Mesenchymal Stem Cells Transplantation in Diabetic Kidney Diseases: A Systematic Review and Meta-analysis

Background: Mesenchymal stem cells (MSCs) therapy shows great promise for diabetic kidney diseases (DKD) patients. Researches have been carried out on this topic in recent years. The main thrust of this paper is to evaluate the therapeutic effects of MSCs on DKD by a meta-analysis and systematically review the mechanism therein. Method: An electronic search of PubMed and U.S National Library of Medicine (NLM) was performed for all articles about the MSCs therapy for DKD without species limitation up to January, 2020. Data were pooled for analysis with Stata SE 12. Result: MSCs-treated group showed great significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months and 6 months. Total hypoglycemic effect was analyzed (SMD=-1.954, 95%CI: -2.389 to -1.519, I²= 85.1%, p＜0.001). Total effects on serum creatinine (SCr), blood urea nitrogen (BUN) were analyzed, suggesting MSCs decreased the SCr and BUN and had an effect on amelioration of impaired renal function (SCr: SMD= -4.838, 95%CI: -6.789 to -2.887, I²= 90.8%, p＜0.001; BUN: SMD= -4.912, 95%CI: -6.402 to -3.422, I²= 89.3 %, p＜0.001). Creatinine clearance rate (CCr) was found decreased in the MSCs-treated group at 2 months. MSCs therapy decreased the excretion of urinary albumin. The fibrosis indicators were detected, and the result showed that transforming growth factor-β, Collagen-I, fibronectin and α-smooth muscle actin were seen decreased significantly in the MSCs-treated group. Conclusion: MSCs might improve animal body weight, glycemic control and pancreas islets function to secrete insulin, and reduced the SCr, BUN, CCr, urinary protein and renal hypertrophy. MSCs can reduce the expression of inflammatory mediators and alleviate renal fibrosis. MSCs therapy is a potential treatment for DKD.