DSEN Abstract
The impact of donor-recipient sex and age on the comparative efficacy and safety of human mesenchymal stromal/stem cell allogeneic treatments for autoimmune conditions: A systematic review

Summary and key messages

This systematic review aimed to examine how donor-recipient differences on age and sex impact MSC treatments for autoimmune diseases.
Findings are mainly based on 18 randomized and 13 non-randomized controlled trials.

The current research on MSC treatments mainly focuses on a wide range of autoimmune diseases.
The absence of reported donor-recipient data is a research limitation in this area.
Bone marrow is the main source of MSCs.
MSC therapy may be effective and safe for patients with difficult-to-treat autoimmune diseases.
Large-scale prospective controlled trials high quality, long-term data with consideration for donor-recipient pairings are needed to evaluate MSC treatment efficacy and safety further.

Authors: DSEN MAGIC

For more information, please contact:
George A. Wells
gawells@ottawaheart.ca

What is the issue?

Autoimmune diseases (ADs) affect about 8 to 10% of people in Western countries, and the number of cases continues to rise.
Conventional treatments can help manage symptoms, but they do not cure these conditions.
Mesenchymal stem cell (MSC) therapy has shown encouraging early results with good safety in some autoimmune diseases.
In allogeneic (cells are donated from another person and not the patient themselves) MSC treatment, differences between donors and recipients may influence how well the treatment works.

What was the aim of the study?

To identify the characteristics of MSC interventions, donors and recipients.
To evaluate the efficacy and safety profile of allogeneic MSCs for patients with ADs.
To examine how donor-recipient differences impact on the outcomes of MSC therapies.

How was the study conducted?

A systematic review was performed. We searched 6 bibliographic databases and grey literature up to August 2023.
Any records that described MSCs therapy for ADs in randomized or non-randomized controlled trials, single arm trials and animal model studies were considered eligible.
Two reviewers independently screened literature. One reviewer extracted data and evaluated the risk of bias, and another reviewer verified the data. Discrepancies were discussed by two reviewers or resolved by a third party.
Meta-analyses were conducted where feasible and appropriate, else, descriptive and tabular summaries were compiled to synthesize the research findings based on the comparative clinical studies identified.

What did the study find?

From 6,261 citations identified, we included 281 unique studies (18 randomized and 14 non-randomized controlled trials, 86 single arm trials and 163 animal studies).
Graft-versus-host disease (GVHD), inflammatory bowel disease (IBD), type 1 diabetes (T1D), systemic lupus erythematosus, and rheumatoid arthritis were most frequently reported indications considered in the included studies (80%).
Reporting of donor-recipient combination data on age and sex was extremely limited.
MSCs were typically from bone marrow, but also umbilical cord, and adipose tissue.
MSC treatment showed potential for treatment response, remission, and healing in steroid refractory-acute GVHD, complex and refractory fistula care in IBD, and for recent-onset T1D, with rare serious treatment-related side effects.

Publication pending