Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by immune-mediated platelet destruction and impaired platelet production. Recent evidence suggests a role for gut microbiome dysbiosis in autoimmune diseases, but its association with ITP remains unclear. This systematic review explores the potential link between the gut microbiome and ITP pathophysiology.

Gastric stem cells (GSCs) and chief cells are vital for maintaining gastric epithelial homeostasis. However, under pathological conditions, these cells undergo significant functional changes, contributing to the progression of precancerous lesions of gastric cancer (PLGC). Dysregulation of key signaling pathways such as WNT, NF-κB, and YAP leads to aberrant cellular behaviors, which are implicated in the early stages of gastric carcinogenesis. This study aimed to elucidate the roles of GSCs and chief cells in maintaining gastric epithelial integrity, their contributions to the development of precancerous lesions, and the molecular mechanisms that regulate their behavior during disease progression.

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.

Colorectal cancer ranks as the third most frequently diagnosed cancer globally. Adipokines, including adiponectin and leptin, are believed to play a vital role in the development and progression of tumors. This study aimed to clarify the association between circulating adiponectin and leptin concentrations and the risk of colorectal cancer and adenoma.

Relapsed B-cell acute lymphoblastic leukemia (B-ALL) remains a therapeutic challenge, particularly in children, adolescents, and young adults. Blinatumomab, a bispecific T-cell engager targeting CD19-positive leukemic cells, has emerged as an alternative to conventional chemotherapy in post-induction consolidation. This meta-analysis aimed to evaluate its impact on survival outcomes, relapse rates, and treatment-related toxicities.

Stress urinary incontinence (SUI) is characterized by the involuntary leakage of urine during activities that increase intra-abdominal pressure. The management of SUI encompasses surgical treatments, such as colposuspension and sling procedures, and nonsurgical ones that involve pelvic floor muscle treatment, behavioral therapies, as well as pharmacological interventions. By exploring nonsurgical options initially, individuals have the opportunity to address the root causes of stress urinary incontinence and strengthen pelvic floor muscles. Background/Objectives: This article delves into the conservative measures in managing SUI among women and the options of minimally invasive strategies for SUI, such as the injection of platelet-rich plasma, stem cells, bulking agents, and laser and radiofrequency therapy. Methods: A search of the literature from 2010 until January 2024 was carried out on PubMed, Cochrane Library, and Web of Science research databases. Results: A total of 34 studies on human females assessing the roles of platelet-rich plasma, laser and radiofrequency therapy, bulking agents, and stem cell therapy were included. Conclusions: The shortcoming of most conservative techniques seems to be represented by the temporary effects and the necessity of repeated treatments. To establish effective medical techniques, adopting more standardized procedures and conducting comprehensive randomized controlled trials is imperative.

While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. MSC therapy has shown promise by targeting left ventricular pressure and improving wall thickness, contributing to reductions in HF-related morbidity and mortality rates. This systematic review and meta-analysis bridges a gap in current research through a focused examination of the most recent clinical trials to cohesively assess MSC therapy in HFrEF patients.

Osteoarthritis (OA) is a progressive and chronic disease that can result in the patient's increased pain and loss of function. There might be some potential approaches to improve the recovery with mesenchymal stem cells (MSCs). The efficacy of using MSCs in treatment of OA was found to have a significant impact on the treatment and was focused on improving physical function and psychometric measures of pain. Although various available data and research studies regarding MSCs have shown their potential in clinical use, there is still limited data of MSCs regarding actual long-term safety and efficacy in larger clinical trials. To address these issues and inform future studies, we performed a clinical systematic review of MSC therapy for knee osteoarthritis combined with arthroscopy procedure. Cochrane (2022), EMBASE (2022), MEDLINE (2022) and PubMed (2022) were utilized as research platforms. Using the inclusion criteria, the total viable studies that were used within the systematic review amounts to around 18 studies. Clinically, MSCs treatment on OA have also reported improvements on the target site, such as that of articular cartilage, subchondral bone, and joint-space width. The results were obtained from data results of WOMAC, VAS, KOOS and ICRS, as well as through radiological imaging using MRI. However, there are still limitations that the reviews provide such as heterogeneity complications of MSCs of the studies reviewed, as well as the potential of risk bias assessment during publication. Therefore, future studies will need to address the evaluation of MSCs effect on cartilage regeneration on knee osteoarthritis (OA), improving structural outcomes of the knee, as well as its efficacy during combined treatment methods of arthroscopy.

Peripheral nerve injuries (PNIs) remain a significant clinical problem, producing permanent motor-sensory deficits and diminishing patient's quality of life. Neurotrophic growth factors, a family of biomolecules, support neuronal survival and regeneration. Among them, Brain-Derived Neurotrophic Factor (BDNF) emerged as a key modulator of neurogenesis and neuroregeneration within the peripheral nervous system. This systematic review evaluates and summarises animal-based evidence on BDNF-based therapies used in peripheral nerve injury (PNI). A literature search in PubMed, EMBASE, Scopus, and Web of Science with the latest results from 10th of October 2024 to identify animal-based studies evaluating the effects of BDNF-based therapies used in PNI. Of 785 records, 40 articles met the inclusion criteria, encompassing 1887 rats and 430 mice or rabbits across various injury models. Gathered studies heterogenicity precluded meta-analysis, but most reports showed superior axonal regeneration, myelination, and functional recovery in BDNF-based therapies compared to control groups. The benefits were most significant with multimodal strategies, including multiple neurotrophins and stem cells. Combined therapies involving multiple neurotrophic growth factors, BDNF, and stem cell therapies showed the most significant improvement in functional outcomes and histological parameters of injured nerves. These results suggest that BDNF-based therapies hold promise for effective PNI treatment. GLOSSARY.

To perform a systematic review and meta-analysis of randomized and comparative studies comparing mesenchymal stromal cells other orthobiological injections for patients with knee osteoarthritis.

Study DesignSystematic review and meta-analysis.ObjectivesThe objective of this study was to conduct a systematic review and meta-analysis of the literature regarding the therapeutic effect of embryonic and mesenchymal stem cells on the treatment of traumatic spinal cord injury (SCI) in humans. Primary outcome measures were overall American Spinal Injury Association (ASIA) scores, ASIA motor and sensory scores, urinary and bowel function, pain, and adverse events.MethodsStudies with human patients ages 18-80 years receiving embryonic, induced pluripotent, or mesenchymal stem cells for SCI were included. Study quality was assessed using the Cochrane risk of bias 2 tool and the Newcastle Ottawa scale for randomized and non-randomized studies, respectively. Primary outcomes were overall ASIA grade, ASIA motor scores, ASIA sensory scores, bladder and bowel function, pain, and adverse events.ResultsThirty total studies with 656 patients were included, with 43.3% of patients experiencing improvement in ASIA grade, 49.4% in motor function, and 73.6% in sensory function. Qualitative analysis of bladder and bowel outcomes suggests overall improved sensation and control. No serious adverse events were reported. The most common side effects were mild and resolved within hours to weeks without requiring additional medical treatment.ConclusionsStem cell transplantation for SCI appears to offer moderate improvements in overall ASIA grade, motor, sensory, bladder, and bowel function, accompanied by a relatively mild and transient side effect profile. Further research, particularly high-quality, blinded, randomized controlled trials, is essential to optimize treatment protocols and achieve more consistent and improved clinical outcomes.

Neurological disorders, ranging from common conditions like Alzheimer's disease that is a progressive neurodegenerative disorder and remains the most common cause of dementia worldwide to rare disorders such as Angelman syndrome, impose a significant global health burden. Altered facial expressions are a common symptom across these disorders, potentially serving as a diagnostic indicator. Deep learning algorithms, especially convolutional neural networks (CNNs), have shown promise in detecting these facial expression changes, aiding in diagnosing and monitoring neurological conditions.

The modulation of microglial reactivity has emerged as a potential target for developing ischemic stroke therapies. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) possess immunomodulatory properties that may influence microglial responses following ischemia. However, individual studies assessing this influence have provided limited results. Therefore, we conducted a systematic review and meta-analysis to investigate whether MSC-EVs treatment alters microglial responses in animal and cellular models of ischemic stroke. In accordance with the PRISMA 2020 statement, we searched PubMed, Web of Science, and EMBASE until October 2023 for studies assessing cellular and molecular parameters of microglial reactivity following MSC-EVs treatment in models of ischemic stroke. We estimated treatment effects using a random-effects meta-analysis of standardized mean differences and estimated heterogeneity via the I2 statistic. The risk of bias was assessed using the SYRCLE questionnaire. The search identified 297 studies, 27 of which met the inclusion criteria. In animal models, MSC-EVs reduced the number, surface area, and fluorescence intensity of Iba1+ cells, as well as the number of Iba1+ cells co-expressing the pro-inflammatory markers CD16, CD32, CD85, and iNOS. Conversely, MSC-EVs increased the number of Iba1+ cells co-expressing the anti-inflammatory markers Arg-1 and CD206. In cellular models, we observed decreased concentrations of TNF-α, IL-1β, and IL-6 in the culture medium. Our meta-analysis consolidates the immunomodulatory effects of MSC-EVs on microglial responses to ischemia, underscoring the potential of microglia-specific therapeutics in the development of MSC-EVs-based and regenerative treatments for ischemic stroke.

Knee osteoarthritis (OA) is a degenerative joint disorder with limited non-surgical treatment options. Adipose-derived mesenchymal stem cell (AD-MSC) therapy has emerged as a promising regenerative approach; however, the comparative efficacy and safety of autologous versus allogeneic AD-MSCs remain unclear. This systematic review and network meta-analysis (NMA) evaluated the effectiveness and safety of intra-articular AD-MSCs in adults with Kellgren-Lawrence Grade II-IV knee OA. A comprehensive search identified eight randomized controlled trials that compared high-dose autologous, high-dose allogeneic, and low-dose allogeneic AD-MSCs to placebo or standard care interventions, such as hyaluronic acid, corticosteroids, or physical therapy. The primary outcomes were pain relief, assessed by the Visual Analog Scale (VAS), and functional improvement, measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), at three, six, and 12 months. Treatment rankings were determined using Surface Under the Cumulative Ranking (SUCRA) probabilities. High-dose autologous AD-MSCs ranked highest for pain relief at three, six, and 12 months (VAS SUCRA: 75.99%, 82.27%, 81.65%), while high-dose allogeneic AD-MSCs ranked highest for functional improvement at six and 12 months (WOMAC SUCRA: 74.6%, 71.71%). Low-dose allogeneic AD-MSCs consistently ranked lowest for both outcomes. Adverse event analysis indicated that low-dose allogeneic AD-MSCs had the highest risk of adverse effects (SUCRA: 22.24%), followed by high-dose allogeneic AD-MSCs (26.52%). In contrast, high-dose autologous AD-MSCs ranked safer (SUCRA: 54.08%). Serious adverse events were rare and unrelated to treatment, and consistency testing confirmed no significant inconsistencies in the NMA framework. Overall, high-dose autologous AD-MSCs provided sustained pain relief over 12 months, while high-dose allogeneic AD-MSCs demonstrated superior long-term functional improvement. These findings support a two-phase treatment model in which autologous AD-MSCs offer early and prolonged symptom relief, and allogeneic AD-MSCs assist in long-term joint recovery. Overall, AD-MSC therapy was well tolerated and may represent a viable, personalized, non-surgical knee OA management strategy.

Managing sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack of global consensus and guidelines and the ongoing advancements in management options, a widely accepted treatment algorithm remains absent. This systematic review updates and evaluates the existing evidence on strategies for managing SIJ pain.

Diabetes mellitus (DM) is a grave autoimmune disorder because of no insulin self-generation. Currently, mainly clinical methods exist, serious adverse effects leading to stem cell therapy are considered. The mesenchymal stem cells (MSCs), require high differentiation capacity and are judged as crucial in DM treatment. The meta-analysis aimed to systemically analyze the particular types of MSCs which play a more important role in DM and which DM is treated more effectively.

Facial symptoms of systemic sclerosis (SSc)-such as reduced skin elasticity, fibrosis and microstomy-significantly impact quality of life. In recent years, autologous fat grafting has emerged as a promising treatment for these issues, but determining the optimal timing and techniques for fat injection remains a challenge for surgeons. Our study aimed to perform a systematic review of the available literature to establish a standardised protocol for this procedure. We reviewed all relevant studies published up to 18 August 2023, focusing specifically on diffuse facial scleroderma. In addition to clinical reports, we included articles discussing the pathophysiological mechanisms behind the effects of adipose stem cells. A total of 18 articles were analysed, revealing a range of methods and timelines for the procedure. The volume of fat injected varied from 6 cc for perioral treatment to 72 cc for a full-face approach, with treatment intervals ranging from one session per year to one every 3 months. On average, around 50% of the fat was reabsorbed within 6 months. Adipose stem cells were identified as a key factor in both tissue regeneration and fat resorption rates. This review supports the effectiveness of autologous fat grafting for facial scleroderma, emphasising the role of adipose stem cells. For optimal results, two procedures spaced 3-6 months apart, followed by annual maintenance, are recommended. Consistent fat volumes in different facial areas are essential to achieve longer-lasting outcomes and minimise resorption.

Metformin's topical application has proven to be a therapeutic wound healing dressing via pro-angiogenic, anti-inflammatory, autophagy-promoting, and antibacterial effects. The systematic review article aimed to evaluate the available evidence (from both preclinical and clinical studies), in order to better understand its therapeutic potential in wound care. We performed a systematic literature search in PubMed, Scopus, Web of Science, Embase, and Cochrane databases till January 2025. A total of 26 studies included in final analysis according to inclusion criteria. The majority of preclinical investigations demonstrated accelerated wound healing with characterized of increased wound closure and collagen deposition, elevated pro-angiogenic markers (e.g., VEGF, CD31, and α-SMA), suppression of pro-inflammatory cytokines, and induction of autophagy signaling. Notably, biomaterial-based delivery platform applications such as hydrogels and nanofibers greatly magnified these therapeutic effects. While encouraging results in in-vitro, in-vivo and animal models have been documented, clinical studies remain limited in scope. In fact, this large disparity between preclinical results and limited clinical evidences obviously highlights the urgent need for properly designed human trials to determine safety, efficacy, and best delivery modalities of topical metformin. Collectively, topical metformin is a novel and potentially valuable addition to wound treatment cares, which could be subjected to further clinical study.

Understanding the biology of implant-associated infections is essential in order to provide adequate detection, prevention and therapeutic strategies. Advanced 3D in vitro models offer valuable insights into the complex interactions between cells and bacteria in the presence of implant materials. This review aims to give a comprehensive overview of current 3D in vitro models that mimic implant-associated infections.

Introduction: Hypertrophic and keloid scars are abnormal tissue growth that can be disfiguring, for which the available treatment has not yielded consistent results. Therefore, this study aimed to evaluate the capability of Adipose tissue-derived stem cell (ADSC) therapy in treating these scars. Methods: A literature search was conducted on PubMed, Scopus, Cochrane Library, and Web of Science from inception until July 2022. We included experimental studies that evaluated ADSCs as a therapy for hypertrophic and keloid scars in both in-vivo and in-vitro models. Results: Our findings extracted from 12 included studies demonstrated that ADSCs have a promising potential in reducing collagen deposition, proliferation, and migration rates of fibroblast, decreasing gene/protein expression of scar-related molecules including levels of TGF-β1 and lowering intracellular signal pathway-related molecules of hypertrophic and keloid scars in both models. However, no significant difference (P > .05) was found in the hypertrophic scar in-vitro models in terms of DCN gene expression. Conclusion: Ultimately, the current studies included in this systematic review support the use of ADSCs to alleviate hypertrophic and keloid scars.