Mesenchymal stem cell-derived extracellular vesicles for treatment of chronic kidney disease in preclinical animal models: a meta-analysis

Objective: Evaluate the effectiveness of extracellular vesicles derived from mesenchymal stem cells (MSCs) in the treatment of chronic kidney disease based on meta-analysis. Methods: . We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, Web of Science and other databases on randomized controlled trial (RCT) of oral traditional Chinese patent medicines and simple preparations to improve inflammatory response in patients with diabetes nephropathy. The search time was from the establishment of the database to October 2022. All researchers independently screened and extracted documents for quality evaluation. Data analysis was conducted on documents that met quality standards using Stata 16.0 software and RevMan 5.4. Results: . 12 studies (n=198) satisfied the inclusion criteria.The results demonstrated that the levels of Scr (SMD=-0.38;95%CI=-4.29,-1.87; P <0.00001),BUN (SMD =−3.68, 95%CI=−5.24, −2.13; P <0.00001),and COL-1(SMD=-5.14; 95%CI=-9.32, -0.97; P <0.00001); α-sma SMD=-4.95%, 95%CI=-5.49,-2.50; P <0.00001); TGF-β (SMD=-4.19%, 95%CI=-6.92, -1.46; P =0.003) and the apoptotic cells (SMD=-3.85%, 95%CI=-5.05, -2.65; P ＜0.00001) were significantly decreased in the EV group. Conclusion: The results confirmed that MSCs-EV therapy could improve renal function and delaying kidney fibrosis in preclinical animal CKD model.