Prospect of Mesenchymal Stem Cells in Enhancing Nerve Regeneration in Brachial Plexus Injury in Animals: A Systematic Review

Document Type : SYSTEMATIC REVIEW

Authors

1 Department of Orthopaedic and Traumatology Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

2 Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

Abstract

Objectives: Brachial plexus injuries (BPI), although rare, often results in significant morbidity. Stem cell was thought
to be one of BPI treatment modalities because of their nerve-forming regeneration potential. Although there is a 
possibility for the use of mesenchymal stem cells as one of BPI treatment, it is still limited on animal studies. 
Therefore, this systematic review aimed to analyze the role of mesenchymal stem cells in nerve regeneration in 
animal models of brachial plexus injury.
Method: This study is a systematic review with PROSPERO registration number CRD4202128321. Literature 
searching was conducted using keywords experimental, animal, brachial plexus injury, mesenchymal stem cell 
implantation, clinical outcomes, electrophysiological outcomes, and histologic outcomes. Searches were performed 
in the PubMed, Scopus, and ScienceDirect databases. The risk of bias was assessed using SYRCLE's risk of bias 
tool for animal studies. The data obtained were described and in-depth analysis was performed.
Result: Four studies were included in this study involving 183 animals from different species those are rats and 
rabbits. There was an increase in muscle weight and shortened initial onset time of muscle contraction in the group 
treated with stem cells. Electrophysiological results showed that mesenchymal stem cells exhibited higher 
(Compound muscle action potential) CMAP amplitude and shorter CMAP latency than control but not better than 
autograft. Histological outcomes showed an increase in axon density, axon number, and the formation of 
connections between nerve cells and target muscles.
Conclusion: Mesenchymal stem cell implantation to animals with brachial plexus injury showed its ability to 
regenerate nerve cells as evidenced by clinical, electrophysiological, and histopathological results. However, this 
systematic study involved experimental animals from various species so that the results cannot be uniformed, and 
conclusion should be drawn cautiously.
 Level of evidence: N/A

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 12, Issue 3
March 2024
Pages 149-158

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History

  • Receive Date: 29 September 2022
  • Revise Date: 15 January 2024
  • Accept Date: 14 January 2024

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