文献类型：期刊文献

英文题名：Optimal strategies for umbilical cord mesenchymal stem cell-derived exosomes in acute kidney injury: a network meta-analysis in rat models

作者：Wanyan, Pingping[1];Li, Nenglian[1];Ma, Linna[1];Zhang, Li[1]

第一作者：Wanyan, Pingping

通信作者：Wanyan, PP[1]

机构：[1]Gansu Univ Chinese Med, Dept Pathol & Pathophysiol, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Dept Pathol & Pathophysiol, Lanzhou, Gansu, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：14

外文期刊名：FRONTIERS IN CELL AND DEVELOPMENTAL BIOLOGY

收录：;Scopus(收录号：2-s2.0-105042428334);WOS:【SCI-EXPANDED(收录号:WOS:001762273700001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the Gansu Natural Science Foundation (Grant No. 21JR7RA413) and the Talent Introduction Research Start-up Fund Project of Gansu University of Chinese Medicine (Grant No. 311/31140616).

语种：英文

外文关键词：acute kidney injury; dosing and delivery strategy; exosomes; network meta-analysis; umbilical cord mesenchymal stem cells

摘要：Background Exosomes derived from umbilical cord mesenchymal stem cells (UCMSC-Exos) have emerged as a highly promising cell-free therapeutic strategy for repairing acute kidney injury (AKI). However, preclinical evidence regarding their efficacy and optimal administration strategy remains heterogeneous and has not been systematically synthesized.Methods PubMed, Web of Science, Embase, and Scopus were systematically searched to identify randomized controlled experiments evaluating UCMSC-Exos in rat models of AKI. Conventional meta-analyses were performed to pool effect sizes, and frequentist network meta-analyses were used to compare the relative efficacy and ranking probabilities of different interventions.Results Fourteen studies were included. Conventional meta-analysis showed that, compared with controls, UCMSC-Exos significantly reduced serum creatinine (Scr; SMD = -5.60, 95% CI: -7.61 to -3.60) and blood urea nitrogen (BUN; SMD = -6.33, 95% CI: -8.91 to -3.75), alleviated renal histological injury scores (SMD = -3.62, 95% CI: -4.91 to -2.), and decreased cell apoptosis (SMD = -4.35, 95% CI: -6.06 to -2.64). Network meta-analysis further indicated that, at a fixed dose of 100 mu g, tail vein injection was significantly superior to subcapsular renal injection in reducing Scr (SUCRA: 94.2% vs. 55.8%) and showed a similar trend for BUN. Within each administration route, distinct dose-response patterns were observed. For tail vein injection, there were no significant differences in efficacy among 30 mu g, 100 mu g, and 250 mu g, although 100 mu g showed the most favorable trend. In contrast, subcapsular renal injection exhibited a dose-dependent pattern, with higher doses (200 mu g, 400 mu g) being more effective than the lower 100 mu g dose. Methodological reporting quality was generally inadequate, and potential publication bias was detected; however, the adjusted effect size remained statistically significant (SMD = -2.59).Conclusion UCMSC-Exos effectively improve renal function, histopathology, and cell survival in rat models of AKI. Tail vein injection, particularly at a dose of 100 mu g, may represent the most effective strategy, whereas subcapsular renal injection may require higher doses to achieve adequate efficacy. These conclusions should be interpreted cautiously, and future studies should more rigorously control for and report potential confounders, such as animal sex and AKI induction methods.