Efficacy of Alveolar Type II Epithelial Cell Transplantation for Pulmonary Fibrosis: A Meta-Analysis

Wanxin  Zhang; Yihua  Wang; Yilun  Du; Ziyuan  Li; Yingwen  Mu; Jiayin  Sun; Zuodong   Liu; Yutong  Guo; Hua  Shao; Yingjun  Guan; Guanqun  Cui; Zhongjun  Du

doi:10.18502/ijph.v52i1.11660

Wanxin Zhang Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Yihua Wang Chemical Institute of Chemical Industry, Xinjiang University of Science and Technology, 841000, Korla, Bayinguoleng Mongolian Autonomous Prefecture, Xinjiang Uygur Autonomous Region, China
Yilun Du Affiliated Hospital of Qinghai University, Xi’ning 810000, Qinghai, China
Ziyuan Li Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Yingwen Mu Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Jiayin Sun Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong
Zuodong Liu Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Yutong Guo Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Hua Shao Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Yingjun Guan Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China
Guanqun Cui Department of Respiratory Medicine, Children's Hospital Affiliated to Shandong Uneiversity, 250022, Ji’nan, Shandong Province, China
Zhongjun Du Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250062, Shandong, China

DOI: https://doi.org/10.18502/ijph.v52i1.11660

Keywords: Alveolar type II epithelial cells; Stem cells; Regenerative medicine; Treatment; Pulmonary fibrosis

Abstract

Background: Cell transplantation is a promising therapeutic strategy for pulmonary fibrosis. In order to clarify the alveolar type II epithelial cell potential utility in the treatment of lung disease, we conducted a meta-analysis, to evaluate alveolar type II epithelial cells in animal models of lung injury and pulmonary fibrosis.

Methods: This review followed the recommendations from the PRISMA statements, Comprehensive retrieval method was used to search Embase, PubMed, Cochrane, Chinese Knowledge Infrastructure, VIP and Wanfang databases. A total of 7 studies and 286 model rats were included. Two researchers independently screened the identified studies, based on inclusion and exclusion criteria. All analyses were conducted using Review Manager V.5.3 software. The combined standard mean difference (SMD) and 95% confidence interval (CI) of data from the included studies were calculated using fixed or random-effects models.

Results: The analysis of three outcome indexes showed that the heterogeneity of the oxygen saturation group was high (I²=85%), the lung weight group (I²=64%) was close to moderate heterogeneity, and the lung hydroxyproline content group (I²=0) was not heterogeneous.

Conclusion: Meta-analysis showed that transplantation of alveolar type II epithelial cells has beneficial effects, and no obvious adverse reactions. Alveolar type II epithelial cell transplantation can significantly reduce the intervention group and lung hydroxyproline content weight, improve the blood oxygen saturation, lung histopathology showed significant improvement in pulmonary fibrosis.