup analysis was also performed due to heterogeneity. Articles were subjected to quality control and PRISMA guidelines were followed.
Results
Twelve studies and 17 experiments were included in the study. After SCI, alginate hydrogel had a moderate effect on motor function recovery (SMD = 0.64; 95% CI 0.28–1.00; p < 0.0001) and alginate scaffolds loaded with drugs, growth factors, or cells on the SCI group compared with untreated SCI animals showed has a strong effect in the treatment of SCI (SMD = 2.82; 95% CI 1.49–4.145; p < 0.0001). Treatment with drug/cell in combination with alginate was more strongly significant compared to the groups treated with drug/cell alone (SMD = 4.55; 95% CI 1.42–7.69; p < 0.0001). Alginate alone or in combination therapy when used as an implant, had a more significant effect than injection.
Conclusion
These findings suggest that alginate is an efficient scaffold for functional recovery and even a much better scaffold for drug/cell delivery after SCI.
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Availability of data and material
The data that support the findings of this study are available from the corresponding author (FR) on request.
Code availability
Not Applicable.
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Acknowledgements
We appreciate Dr. Mahmoud Yousefifard for his help in designing of search strategy.
Funding
FR was supported by the IRAN University of Medical Sciences, Grant 99-1-32-18492.
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FR conceived of the presented idea. AJD, HN, ZB, MR and BR; first and second screening of articles, data gathering, providing Table 1. FR developed the search strategies and performed meta-analysis. MH, AJD, FR, ZB and MR wrote the manuscript with support from FR. All authors discussed the results and contributed to the final manuscript.
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MRH declares the following potential conflicts of interest. Scientific Advisory Boards: Transdermal Cap Inc, Cleveland, OH; BeWell Global Inc, Wan Chai, Hong Kong; Hologenix Inc. Santa Monica, CA; LumiThera Inc, Poulsbo, WA; Vielight, Toronto, Canada; Bright Photomedicine, Sao Paulo, Brazil; Quantum Dynamics LLC, Cambridge, MA; Global Photon Inc, Bee Cave, TX; Medical Coherence, Boston MA; NeuroThera, Newark DE; JOOVV Inc, Minneapolis-St. Paul MN; AIRx Medical, Pleasanton CA; FIR Industries, Inc. Ramsey, NJ; UVLRx Therapeutics, Oldsmar, FL; Ultralux UV Inc, Lansing MI; Illumiheal & Petthera, Shoreline, WA; MB Lasertherapy, Houston, TX; ARRC LED, San Clemente, CA; Varuna Biomedical Corp. Incline Village, NV; Niraxx Light Therapeutics, Inc, Boston, MA. Consulting; Lexington Int, Boca Raton, FL; USHIO Corp, Japan; Merck KGaA, Darmstadt, Germany; Philips Electronics Nederland B.V. Eindhoven, Netherlands; Johnson & Johnson Inc, Philadelphia, PA; Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany. Stockholdings: Global Photon Inc, Bee Cave, TX; Mitonix, Newark, DE. Other authors declare no conflict of interest.
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Jahandideh, A., Noori, H., Rahimi, B. et al. Alginate scaffolds improve functional recovery after spinal cord injury. Eur J Trauma Emerg Surg 48, 1711–1721 (2022). https://doi.org/10.1007/s00068-021-01760-7
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DOI: https://doi.org/10.1007/s00068-021-01760-7