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Rongen JJ, Hannink G, van Tienen TG, van Luijk J, Hooijmans CR. The protective effect of meniscus allograft transplantation on articular cartilage: a systematic review of animal studies. Osteoarthritis Cartilage 2015; 23:1242-53. [PMID: 25960117 DOI: 10.1016/j.joca.2015.04.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/07/2015] [Accepted: 04/29/2015] [Indexed: 02/02/2023]
Abstract
Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy.
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Affiliation(s)
- J J Rongen
- Radboud University Medical Center, Orthopaedic Research Lab, Nijmegen, The Netherlands.
| | - G Hannink
- Radboud University Medical Center, Orthopaedic Research Lab, Nijmegen, The Netherlands.
| | - T G van Tienen
- Radboud University Medical Center, Orthopaedic Research Lab, Nijmegen, The Netherlands; Kliniek Viasana, Mill, The Netherlands.
| | - J van Luijk
- SYRCLE at Central Animal Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - C R Hooijmans
- SYRCLE at Central Animal Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands.
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Yin B, Xu Y, Wei R, Luo B. Ginkgo biloba on focal cerebral ischemia: a systematic review and meta-analysis. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2015; 42:769-83. [PMID: 25004874 DOI: 10.1142/s0192415x14500499] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Gingko biloba extract (EGB) has been used in traditional medicines for centuries, and although its application to cerebral ischemia has been of great interest in recent years, high quality evidence-based clinical trials have not been carried out. This systematic review and meta-analysis aimed to examine the neuroprotective effect of EGB on focal cerebral ischemia in animal models. A systematic literature search was performed using five databases spanning January 1980-July 2013. The outcome was assessed using the effect size, which was based on infarct size and/or neurological score. A total of 42 studies with 1,232 experimental animals matched our inclusion criteria. The results revealed that EGB improved the effect size by 34% compared to the control group. The animal species, the method and time to measure outcome, and the route and dosage of EGB administration affected the variability of the effect size. Mechanisms of EGB neuroprotection were reported as anti-apoptotic, anti-oxidative, and anti-inflammatory. In conclusion, EGB exerts a significant protective effect on experimental focal cerebral ischemia. However, possible experimental bias should be taken into account in future clinical studies.
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Affiliation(s)
- Bo Yin
- Brain Medical Center, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China , Department of Neurology, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
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Li HQ, Li JH, Liu AJ, Ye MY, Zheng GQ. GV20-based acupuncture for animal models of acute intracerebral haemorrhage: a preclinical systematic review and meta-analysis. Acupunct Med 2014; 32:495-502. [PMID: 25341497 DOI: 10.1136/acupmed-2014-010546] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Spontaneous intracerebral haemorrhage (ICH) is the most devastating subtype of stroke, but there is currently no evidence-based treatment strategy. Acupuncture is a well-known traditional Chinese therapy for stroke-induced disability, and GV20 is the commonly used acupuncture point. OBJECTIVE To evaluate the efficacy of GV20-based acupuncture in animal models of acute ICH. METHODS Studies of GV20-based acupuncture in animal models of acute ICH were identified from six databases up to July 2013. Study quality for each included article was evaluated according to the CAMARADES 10-item checklist. Outcome measures were neurological deficit scores and brain water content. All the data were analysed using RevMan V.5.1 software. RESULTS Nineteen studies were identified describing procedures involving 1628 animals. The quality score of the studies ranged from 3 to 6, with a mean of 4.6. The global estimate of the effect of GV20-based acupuncture was 0.19 (95% CI 0.13 to 0.25, p<0.001) SDs improvement in outcome compared with controls. In subgroup analyses, size of effect was higher where the outcome was measured as the neurological deficit score than the brain water content or both (p<0.001). CONCLUSIONS These findings show the possible efficacy of GV20-based acupuncture in animal models of acute ICH, suggesting it as a candidate therapy for acute ICH.
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Affiliation(s)
- Hui-qin Li
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ji-huang Li
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ai-ju Liu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mai-yun Ye
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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McCann SK, Irvine C, Mead GE, Sena ES, Currie GL, Egan KE, Macleod MR, Howells DW. Efficacy of antidepressants in animal models of ischemic stroke: a systematic review and meta-analysis. Stroke 2014; 45:3055-63. [PMID: 25184357 DOI: 10.1161/strokeaha.114.006304] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE Poststroke depression is a prevalent complication of stroke with unclear pathogenesis. The benefits of antidepressants in this context and their effects on stroke recovery other than effects on mood are not clearly defined, with some studies suggesting efficacy in improving functional outcome in both depressed and nondepressed stroke patients. We have analyzed the preclinical animal data on antidepressant treatment in focal cerebral ischemia, modeled±depression, to help inform clinical trial design. METHODS We performed a systematic review and meta-analysis of data from experiments testing the efficacy of antidepressants versus no treatment to reduce infarct volume or improve neurobehavioral or neurogenesis outcomes in animal models of stroke. We used random-effects metaregression to test the impact of study quality and design characteristics and used trim and fill to assess publication bias. RESULTS We identified 44 publications describing the effects of 22 antidepressant drugs. The median quality checklist score was 5 of a possible 10 (interquartile range, 4-7). Overall, antidepressants reduced infarct volume by 27.3% (95% confidence interval, 20.7%-33.8%) and improved neurobehavioral outcomes by 53.7% (46.4%-61.1%). There was little evidence for an effect of selective serotonin reuptake inhibitors on infarct volume. For neurobehavioral outcomes there was evidence of publication bias. Selective serotonin reuptake inhibitors were the most frequently studied antidepressant subtype and improved neurobehavioral outcome by 51.8% (38.6%-64.9%) and increased neurogenesis by 2.2 SD (1.3-3.0). CONCLUSIONS In line with current clinical data and despite some limitations, antidepressant treatments seem to improve infarct volume and neurobehavioral outcome in animal models of ischemic stroke.
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Affiliation(s)
- Sarah K McCann
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Cadi Irvine
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Gillian E Mead
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Emily S Sena
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Gillian L Currie
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Kieren E Egan
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Malcolm R Macleod
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M).
| | - David W Howells
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
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Abstract
Diverse preconditioning (PC) stimuli protect against a wide variety of neuronal insults in animal models, engendering enthusiasm that PC could be used to protect the brain clinically. Candidate clinical applications include cardiac and vascular surgery, after subarachnoid hemorrhage, and prior to conditions in which acute neuronal injury is anticipated. However, disappointments in clinical validation of multiple neuroprotectants suggest potential problems translating animal data into successful human therapies. Thus, despite strong promise of preclinical PC studies, caution should be maintained in translating these findings into clinical applications. The Stroke Therapy Academic Industry Roundtable (STAIR) working group and the National institute of Neurological Diseases and Stroke (NINDS) proposed working guidelines to improve the utility of preclinical studies that form the foundation of therapies for neurological disease. Here, we review the applicability of these consensus criteria to preconditioning studies and discuss additional considerations for PC studies. We propose that special attention should be paid to several areas, including 1) safety and dosage of PC treatments; 2) meticulously matching preclinical modeling to the human condition to be tested; and 3) timing of both the initiation and discontinuation of the PC stimulus relative to injury ictus.
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Affiliation(s)
- Michael M Wang
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA ; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA ; Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan USA
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Peng W, Xing Z, Yang J, Wang Y, Wang W, Huang W. The efficacy of erythropoietin in treating experimental traumatic brain injury: a systematic review of controlled trials in animal models. J Neurosurg 2014; 121:653-64. [PMID: 25036201 DOI: 10.3171/2014.6.jns132577] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECT Erythropoietin (EPO) shows promise as a neuroprotective agent in animal models of traumatic brain injury (TBI). However, clinical trials of the efficacy of EPO treatment in patients with TBI yield conflicting results. The authors conducted a systematic review and meta-analysis to assess the effect of EPO in experimental animal models of TBI, the goal being to inform the design of future clinical trials. METHODS The authors identified eligible studies by searching PubMed, Web of Science, MEDLINE, Embase, and Google Scholar in October 2013. Data were pooled using the random-effects model, and results were reported in terms of standardized mean difference. Statistical heterogeneity was examined using both I(2) and chi-square tests, and the presence of small study effects was investigated with funnel plots and Egger tests. In-depth analyses were performed for lesion volume and neurobehavioral outcome, and the studies' methodological quality was also evaluated. RESULTS Of a total of 290 studies, 13 found an effect of EPO on lesion volume and neurobehavioral outcome. Overall, the methodological quality of the studies was poor, and there was evidence of statistical heterogeneity among the publications as well as small-study effects. However, in-depth analyses showed statistically significant findings in favor of a beneficial effect of EPO after TBI. CONCLUSIONS Despite limitations of this systematic review that may have influenced the findings, the authors conclude that EPO might be beneficial in treating experimental TBI in terms of reducing lesion volume and improving neurobehavioral outcome. However, this review also indicates that more well-designed and well-reported animal studies are needed.
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Affiliation(s)
- Weijun Peng
- Institute of Integrated Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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57
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Antonic A, Dottori M, Leung J, Sidon K, Batchelor PE, Wilson W, Macleod MR, Howells DW. Hypothermia protects human neurons. Int J Stroke 2014; 9:544-52. [PMID: 24393199 PMCID: PMC4235397 DOI: 10.1111/ijs.12224] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 10/14/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Hypothermia provides neuroprotection after cardiac arrest, hypoxic-ischemic encephalopathy, and in animal models of ischemic stroke. However, as drug development for stroke has been beset by translational failure, we sought additional evidence that hypothermia protects human neurons against ischemic injury. METHODS Human embryonic stem cells were cultured and differentiated to provide a source of neurons expressing β III tubulin, microtubule-associated protein 2, and the Neuronal Nuclei antigen. Oxygen deprivation, oxygen-glucose deprivation, and H2 O2 -induced oxidative stress were used to induce relevant injury. RESULTS Hypothermia to 33°C protected these human neurons against H2 O2 -induced oxidative stress reducing lactate dehydrogenase release and Terminal deoxynucleotidyl transferase dUTP nick end labeling-staining by 53% (P ≤ 0·0001; 95% confidence interval 34·8-71·04) and 42% (P ≤ 0·0001; 95% confidence interval 27·5-56·6), respectively, after 24 h in culture. Hypothermia provided similar protection against oxygen-glucose deprivation (42%, P ≤ 0·001, 95% confidence interval 18·3-71·3 and 26%, P ≤ 0·001; 95% confidence interval 12·4-52·2, respectively) but provided no protection against oxygen deprivation alone. Protection (21%) persisted against H2 O2 -induced oxidative stress even when hypothermia was initiated six-hours after onset of injury (P ≤ 0·05; 95% confidence interval 0·57-43·1). CONCLUSION We conclude that hypothermia protects stem cell-derived human neurons against insults relevant to stroke over a clinically relevant time frame. Protection against H2 O2 -induced injury and combined oxygen and glucose deprivation but not against oxygen deprivation alone suggests an interaction in which protection benefits from reduction in available glucose under some but not all circumstances.
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Affiliation(s)
- Ana Antonic
- Florey Institute of Neuroscience and Mental HealthHeidelberg, Vic, Australia
- Department of Medicine, University of MelbourneHeidelberg, Vic, Australia
| | - Mirella Dottori
- Centre for Neuroscience Research, Department of Anatomy and Neuroscience, University of MelbourneMelbourne, Vic, Australia
| | - Jessie Leung
- Centre for Neuroscience Research, Department of Anatomy and Neuroscience, University of MelbourneMelbourne, Vic, Australia
| | - Kate Sidon
- Florey Institute of Neuroscience and Mental HealthHeidelberg, Vic, Australia
- Department of Medicine, University of MelbourneHeidelberg, Vic, Australia
| | - Peter E Batchelor
- Department of Medicine, University of MelbourneHeidelberg, Vic, Australia
| | - William Wilson
- CSIRO Mathematics, Informatics and Statistics, Riverside Life Sciences PrecinctNorth Ryde, NSW, Australia
| | - Malcolm R Macleod
- Department of Clinical Neurosciences, Western General Hospital, University of EdinburghEdinburgh, UK
| | - David W Howells
- Florey Institute of Neuroscience and Mental HealthHeidelberg, Vic, Australia
- Department of Medicine, University of MelbourneHeidelberg, Vic, Australia
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The need for randomization in animal trials: an overview of systematic reviews. PLoS One 2014; 9:e98856. [PMID: 24906117 PMCID: PMC4048216 DOI: 10.1371/journal.pone.0098856] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/07/2014] [Indexed: 12/31/2022] Open
Abstract
Background and Objectives Randomization, allocation concealment, and blind outcome assessment have been shown to reduce bias in human studies. Authors from the Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies (CAMARADES) collaboration recently found that these features protect against bias in animal stroke studies. We extended the scope the work from CAMARADES to include investigations of treatments for any condition. Methods We conducted an overview of systematic reviews. We searched Medline and Embase for systematic reviews of animal studies testing any intervention (against any control) and we included any disease area and outcome. We included reviews comparing randomized versus not randomized (but otherwise controlled), concealed versus unconcealed treatment allocation, or blinded versus unblinded outcome assessment. Results Thirty-one systematic reviews met our inclusion criteria: 20 investigated treatments for experimental stroke, 4 reviews investigated treatments for spinal cord diseases, while 1 review each investigated treatments for bone cancer, intracerebral hemorrhage, glioma, multiple sclerosis, Parkinson's disease, and treatments used in emergency medicine. In our sample 29% of studies reported randomization, 15% of studies reported allocation concealment, and 35% of studies reported blinded outcome assessment. We pooled the results in a meta-analysis, and in our primary analysis found that failure to randomize significantly increased effect sizes, whereas allocation concealment and blinding did not. In our secondary analyses we found that randomization, allocation concealment, and blinding reduced effect sizes, especially where outcomes were subjective. Conclusions Our study demonstrates the need for randomization, allocation concealment, and blind outcome assessment in animal research across a wide range of outcomes and disease areas. Since human studies are often justified based on results from animal studies, our results suggest that unduly biased animal studies should not be allowed to constitute part of the rationale for human trials.
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Systematic review and meta-analysis of the bone protective effect of phytoestrogens on osteoporosis in ovariectomized rats. Nutr Res 2014; 34:467-77. [DOI: 10.1016/j.nutres.2014.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/08/2014] [Accepted: 05/12/2014] [Indexed: 01/08/2023]
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Currie GL, Sena ES, Fallon MT, Macleod MR, Colvin LA. Using Animal Models to Understand Cancer Pain in Humans. Curr Pain Headache Rep 2014; 18:423. [DOI: 10.1007/s11916-014-0423-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Vu Q, Xie K, Eckert M, Zhao W, Cramer SC. Meta-analysis of preclinical studies of mesenchymal stromal cells for ischemic stroke. Neurology 2014; 82:1277-86. [PMID: 24610327 DOI: 10.1212/wnl.0000000000000278] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To evaluate the quality of preclinical evidence for mesenchymal stromal cell (MSC) treatment of ischemic stroke, determine effect size of MSC therapy, and identify clinical measures that correlate with differences in MSC effects. METHODS A literature search identified studies of MSCs in animal models of cerebral ischemia. For each, a Quality Score was derived, and effect size of MSCs was determined for the most common behavioral and histologic endpoints. RESULTS Of 46 studies, 44 reported that MSCs significantly improved outcome. The median Quality Score was 5.5 (of 10). The median effect size was 1.78 for modified Neurological Severity Score, 1.73 for the adhesive removal test, 1.02 for the rotarod test, and 0.93 for infarct volume reduction. Quality Score correlated significantly and positively with effect size for the modified Neurological Severity Score. Effect sizes varied significantly with clinical measures such as administration route (intracerebral > intra-arterial > IV, although effect size for IV was nonetheless very large at 1.55) and species receiving MSCs (primate > rat > mouse). Because many MSC mechanisms are restorative, analyses were repeated examining only the 36 preclinical studies administering MSCs ≥ 24 hours poststroke; results were overall very similar. CONCLUSIONS In preclinical studies, MSCs have consistently improved multiple outcome measures, with very large effect sizes. Results were robust across species studied, administration route, species of MSC origin, timing, degree of immunogenicity, and dose, and in the presence of comorbidities. In contrast to meta-analyses of preclinical data for other stroke therapies, higher-quality MSC preclinical studies were associated with larger behavioral gains. These findings support the utility of further studies to translate MSCs in the treatment of ischemic stroke in humans.
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Affiliation(s)
- Quynh Vu
- From the Departments of Neurology and Anatomy & Neurobiology (Q.V., K.X., S.C.C.), Pharmaceutical Sciences, Biomedical Engineering, and Chao Family Comprehensive Cancer Center (M.E., W.Z.), and Sue and Bill Gross Stem Cell Research Center (Q.V., K.X., M.E., W.Z., S.C.C.), University of California, Irvine
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Egan KJ, Janssen H, Sena ES, Longley L, Speare S, Howells DW, Spratt NJ, Macleod MR, Mead GE, Bernhardt J. Exercise reduces infarct volume and facilitates neurobehavioral recovery: results from a systematic review and meta-analysis of exercise in experimental models of focal ischemia. Neurorehabil Neural Repair 2014; 28:800-12. [PMID: 24553105 DOI: 10.1177/1545968314521694] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Regular exercise reduces the risk of a first-ever stroke and is associated with smaller infarcts. Although evidence has suggested that therapeutic exercise following stroke is beneficial, we do not yet know whether exercise reduces stroke severity and improves functional recovery. The mechanisms underlying any benefit remain unclear. OBJECTIVE To conduct a systematic review and meta-analysis of studies testing exercise in animal models of ischemic stroke where outcomes were measured as infarct volume, neurobehavioral score, neurogenesis, or a combination of these. We also sought evidence of publication bias. METHODS We searched 3 online databases for publications reporting the use of exercise in focal cerebral ischemia. We used DerSimonian and Laird normalized random-effects meta-analysis and meta-regression to determine the impact of study quality and design on the efficacy of exercise. RESULTS. Overall, exercise reduced infarct volume by 25.2% (95% confidence interval [CI] = 19.0%-31.3%; 65 experiments and 986 animals) and improved neurobehavioral score by 38.2% (95% CI = 29.1%-47.3%; 42 experiments; n = 771). For both outcomes, larger effects were seen when exercise preceded ischemia rather than came after it. For neurobehavioral scores, we found evidence of publication bias. Reported study quality was moderate (median score 5/10). Both model-specific (e.g., type of ischemia) and exercise-specific characteristics influenced reported outcome. CONCLUSION. Exercise, either before or after ischemia, reduced infarct volume and improved neurobehavioral score. However, overall estimates of efficacy were higher in studies at risk of bias, and for neurobehavioral outcomes, there was evidence of a substantial publication bias.
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Affiliation(s)
| | | | - Emily S Sena
- University of Edinburgh, UK Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | | | - Sally Speare
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - David W Howells
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | | | | | | | - Julie Bernhardt
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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63
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A systematic review and meta-analysis of Baihui (GV20)-based scalp acupuncture in experimental ischemic stroke. Sci Rep 2014; 4:3981. [PMID: 24496233 PMCID: PMC5379241 DOI: 10.1038/srep03981] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/15/2014] [Indexed: 11/08/2022] Open
Abstract
Acupuncture for stroke has been used in China for over 2,000 years and nowadays is increasingly practiced elsewhere in the world. However, previous studies had conflicting findings on the results of acupuncture. Here, we conducted a systematic review and meta-analysis to assess the current evidence for the effect of Baihui (GV20)-based scalp acupuncture in animal models of focal cerebral ischemia. Six databases from the inception of each database up to June 2013 were electronically searched. Primary outcomes were infarct size and neurobehavioral outcome. Ultimately, 54 studies involving 1816 animals were identified describing procedures. Meta-analysis results showed that twelve studies reported significant effects of Baihui (GV20)-based scalp acupuncture for improving infarct volume compared with middle cerebral artery occlusion group (P < 0.01), and thirty-two studies reported significant effects of Baihui (GV20)-based scalp acupuncture for improving the neurological function score when compared with the control group (P < 0.01). In conclusion, Baihui (GV20)-based scalp acupuncture could improve infarct volume and neurological function score and exert potential neuroprotective role in experimental ischemic stroke.
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Krauth D, Anglemyer A, Philipps R, Bero L. Nonindustry-sponsored preclinical studies on statins yield greater efficacy estimates than industry-sponsored studies: a meta-analysis. PLoS Biol 2014; 12:e1001770. [PMID: 24465178 PMCID: PMC3897361 DOI: 10.1371/journal.pbio.1001770] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/09/2013] [Indexed: 11/18/2022] Open
Abstract
This study by Lisa Bero and colleagues uses published preclinical statin research to show that nonindustry-funded animal studies yield more efficacious drug results than do industry-funded ones. Industry-sponsored clinical drug studies are associated with publication of outcomes that favor the sponsor, even when controlling for potential bias in the methods used. However, the influence of sponsorship bias has not been examined in preclinical animal studies. We performed a meta-analysis of preclinical statin studies to determine whether industry sponsorship is associated with either increased effect sizes of efficacy outcomes and/or risks of bias in a cohort of published preclinical statin studies. We searched Medline (January 1966–April 2012) and identified 63 studies evaluating the effects of statins on atherosclerosis outcomes in animals. Two coders independently extracted study design criteria aimed at reducing bias, results for all relevant outcomes, sponsorship source, and investigator financial ties. The I2 statistic was used to examine heterogeneity. We calculated the standardized mean difference (SMD) for each outcome and pooled data across studies to estimate the pooled average SMD using random effects models. In a priori subgroup analyses, we assessed statin efficacy by outcome measured, sponsorship source, presence or absence of financial conflict information, use of an optimal time window for outcome assessment, accounting for all animals, inclusion criteria, blinding, and randomization. The effect of statins was significantly larger for studies sponsored by nonindustry sources (−1.99; 95% CI −2.68, −1.31) versus studies sponsored by industry (−0.73; 95% CI −1.00, −0.47) (p value<0.001). Statin efficacy did not differ by disclosure of financial conflict information, use of an optimal time window for outcome assessment, accounting for all animals, inclusion criteria, blinding, and randomization. Possible reasons for the differences between nonindustry- and industry-sponsored studies, such as selective reporting of outcomes, require further study. Industry-sponsored clinical drug studies are associated with publication of outcomes that favor the sponsor, even when controlling for potential bias in the methods used. However, the influence of sponsorship bias has not been examined in preclinical animal studies. We performed a meta-analysis to identify whether industry sponsorship is associated with increased risks of bias or effect sizes of outcomes in a cohort of published preclinical studies of the effects of statins on outcomes related to atherosclerosis. We found that in contrast to clinical studies, the effect of statins was significantly larger for studies sponsored by nonindustry sources versus studies sponsored by industry. Furthermore, statin efficacy did not differ with respect to disclosure of financial conflict information, use of an optimal time window for outcome assessment, accounting for all animals, inclusion criteria, blinding, and randomization. Possible reasons for the differences between nonindustry- and industry-sponsored studies, such as selective outcome reporting, require further study. Overall, our findings provide empirical evidence regarding the impact of funding and other methodological criteria on research outcomes.
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Affiliation(s)
- David Krauth
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
| | - Andrew Anglemyer
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
| | - Rose Philipps
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
| | - Lisa Bero
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
- Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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Schmidt A, Wellmann J, Schilling M, Strecker JK, Sommer C, Schäbitz WR, Diederich K, Minnerup J. Meta-analysis of the Efficacy of Different Training Strategies in Animal Models of Ischemic Stroke. Stroke 2014; 45:239-47. [DOI: 10.1161/strokeaha.113.002048] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Antje Schmidt
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jürgen Wellmann
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Matthias Schilling
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jan-Kolja Strecker
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Clemens Sommer
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Wolf-Rüdiger Schäbitz
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Kai Diederich
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jens Minnerup
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
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Bink DI, Ritz K, Aronica E, van der Weerd L, Daemen MJAP. Mouse models to study the effect of cardiovascular risk factors on brain structure and cognition. J Cereb Blood Flow Metab 2013; 33:1666-84. [PMID: 23963364 PMCID: PMC3824184 DOI: 10.1038/jcbfm.2013.140] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/24/2013] [Accepted: 07/16/2013] [Indexed: 12/13/2022]
Abstract
Recent clinical data indicates that hemodynamic changes caused by cardiovascular diseases such as atherosclerosis, heart failure, and hypertension affect cognition. Yet, the underlying mechanisms of the resulting vascular cognitive impairment (VCI) are poorly understood. One reason for the lack of mechanistic insights in VCI is that research in dementia primarily focused on Alzheimer's disease models. To fill in this gap, we critically reviewed the published data and various models of VCI. Typical findings in VCI include reduced cerebral perfusion, blood-brain barrier alterations, white matter lesions, and cognitive deficits, which have also been reported in different cardiovascular mouse models. However, the tests performed are incomplete and differ between models, hampering a direct comparison between models and studies. Nevertheless, from the currently available data we conclude that a few existing surgical animal models show the key features of vascular cognitive decline, with the bilateral common carotid artery stenosis hypoperfusion mouse model as the most promising model. The transverse aortic constriction and myocardial infarction models may be good alternatives, but these models are as yet less characterized regarding the possible cerebral changes. Mixed models could be used to study the combined effects of different cardiovascular diseases on the deterioration of cognition during aging.
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Affiliation(s)
- Diewertje I Bink
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Katja Ritz
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eleonora Aronica
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- SEIN—Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Louise van der Weerd
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mat JAP Daemen
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Shimamura M, Zhou P, Casolla B, Qian L, Capone C, Kurinami H, Iadecola C, Anrather J. Prostaglandin E2 type 1 receptors contribute to neuronal apoptosis after transient forebrain ischemia. J Cereb Blood Flow Metab 2013; 33:1207-14. [PMID: 23632967 PMCID: PMC3734771 DOI: 10.1038/jcbfm.2013.69] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/02/2013] [Accepted: 04/03/2013] [Indexed: 11/09/2022]
Abstract
Cyclooxygenase-2-derived prostaglandin E2 (PGE2) contributes to excitotoxic and ischemic neuronal cell death by engaging neuronal PGE2 type 1 receptors (EP1R). Our previous studies have shown that EP1R signaling resulted in disturbances of intracellular Ca(2+) homeostasis and suppression of the pro-survival protein kinase AKT. The aim of this study was to investigate whether these pathophysiological mechanism have a role in the neuronal cell death after transient forebrain ischemia. Mice were subjected to ischemia/reperfusion by bilateral common carotid artery occlusion. Hippocampal cornu ammonis area 1 (CA1) neuronal cell death was determined 5 days after reperfusion. Animals treated with the EP1R antagonist SC51089 or EP1R-deficient mice (EP1(-/-)) showed significantly less neuronal injury as compared to vehicle-treated wild-type controls. Benefits of EP1R blockage were still evident 14 days after injury. Better neuronal survival was correlated with reduced neuronal caspase-3 activity and decreased nuclear translocation of the apoptosis-inducing factor . Neuroprotection could be reverted by intracerebroventricular administration of the phosphoinositide 3-kinase inhibitor LY294002 and was not further increased by the calcineurin inhibitor FK506. These data implicate EP1R in postischemic neuronal apoptosis possibly by facilitating AKT inhibition.
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Affiliation(s)
- Munehisa Shimamura
- Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY 10065, USA
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Tsilidis KK, Panagiotou OA, Sena ES, Aretouli E, Evangelou E, Howells DW, Salman RAS, Macleod MR, Ioannidis JPA. Evaluation of excess significance bias in animal studies of neurological diseases. PLoS Biol 2013; 11:e1001609. [PMID: 23874156 PMCID: PMC3712913 DOI: 10.1371/journal.pbio.1001609] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 06/06/2013] [Indexed: 12/12/2022] Open
Abstract
Animal studies generate valuable hypotheses that lead to the conduct of preventive or therapeutic clinical trials. We assessed whether there is evidence for excess statistical significance in results of animal studies on neurological disorders, suggesting biases. We used data from meta-analyses of interventions deposited in Collaborative Approach to Meta-Analysis and Review of Animal Data in Experimental Studies (CAMARADES). The number of observed studies with statistically significant results (O) was compared with the expected number (E), based on the statistical power of each study under different assumptions for the plausible effect size. We assessed 4,445 datasets synthesized in 160 meta-analyses on Alzheimer disease (n = 2), experimental autoimmune encephalomyelitis (n = 34), focal ischemia (n = 16), intracerebral hemorrhage (n = 61), Parkinson disease (n = 45), and spinal cord injury (n = 2). 112 meta-analyses (70%) found nominally (p≤0.05) statistically significant summary fixed effects. Assuming the effect size in the most precise study to be a plausible effect, 919 out of 4,445 nominally significant results were expected versus 1,719 observed (p<10⁻⁹). Excess significance was present across all neurological disorders, in all subgroups defined by methodological characteristics, and also according to alternative plausible effects. Asymmetry tests also showed evidence of small-study effects in 74 (46%) meta-analyses. Significantly effective interventions with more than 500 animals, and no hints of bias were seen in eight (5%) meta-analyses. Overall, there are too many animal studies with statistically significant results in the literature of neurological disorders. This observation suggests strong biases, with selective analysis and outcome reporting biases being plausible explanations, and provides novel evidence on how these biases might influence the whole research domain of neurological animal literature.
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Affiliation(s)
- Konstantinos K. Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Orestis A. Panagiotou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Emily S. Sena
- Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Eleni Aretouli
- Department of Methods and Experimental Psychology, University of Deusto, Bilbao, Spain
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - David W. Howells
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Rustam Al-Shahi Salman
- Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Malcolm R. Macleod
- Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom
| | - John P. A. Ioannidis
- Stanford Prevention Research Center, Department of Medicine, and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California, United States of America
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Vesterinen HM, Currie GL, Carter S, Mee S, Watzlawick R, Egan KJ, Macleod MR, Sena ES. Systematic review and stratified meta-analysis of the efficacy of RhoA and Rho kinase inhibitors in animal models of ischaemic stroke. Syst Rev 2013; 2:33. [PMID: 23687965 PMCID: PMC3665471 DOI: 10.1186/2046-4053-2-33] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 05/01/2013] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND There is currently only one clinically approved drug, tissue plasminogen activator (tPA), for the treatment of acute ischaemic stroke. The RhoA pathway, including RhoA and its downstream effector Rho kinase (ROCK), has been identified as a possible therapeutic target. Our aim was to assess the impact of study design characteristics and study quality on reported measures of efficacy and to assess for the presence and impact of publication bias. METHODS We conducted a systematic review and meta-analysis on publications describing the efficacy of RhoA and ROCK inhibitors in animal models of focal cerebral ischaemia where outcome was assessed as a change in lesion size or neurobehavioural score, or both. RESULTS We identified 25 published papers which met our inclusion criteria. RhoA and ROCK inhibitors reduced lesion size by 37.3% in models of focal cerebral ischaemia (95% CI, 28.6% to 46.0%, 41 comparisons), and reduced neurobehavioural data by 40.5% (33.4% to 47.7%, 30 comparisons). Overall study quality was low (median=4, interquartile range 3-5) and measures to reduce bias were seldom reported. Publication bias was prevalent and associated with a substantial overstatement of efficacy for lesion size. CONCLUSIONS RhoA and ROCK inhibitors appear to be effective in animal models of stroke. However the low quality score, publication bias and limited number of studies are areas which need attention prior to conducting clinical trials.
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Affiliation(s)
- Hanna M Vesterinen
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Gillian L Currie
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Samantha Carter
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Sarah Mee
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Ralf Watzlawick
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin, D 10117, Germany
| | - Kieren J Egan
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Malcolm R Macleod
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
- Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, Scotland, EH4 2XU, United Kingdom
| | - Emily S Sena
- The Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
- Florey Institutes of Neuroscience and Mental Health, 245 Burgundy Street, Victoria, 3084, Australia
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Affiliation(s)
- David W. Howells
- From the Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom (M.R.M.)
| | - Malcolm R. Macleod
- From the Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom (M.R.M.)
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Katz DM, Berger-Sweeney JE, Eubanks JH, Justice MJ, Neul JL, Pozzo-Miller L, Blue ME, Christian D, Crawley JN, Giustetto M, Guy J, Howell CJ, Kron M, Nelson SB, Samaco RC, Schaevitz LR, St Hillaire-Clarke C, Young JL, Zoghbi HY, Mamounas LA. Preclinical research in Rett syndrome: setting the foundation for translational success. Dis Model Mech 2013; 5:733-45. [PMID: 23115203 PMCID: PMC3484856 DOI: 10.1242/dmm.011007] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In September of 2011, the National Institute of Neurological Disorders and Stroke (NINDS), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the International Rett Syndrome Foundation (IRSF) and the Rett Syndrome Research Trust (RSRT) convened a workshop involving a broad cross-section of basic scientists, clinicians and representatives from the National Institutes of Health (NIH), the US Food and Drug Administration (FDA), the pharmaceutical industry and private foundations to assess the state of the art in animal studies of Rett syndrome (RTT). The aim of the workshop was to identify crucial knowledge gaps and to suggest scientific priorities and best practices for the use of animal models in preclinical evaluation of potential new RTT therapeutics. This review summarizes outcomes from the workshop and extensive follow-up discussions among participants, and includes: (1) a comprehensive summary of the physiological and behavioral phenotypes of RTT mouse models to date, and areas in which further phenotypic analyses are required to enhance the utility of these models for translational studies; (2) discussion of the impact of genetic differences among mouse models, and methodological differences among laboratories, on the expression and analysis, respectively, of phenotypic traits; and (3) definitions of the standards that the community of RTT researchers can implement for rigorous preclinical study design and transparent reporting to ensure that decisions to initiate costly clinical trials are grounded in reliable preclinical data.
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Affiliation(s)
- David M Katz
- Department of Neurosciences, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44120, USA.
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Currie GL, Delaney A, Bennett MI, Dickenson AH, Egan KJ, Vesterinen HM, Sena ES, Macleod MR, Colvin LA, Fallon MT. Animal models of bone cancer pain: systematic review and meta-analyses. Pain 2013; 154:917-26. [PMID: 23582155 DOI: 10.1016/j.pain.2013.02.033] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 01/29/2013] [Accepted: 02/28/2013] [Indexed: 12/19/2022]
Abstract
Pain can significantly decrease the quality of life of patients with advanced cancer. Current treatment strategies often provide inadequate analgesia and unacceptable side effects. Animal models of bone cancer pain are used in the development of novel pharmacological approaches. Here we conducted a systematic review and meta-analysis of publications describing in vivo modelling of bone cancer pain in which behavioural, general health, macroscopic, histological, biochemical, or electrophysiological outcomes were reported and compared to appropriate controls. In all, 150 publications met our inclusion criteria, describing 38 different models of bone cancer pain. Reported methodological quality was low; only 31% of publications reported blinded assessment of outcome, and 11% reported random allocation to group. No publication reported a sample size calculation. Studies that reported measures to reduce bias reported smaller differences in behavioural outcomes between tumour-bearing and control animals, and studies that presented a statement regarding a conflict of interest reported larger differences in behavioural outcomes. Larger differences in behavioural outcomes were reported in female animals, when cancer cells were injected into either the tibia or femur, and when MatLyLu prostate or Lewis Lung cancer cells were used. Mechanical-evoked pain behaviours were most commonly reported; however, the largest difference was observed in spontaneous pain behaviours. In the spinal cord astrocyte activation and increased levels of Substance P receptor internalisation, c-Fos, dynorphin, tumor necrosis factor-α and interleukin-1β have been reported in bone cancer pain models, suggesting several potential therapeutic targets. However, the translational impact of animal models on clinical pain research could be enhanced by improving methodological quality.
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Affiliation(s)
- Gillian L Currie
- Department of Clinical Neurosciences, Chancellors Building, University of Edinburgh, Edinburgh, UK
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Turner RC, Dodson SC, Rosen CL, Huber JD. The science of cerebral ischemia and the quest for neuroprotection: navigating past failure to future success. J Neurosurg 2013; 118:1072-85. [PMID: 23331000 DOI: 10.3171/2012.11.jns12408] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ischemic stroke remains a leading cause of morbidity and death for which few therapeutic options are available. The development of neuroprotective agents, a once promising field of investigation, has failed to translate from bench to bedside successfully. This work reviews the ischemic cascade, agents targeting steps within the cascade, and potential reasons for lack of translation. Additional therapeutic targets are highlighted and areas requiring further investigation are discussed. It is clear that alternative targets need to be pursued, such as the role glia play in neurological injury and recovery, particularly the interactions between neurons, astrocytes, microglia, and the vasculature. Similarly, the biphasic nature of many signaling molecules such as matrix metalloproteinases and high-mobility group box 1 protein must be further investigated to elucidate periods of detrimental versus beneficial activity.
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Affiliation(s)
- Ryan C Turner
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia 26506-9183, USA
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Wei RL, Teng HJ, Yin B, Xu Y, Du Y, He FP, Chu KT, Luo BY, Zheng GQ. A systematic review and meta-analysis of buyang huanwu decoction in animal model of focal cerebral ischemia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:138484. [PMID: 23861695 PMCID: PMC3687599 DOI: 10.1155/2013/138484] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/20/2013] [Indexed: 12/04/2022]
Abstract
Buyang Huanwu Decoction (BHD) is a well-known Chinese herbal prescription for ischemic stroke. The objective of this systematic review and meta-analysis is to provide the current evidence for neuroprotective effects of BHD and its possible mechanisms in animal models of focal ischemia. A systematic literature search, through October 2012, was performed using six databases. The outcome measures assessed were infarct size and/or neurological score. Fifty-six studies with 1270 animals that met the inclusion criteria were identified. The median score for methodological quality was 3 with a range of 2 to 6. Compared with vehicle or no treatment controls, BHD gave a 37% improvement in outcome for all doses ranging from 1.0 g/kg to 60 g/kg at each time point that BHD was administered (P < 0.01). Efficacy was higher in mouse models that utilized suture occlusion and temporary ischemia. The neuroprotective effects of BHD are involved in multiple mechanisms and act upon multiple cell types. In conclusion, BHD possesses substantial neuroprotective effects in experimental stroke probably as a result of the multitarget therapy strategy typically utilized in traditional Chinese medicine. Future research should examine the presence of possible experimental bias and an in-depth study of herbal compound preparations.
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Affiliation(s)
- Rui-li Wei
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Hai-juan Teng
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Bo Yin
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Yang Xu
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Yue Du
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Fang-pin He
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Ke-tan Chu
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
| | - Ben-yan Luo
- Brain Medical Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou Zhejiang 31000, China
- *Ben-yan Luo: and
| | - Guo-qing Zheng
- The Center of Neurology and Rehabilitation, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China
- *Guo-qing Zheng:
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Landis SC, Amara SG, Asadullah K, Austin CP, Blumenstein R, Bradley EW, Crystal RG, Darnell RB, Ferrante RJ, Fillit H, Finkelstein R, Fisher M, Gendelman HE, Golub RM, Goudreau JL, Gross RA, Gubitz AK, Hesterlee SE, Howells DW, Huguenard J, Kelner K, Koroshetz W, Krainc D, Lazic SE, Levine MS, Macleod MR, McCall JM, Moxley RT, Narasimhan K, Noble LJ, Perrin S, Porter JD, Steward O, Unger E, Utz U, Silberberg SD. A call for transparent reporting to optimize the predictive value of preclinical research. Nature 2012; 490:187-91. [PMID: 23060188 DOI: 10.1038/nature11556] [Citation(s) in RCA: 872] [Impact Index Per Article: 72.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 09/10/2012] [Indexed: 01/02/2023]
Abstract
The US National Institute of Neurological Disorders and Stroke convened major stakeholders in June 2012 to discuss how to improve the methodological reporting of animal studies in grant applications and publications. The main workshop recommendation is that at a minimum studies should report on sample-size estimation, whether and how animals were randomized, whether investigators were blind to the treatment, and the handling of data. We recognize that achieving a meaningful improvement in the quality of reporting will require a concerted effort by investigators, reviewers, funding agencies and journal editors. Requiring better reporting of animal studies will raise awareness of the importance of rigorous study design to accelerate scientific progress.
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Affiliation(s)
- Story C Landis
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland 20892, USA
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77
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Kim HA, Brait VH, Lee S, De Silva TM, Diep H, Eisenhardt A, Drummond GR, Sobey CG. Brain infarct volume after permanent focal ischemia is not dependent on Nox2 expression. Brain Res 2012; 1483:105-11. [PMID: 23000198 DOI: 10.1016/j.brainres.2012.09.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 08/19/2012] [Accepted: 09/12/2012] [Indexed: 01/18/2023]
Abstract
Reactive oxygen species (ROS) generated by Nox2 oxidase are reported to contribute to infarct damage following cerebral ischemia-reperfusion. Here we have examined for the first time the role of Nox2 expression in outcomes following permanent focal cerebral ischemia. Ischemia was induced by middle cerebral artery filament occlusion (MCAO) for 24h in wild-type (WT) and Nox2(-/y) mice. Neurological deficit and the hanging wire test were assessed, and infarct and edema volumes were estimated using thionin-stained brain sections. Genetic deletion of Nox2 had no effect on any outcome measures at 24h after permanent MCAO. Our data therefore suggest that ROS production by Nox2 oxidase activity plays no significant role in the pathophysiology of cerebral ischemia in the absence of reperfusion.
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Affiliation(s)
- Hyun Ah Kim
- Department of Pharmacology, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
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78
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Zawadzka M, Dabrowski M, Gozdz A, Szadujkis B, Sliwa M, Lipko M, Kaminska B. Early steps of microglial activation are directly affected by neuroprotectant FK506 in both in vitro inflammation and in rat model of stroke. J Mol Med (Berl) 2012; 90:1459-71. [PMID: 22806180 PMCID: PMC3506835 DOI: 10.1007/s00109-012-0925-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 05/10/2012] [Accepted: 05/30/2012] [Indexed: 02/05/2023]
Abstract
Neuroprotective and/or neuroregenerative activity of FK506, its derivatives, and to a lesser extent cyclosporin A (CsA) in animal models of neurodegenerative diseases of different etiology have been reported. Here, we verified a hypothesis that the most likely mechanism of their neuroprotective action is inhibition of the early steps of inflammatory activation of microglia by interference with mitogen-activated protein kinase (MAPK) signaling. The effect of immunosuppressants on lipopolysaccharide (LPS)-induced changes in morphology, proliferation, and motility of rat primary microglial cultures was evaluated. FK506 and CsA directly inhibited LPS-induced microglia activation and inflammatory responses. While both drugs efficiently reduced the expression of iNOS and the release of nitric oxide, only FK506 strongly inhibited the expression of Cox-2 and secretion of the mature form of IL-1β. FK506 strongly reduced LPS-induced activation of MAPK, and its downstream signaling crucial for inflammatory responses. Comparative analysis of global gene expression in rat ischemic brains and in LPS-stimulated microglial cultures revealed many genes and signaling pathways regulated in the same way in both systems. FK506 treatment blocked a majority of genes induced by an ischemic insult in the cortex, in particular inflammatory/innate immunity and apoptosis-related genes. Microglia-mediated inflammation is considered as one of the most important components of brain injury after trauma or stroke; thus, effective and multifaceted blockade of microglial activation by FK506 has clinical relevance and potential therapeutic implications.
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Affiliation(s)
- Malgorzata Zawadzka
- Laboratory of Transcription Regulation, Department Cell Biology, Nencki Institute of Experimental Biology, 3 Pasteur Str., 02-093 Warsaw, Poland
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79
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Yao H, Nabika T. Standards and pitfalls of focal ischemia models in spontaneously hypertensive rats: with a systematic review of recent articles. J Transl Med 2012; 10:139. [PMID: 22770528 PMCID: PMC3579704 DOI: 10.1186/1479-5876-10-139] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 07/02/2012] [Indexed: 01/10/2023] Open
Abstract
We reviewed the early development of various focal ischemia models in spontaneously hypertensive rats (SHR), and summarized recent reports on this topic. Among 6 focal ischemia models established in divergent substrains of SHR, distal middle cerebral artery occlusion is the most frequently used and relevant method of focal ischemia in the light of penumbra concept. We performed an online PubMed search (2001–2010), and identified 118 original articles with focal ischemia in SHR. Physiological parameters such as age, body weight, and even blood pressure were often neglected in the literature: the information regarding the physiological parameters of SHR is critical, and should be provided within the methodology section of all articles related to stroke models in SHR. Although the quality of recent studies on neuroprotective strategy is improving, the mechanisms underlying the protection should be more clearly recognized so as to facilitate the translation from animal studies to human stroke. To overcome the genetic heterogeneity in substrains of SHR, new approaches, such as a huge repository of genetic markers in rat strains and the congenic strategy, are currently in progress.
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Affiliation(s)
- Hiroshi Yao
- Laboratory for Neurochemistry, Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Mitsu 160, Yoshinogari, Kanzaki, Saga 842-0192, Japan.
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80
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Kaundal RK, Deshpande TA, Gulati A, Sharma SS. Targeting endothelin receptors for pharmacotherapy of ischemic stroke: current scenario and future perspectives. Drug Discov Today 2012; 17:793-804. [DOI: 10.1016/j.drudis.2012.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 01/01/2012] [Accepted: 02/18/2012] [Indexed: 01/05/2023]
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81
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Janssen H, Speare S, Spratt NJ, Sena ES, Ada L, Hannan AJ, McElduff P, Bernhardt J. Exploring the efficacy of constraint in animal models of stroke: meta-analysis and systematic review of the current evidence. Neurorehabil Neural Repair 2012; 27:3-12. [PMID: 22714123 DOI: 10.1177/1545968312449696] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Constraint-induced movement therapy (CIMT) is used to counteract learned nonuse observed following stroke in humans and has been shown to improve function. Variations of CIMT used in animal models of stroke have the potential to inform and improve our understanding of this intervention. OBJECTIVE To conduct a systematic review of studies investigating constraint in experimental stroke. The authors aimed to assess the quality and establish the efficacy of constraint on neurobehavior, cognitive function, infarct size, and stress and mortality and to determine the optimal dose or time to administration. METHODS Systematic review with meta-analysis was used. Data were analyzed using DerSimonian and Laird weighted-mean-difference random effects meta-analysis. RESULTS The quality scores of the 8 articles (15 studies) included were moderate (median 5/10; interquartile range, 4.8-6.0). There was a trend for animals with constraint to have worse neurobehavioral scores (-10% worse; 95% confidence interval [CI] = -20 to 0; P = .06). Infarct volumes were not significantly different between groups (-3% larger with constraint; 95% CI = -15 to 9; P = .63). Cognitive function was significantly better after constraint, although this estimate was based on only 28 animals from 2 studies. Insufficient data prevented analysis of the effect of constraint on stress and mortality. CONCLUSIONS This meta-analysis showed no benefit of constraint on neurobehavioral scores, which is at odds with some human studies. Animal models may help us efficiently explore the biological basis of rehabilitation interventions; however, review of the data in this study raise uncertainty about its effectiveness in humans.
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Affiliation(s)
- Heidi Janssen
- University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia.
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82
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Ankolekar S, Rewell S, Howells DW, Bath PMW. The Influence of Stroke Risk Factors and Comorbidities on Assessment of Stroke Therapies in Humans and Animals. Int J Stroke 2012; 7:386-97. [DOI: 10.1111/j.1747-4949.2012.00802.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The main driving force behind the assessment of novel pharmacological agents in animal models of stroke is to deliver new drugs to treat the human disease rather than to increase knowledge of stroke pathophysiology. There are numerous animal models of the ischaemic process and it appears that the same processes operate in humans. Yet, despite these similarities, the drugs that appear effective in animal models have not worked in clinical trials. To date, tissue plasminogen activator is the only drug that has been successfully used at the bedside in hyperacute stroke management. Several reasons have been put forth to explain this, but the failure to consider comorbidities and risk factors common in older people is an important one. In this article, we review the impact of the risk factors most studied in animal models of acute stroke and highlight the parallels with human stroke, and, where possible, their influence on evaluation of therapeutic strategies.
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Affiliation(s)
| | - Sarah Rewell
- Florey Neuroscience Institutes, Melbourne Brain Centre, Heidelberg, Australia
| | - David W. Howells
- Florey Neuroscience Institutes, Melbourne Brain Centre, Heidelberg, Australia
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83
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O'Collins VE, Macleod MR, Donnan GA, Howells DW. Evaluation of combination therapy in animal models of cerebral ischemia. J Cereb Blood Flow Metab 2012; 32:585-97. [PMID: 22293990 PMCID: PMC3318154 DOI: 10.1038/jcbfm.2011.203] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 12/23/2011] [Indexed: 12/31/2022]
Abstract
Combination therapy has been identified as a promising strategy to improve stroke management. We conducted a systematic review and meta-analysis of evidence from animal models of ischemic stroke to determine whether combining treatments improved efficacy. Multiple databases were searched and data were extracted from focal ischemia experiments comparing control groups, single treatments, and combination treatments. Of 11,430 papers identified, 142 met the inclusion criteria; these tested 126 treatments in 373 experiments using 8,037 animals (I(2)=85 to 96%). Taken together, single treatments reduced infarct size by 20% and improved neurological score by 12% compared with control; a second therapy improved efficacy by an additional 18% and 25%, respectively. Publication bias may affect combination efficacy for infarct size but not neurological score. Combining thrombolysis with other therapies may extend the time window from 4.4 to 8 hours in animal models, although testing beyond 6 hours is required to confirm this. Benefits of additional therapy decreased as the efficacy of the primary treatment increased, with combination efficacy reaching a ceiling at 60% to 80% protection. Combining treatments may bring benefits and extend the time window for treatment. More evidence is needed due to potential publication bias and heterogeneity.
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Affiliation(s)
- Victoria E O'Collins
- Florey Neuroscience Institutes, Melbourne Brain Centre, Heidelberg, Victoria, Australia.
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84
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The Translation Procedure of Low-Level Laser Therapy in Acute Ischemic Stroke: A Nonpharmaceutics Noninvasive Method. Transl Stroke Res 2012. [DOI: 10.1007/978-1-4419-9530-8_35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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85
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Kirkman MA, Allan SM, Parry-Jones AR. Experimental intracerebral hemorrhage: avoiding pitfalls in translational research. J Cereb Blood Flow Metab 2011; 31:2135-51. [PMID: 21863040 PMCID: PMC3210340 DOI: 10.1038/jcbfm.2011.124] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/20/2011] [Accepted: 07/28/2011] [Indexed: 12/12/2022]
Abstract
Intracerebral hemorrhage (ICH) has the highest mortality of all stroke subtypes, yet treatments are mainly limited to supportive management, and surgery remains controversial. Despite significant advances in our understanding of ICH pathophysiology, we still lack preclinical models that accurately replicate the underlying mechanisms of injury. Current experimental ICH models (including autologous blood and collagenase injection) simulate different aspects of ICH-mediated injury but lack some features of the clinical condition. Newly developed models, notably hypertension- and oral anticoagulant therapy-associated ICH models, offer added benefits but further study is needed to fully validate them. Here, we describe and discuss current approaches to experimental ICH, with suggestions for changes in how this condition is studied in the laboratory. Although advances in imaging over the past few decades have allowed greater insight into clinical ICH, there remains an important role for experimental models in furthering our understanding of the basic pathophysiologic processes underlying ICH, provided limitations of animal models are borne in mind. Owing to differences in existing models and the failed translation of benefits in experimental ICH to clinical practice, putative neuroprotectants should be trialed in multiple models using both histological and functional outcomes until a more accurate model of ICH is developed.
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Affiliation(s)
- Matthew A Kirkman
- Faculty of Life Sciences, The University of Manchester, Manchester, UK
| | - Stuart M Allan
- Faculty of Life Sciences, The University of Manchester, Manchester, UK
| | - Adrian R Parry-Jones
- The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK
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86
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Korevaar DA, Hooft L, ter Riet G. Systematic reviews and meta-analyses of preclinical studies: publication bias in laboratory animal experiments. Lab Anim 2011; 45:225-30. [PMID: 21737463 DOI: 10.1258/la.2011.010121] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In 2006, Peters et al. identified 86 systematic reviews (SRs) of laboratory animal experiments (LAEs). They found 46 LAE meta-analyses (MAs), often of poor quality. Six of these 46 MAs tried to assess publication bias. Publication bias is the phenomenon of an experiment's results determining its likelihood of publication, often over-representing positive findings. As such, publication bias is the Achilles heel of any SR. Since researchers increasingly become aware of the fact that SRs directly support the 'three Rs', we expect the number of SRs of LAEs will sharply increase. Therefore, it is useful to see how publication bias is dealt with. Our objective was to identify all SRs and MAs of LAEs where the purpose was to inform human health published between July 2005 and 2010 with special attention to MAs' quality features and publication bias. We systematically searched Medline, Embase, Toxline and ScienceDirect from July 2005 to 2010, updating Peters' review. LAEs not directly informing human health or concerning fundamental biology were excluded. We found 2780 references of which 163 met the inclusion criteria: 158 SRs, of which 30 performed an MA, and five MAs without an SR. The number of SRs roughly doubled every three years since 1997. The number of MAs roughly doubled every five years since 1999. Compared with before July 2005, more MAs were preceded by SR and reported on (quality) features of included studies and heterogeneity. A statistically significant proportion of MAs considered publication bias (26/35) and tried to formally assess it (21/35).
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Affiliation(s)
- D A Korevaar
- Department of General Practice, Academic Medical Center (AMC), University of Amsterdam (UvA), PO Box 22700, 1100 DD Amsterdam, The Netherlands.
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87
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Dopamine agonists in animal models of Parkinson's disease: a systematic review and meta-analysis. Parkinsonism Relat Disord 2011; 17:313-20. [PMID: 21376651 DOI: 10.1016/j.parkreldis.2011.02.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 02/07/2011] [Accepted: 02/09/2011] [Indexed: 01/31/2023]
Abstract
BACKGROUND Parkinson's disease (PD) can be a severely disabling condition in spite of therapies currently available. Systematic review and meta-analysis can provide an overview of a field of research and identify potential sources of bias and limits to efficacy. In this study we use these tools to describe the reported efficacy of dopamine agonists in animal models of PD. METHODS Publications were identified by electronic searching of three online databases. Data were extracted for neurobehavioural outcome, for study design and for the reporting of measures to avoid bias. Standardised mean difference meta-analysis was used to provide summary estimates of efficacy, with the effects of study quality and study design explored using stratified meta-analysis. RESULTS 253 publications reported the use of a dopamine agonist in an animal model of PD; of these 121 reported data suitable for inclusion in meta-analysis. 47 interventions were tested in 601 experiments using 4181 animals. Overall, neurobehavioural outcome was improved by 1.08 standard deviations (SD; 95% Confidence Interval (CI) 0.97-1.19). Reporting of measures to reduce bias was low and publications which reported the blinded assessment of outcome had significantly smaller effect sizes (0.85, 95% CI 0.64 to 1.07) than those which did not (1.18, 95% CI 1.05 to 1.31, p < 0.005). CONCLUSIONS While dopamine agonists do appear to have efficacy in animal models of PD the low prevalence of reporting of measures to avoid bias is of concern. Systematic review of individual interventions may be helpful in the design of future preclinical and clinical trials.
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88
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Calcineurin inhibition with FK506 ameliorates dendritic spine density deficits in plaque-bearing Alzheimer model mice. Neurobiol Dis 2010; 41:650-4. [PMID: 21134458 DOI: 10.1016/j.nbd.2010.11.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 10/19/2010] [Accepted: 11/26/2010] [Indexed: 11/20/2022] Open
Abstract
Synapse loss is the strongest correlate of cognitive decline in Alzheimer's disease, and synapses are an attractive therapeutic target due to their plastic nature that allows for potential recovery with intervention. We have previously demonstrated in transgenic mice that form senile plaques that dendrites surrounding plaques become dystrophic and lose postsynaptic dendritic spines. Furthermore, we found strong evidence that plaque-associated dendritic changes are mediated by calcineurin, a calcium-dependent phosphatase involved in cell signaling, using in vitro models and genetically encoded inhibitors in mouse models. In this study, we pharmacologically inhibited calcineurin with FK506 treatment to test the hypothesis that calcineurin inhibition will allow recovery of plaque-associated synapse loss. We found that in plaque bearing transgenic mice, short term (1 week) FK506 treatment results in an amelioration of dendritic spine loss. We also observe an effect on spine morphology in wild-type mice with FK506 treatment. These data show that systemic FK506 administration, and hence calcineurin inhibition, may be neuroprotective for amyloid beta induced synaptic alterations.
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89
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Sena ES, Briscoe CL, Howells DW, Donnan GA, Sandercock PAG, Macleod MR. Factors affecting the apparent efficacy and safety of tissue plasminogen activator in thrombotic occlusion models of stroke: systematic review and meta-analysis. J Cereb Blood Flow Metab 2010; 30:1905-13. [PMID: 20648038 PMCID: PMC3002882 DOI: 10.1038/jcbfm.2010.116] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Thrombolysis with recombinant tissue plasminogen activator (rtPA) improves outcome in animal models of stroke and in clinical trial, but is associated with increased intracranial hemorrhage. Here, we explore the impact of biologic and experimental design factors on efficacy and bleeding. We conducted a systematic review of studies describing the effect of tPA in thrombotic occlusion models of ischemic stroke followed by random effects meta-analysis, meta-regression, and trim and fill. We identified 202, 66, 128, and 54 comparisons reporting infarct volume, neurobehavioral score, hemorrhage, and mortality, respectively. The rtPA reduced infarct volume by 25.2% (95% confidence interval=21.8 to 28.6, 3388 animals), improved neurobehavioral score by 18.0% (12.6% to 23.3%, n=1243), increased the risk of hemorrhage (odds ratio=1.71, 1.42 to 2.07, n=2833) and had no significant effect on mortality (odds ratio=0.82, 0.62 to 1.08, n=1274). There was an absolute reduction in efficacy of 1.1% (0.7% to 1.4%) for every 10 minutes delay to treatment. Cumulative meta-analysis showed that the estimate of efficacy fell as more data became available. Publication bias inflated efficacy by 5.1% (infarct volume) and 8.1% (neurobehavioral score). This data set was large enough to be adequately powered to estimate with precision the impact of biologic and experimental factors on the efficacy and safety of rtPA.
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Affiliation(s)
- Emily S Sena
- Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK
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90
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Hooijmans C, de Vries R, Leenaars M, Ritskes-Hoitinga M. The Gold Standard Publication Checklist (GSPC) for improved design, reporting and scientific quality of animal studies GSPC versus ARRIVE guidelines. Lab Anim 2010; 45:61. [PMID: 21088032 PMCID: PMC3104814 DOI: 10.1258/la.2010.010130] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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91
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Ottens AK, Bustamante L, Golden EC, Yao C, Hayes RL, Wang KKW, Tortella FC, Dave JR. Neuroproteomics: a biochemical means to discriminate the extent and modality of brain injury. J Neurotrauma 2010; 27:1837-52. [PMID: 20698760 DOI: 10.1089/neu.2010.1374] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Diagnosis and treatment of stroke and traumatic brain injury remain significant health care challenges to society. Patient care stands to benefit from an improved understanding of the interactive biochemistry underlying neurotrauma pathobiology. In this study, we assessed the power of neuroproteomics to contrast biochemical responses following ischemic and traumatic brain injuries in the rat. A middle cerebral artery occlusion (MCAO) model was employed in groups of 30-min and 2-h focal neocortical ischemia with reperfusion. Neuroproteomes were assessed via tandem cation-anion exchange chromatography-gel electrophoresis, followed by reversed-phase liquid chromatography-tandem mass spectrometry. MCAO results were compared with those from a previous study of focal contusional brain injury employing the same methodology to characterize homologous neocortical tissues at 2 days post-injury. The 30-min MCAO neuroproteome depicted abridged energy production involving pentose phosphate, modulated synaptic function and plasticity, and increased chaperone activity and cell survival factors. The 2-h MCAO data indicated near complete loss of ATP production, synaptic dysfunction with degraded cytoarchitecture, more conservative chaperone activity, and additional cell survival factors than those seen in the 30-min MCAO model. The TBI group exhibited disrupted metabolism, but with retained malate shuttle functionality. Synaptic dysfunction and cytoarchitectural degradation resembled the 2-h MCAO group; however, chaperone and cell survival factors were more depressed following TBI. These results underscore the utility of neuroproteomics for characterizing interactive biochemistry for profiling and contrasting the molecular aspects underlying the pathobiological differences between types of brain injuries.
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Affiliation(s)
- Andrew K Ottens
- Department of Anatomy, Medical College of Virginia at Virginia Commonwealth University, Richmond, Virginia 23298-0709, USA.
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92
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Gibson CL, Murphy SP. Benefits of histone deacetylase inhibitors for acute brain injury: a systematic review of animal studies. J Neurochem 2010; 115:806-13. [PMID: 20831615 DOI: 10.1111/j.1471-4159.2010.06993.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Drugs that inhibit histone deacetylase (HDAC) activities have enormous potential as neuroprotective agents. We performed a systematic review of controlled animal studies that administered known inhibitors of the zinc-dependent HDACs before and/or after acute cerebral injury and assessed anatomic/functional outcomes. Relevant studies were found by searching PubMed, Embase and Web of Science. From more than 100 identified publications, those data meeting specific criteria were analyzed using the Cochrane Review Manager software. A beneficial effect of administering HDAC inhibitors was seen in studies involving cerebral ischemia or non-ischemic models of acute cerebral injury. Specific studies assessed efficacy when drug was administered up to 14 days prior to, and 14 days following, the onset of cerebral injury. This systematic review provides objective evidence of a neuroprotective role for drugs that inhibit HDACs and highlights particular areas that require further experimental investigation.
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Affiliation(s)
- Claire L Gibson
- School of Psychology, University of Leicester, Leicester, UK.
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93
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Methodological quality of preclinical stroke studies is not required for publication in high-impact journals. J Cereb Blood Flow Metab 2010; 30:1619-24. [PMID: 20517323 PMCID: PMC2949256 DOI: 10.1038/jcbfm.2010.74] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Omitting quality characteristics in animal stroke studies leads to an overestimation of the efficacy of candidate stroke drugs. Nevertheless, the methodological quality of preclinical stroke studies is often limited. As publishing of research results in high-impact journals is an important motivation for scientists, we analyzed whether study quality predicts high-impact publishing. Animal stroke studies of neuroprotective drugs that were recently investigated in clinical phase II/III trials were included in the analysis. Data on the study quality and other important study characteristics were extracted. Regression analyses were performed to estimate the effect of the study characteristics on the journal's impact factor. We identified 117 studies that investigated 12 different drugs. Study quality was not associated with the impact factor before (beta=-0.2, P=0.50) and after adjustment for other study characteristics (beta=-0.3, P=0.19). There was a significant association of the number of investigated mechanisms and applied techniques with the impact factor (beta=1.4, P<0.0001). Our findings show that the quality of animal experimental stroke studies is not relevant for publishing in high-impact journals. The major predictor for accepting preclinical stroke studies in high-impact journals is the complexity of the investigation into a stroke drug's mode of action.
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94
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Hooijmans CR, Leenaars M, Ritskes-Hoitinga M. A gold standard publication checklist to improve the quality of animal studies, to fully integrate the Three Rs, and to make systematic reviews more feasible. Altern Lab Anim 2010; 38:167-82. [PMID: 20507187 DOI: 10.1177/026119291003800208] [Citation(s) in RCA: 209] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systematic reviews are generally regarded by professionals in the field of evidence-based medicine as the highest level of medical evidence, and they are already standard practice for clinical studies. However, they are not yet widely used nor undertaken in the field of animal experimentation, even though there is a lot to be gained from the process. Therefore, a gold standard publication checklist (GSPC) for animal studies is presented in this paper. The items on the checklist have been selected on the basis of a literature analysis and the resulting scientific evidence that these factors are decisive in determining the outcome of animal studies. In order to make future systematic reviews and meta-analyses of animal studies possible, to allow others to replicate and build on work previously published, diminish the number of animals needed in animal experimentation (reduction), improve animal welfare (refinement) and, above all, improve the quality of scientific papers on animal experimentation, this publication checklist needs to be used and followed. We have discussed and optimised this GSPC through feedback from interviews with experts in the field of animal experimentation. From these interviews, it became clear that scientists will adopt this GSPC when journals demand it. The GSPC was compared with the current instructions for authors from nine different journals, selected on the basis that they featured a high number of publications on animal studies. In general, the journals' demands for the description of the animal studies are so limited that it is not possible to repeat the studies, let alone carry out a systematic review. By using the GSPC for animal studies, the quality of scientific papers will be improved. The use of the GSPC and the concomitant improvement in the quality of scientific papers will also contribute to decreased variation and increased standardisation and, as a consequence, a reduction in the numbers of animals used and a more reliable outcome of animal studies. It is of major importance that journal editors become convinced of and adopt these recommendations, because only then will scientists follow these guidelines to the full extent.
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Affiliation(s)
- Carlijn R Hooijmans
- Radboud University Nijmegen Medical Centre, Central Animal Laboratory and 3R Research Centre, Geert Grooteplein Noord 29, route 231, 6525 EZ Nijmegen, The Netherlands
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95
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Vesterinen HM, Sena ES, ffrench-Constant C, Williams A, Chandran S, Macleod MR. Improving the translational hit of experimental treatments in multiple sclerosis. Mult Scler 2010; 16:1044-55. [DOI: 10.1177/1352458510379612] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: In other neurological diseases, the failure to translate pre-clinical findings to effective clinical treatments has been partially attributed to bias introduced by shortcomings in the design of animal experiments. Objectives: Here we evaluate published studies of interventions in animal models of multiple sclerosis for methodological design and quality and to identify candidate interventions with the best evidence of efficacy. Methods: A systematic review of the literature describing experiments testing the effectiveness of interventions in animal models of multiple sclerosis was carried out. Data were extracted for reported study quality and design and for neurobehavioural outcome. Weighted mean difference meta-analysis was used to provide summary estimates of the efficacy for drugs where this was reported in five or more publications. Results: The use of a drug in a pre-clinical multiple sclerosis model was reported in 1152 publications, of which 1117 were experimental autoimmune encephalomyelitis (EAE). For 36 interventions analysed in greater detail, neurobehavioural score was improved by 39.6% (95% CI 34.9—44.2%, p < 0.001). However, few studies reported measures to reduce bias, and those reporting randomization or blinding found significantly smaller effect sizes. Conclusions: EAE has proven to be a valuable model in elucidating pathogenesis as well as identifying candidate therapies for multiple sclerosis. However, there is an inconsistent application of measures to limit bias that could be addressed by adopting methodological best practice in study design. Our analysis provides an estimate of sample size required for different levels of power in future studies and suggests a number of interventions for which there are substantial animal data supporting efficacy.
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Affiliation(s)
- Hanna M Vesterinen
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK
| | - Emily S Sena
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK
| | - Charles ffrench-Constant
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK
| | - Anna Williams
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK
| | - Siddharthan Chandran
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK
| | - Malcolm R Macleod
- Centre for Clinical Brain Sciences, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, UK,
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96
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Different strokes for different folks: the rich diversity of animal models of focal cerebral ischemia. J Cereb Blood Flow Metab 2010; 30:1412-31. [PMID: 20485296 PMCID: PMC2949237 DOI: 10.1038/jcbfm.2010.66] [Citation(s) in RCA: 218] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
No single animal model is able to encompass all of the variables known to affect human ischemic stroke. This review highlights the major strengths and weaknesses of the most commonly used animal models of acute ischemic stroke in the context of matching model and experimental aim. Particular emphasis is placed on the relationships between outcome and underlying vascular variability, physiologic control, and use of models of comorbidity. The aim is to provide, for novice and expert alike, an overview of the key controllable determinants of experimental stroke outcome to help ensure the most effective application of animal models to translational research.
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97
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Parry-Jones A, Boutin H, Denes A, McColl B, Hopkins S, Allan S, Tyrrell P. Interleukin-1 receptor antagonist in animal models of stroke: a fair summing up? J Stroke Cerebrovasc Dis 2010; 19:512-3. [PMID: 20621515 DOI: 10.1016/j.jstrokecerebrovasdis.2010.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 01/12/2010] [Indexed: 10/19/2022] Open
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98
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Percie du Sert N, Rudd JA, Apfel CC, Andrews PLR. Cisplatin-induced emesis: systematic review and meta-analysis of the ferret model and the effects of 5-HT₃ receptor antagonists. Cancer Chemother Pharmacol 2010; 67:667-86. [PMID: 20509026 PMCID: PMC3043247 DOI: 10.1007/s00280-010-1339-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 04/16/2010] [Indexed: 01/17/2023]
Abstract
Purpose The ferret cisplatin emesis model has been used for ~30 years and enabled identification of clinically used anti-emetics. We provide an objective assessment of this model including efficacy of 5-HT3 receptor antagonists to assess its translational validity. Methods A systematic review identified available evidence and was used to perform meta-analyses. Results Of 182 potentially relevant publications, 115 reported cisplatin-induced emesis in ferrets and 68 were included in the analysis. The majority (n = 53) used a 10 mg kg−1 dose to induce acute emesis, which peaked after 2 h. More recent studies (n = 11) also used 5 mg kg−1, which induced a biphasic response peaking at 12 h and 48 h. Overall, 5-HT3 receptor antagonists reduced cisplatin (5 mg kg−1) emesis by 68% (45–91%) during the acute phase (day 1) and by 67% (48–86%) and 53% (38–68%, all P < 0.001), during the delayed phase (days 2, 3). In an analysis focused on the acute phase, the efficacy of ondansetron was dependent on the dosage and observation period but not on the dose of cisplatin. Conclusion Our analysis enabled novel findings to be extracted from the literature including factors which may impact on the applicability of preclinical results to humans. It reveals that the efficacy of ondansetron is similar against low and high doses of cisplatin. Additionally, we showed that 5-HT3 receptor antagonists have a similar efficacy during acute and delayed emesis, which provides a novel insight into the pharmacology of delayed emesis in the ferret.
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Affiliation(s)
- N Percie du Sert
- Division of Basic Medical Sciences, St George's University of London, London, UK.
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99
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van der Worp HB, Howells DW, Sena ES, Porritt MJ, Rewell S, O'Collins V, Macleod MR. Can animal models of disease reliably inform human studies? PLoS Med 2010; 7:e1000245. [PMID: 20361020 PMCID: PMC2846855 DOI: 10.1371/journal.pmed.1000245] [Citation(s) in RCA: 835] [Impact Index Per Article: 59.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
H. Bart van der Worp and colleagues discuss the controversies and possibilities of translating the results of animal experiments into human clinical trials.
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Affiliation(s)
- H Bart van der Worp
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands.
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100
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Sena ES, van der Worp HB, Bath PMW, Howells DW, Macleod MR. Publication bias in reports of animal stroke studies leads to major overstatement of efficacy. PLoS Biol 2010; 8:e1000344. [PMID: 20361022 PMCID: PMC2846857 DOI: 10.1371/journal.pbio.1000344] [Citation(s) in RCA: 391] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 02/18/2010] [Indexed: 12/31/2022] Open
Abstract
The consolidation of scientific knowledge proceeds through the interpretation and then distillation of data presented in research reports, first in review articles and then in textbooks and undergraduate courses, until truths become accepted as such both amongst "experts" and in the public understanding. Where data are collected but remain unpublished, they cannot contribute to this distillation of knowledge. If these unpublished data differ substantially from published work, conclusions may not reflect adequately the underlying biological effects being described. The existence and any impact of such "publication bias" in the laboratory sciences have not been described. Using the CAMARADES (Collaborative Approach to Meta-analysis and Review of Animal Data in Experimental Studies) database we identified 16 systematic reviews of interventions tested in animal studies of acute ischaemic stroke involving 525 unique publications. Only ten publications (2%) reported no significant effects on infarct volume and only six (1.2%) did not report at least one significant finding. Egger regression and trim-and-fill analysis suggested that publication bias was highly prevalent (present in the literature for 16 and ten interventions, respectively) in animal studies modelling stroke. Trim-and-fill analysis suggested that publication bias might account for around one-third of the efficacy reported in systematic reviews, with reported efficacy falling from 31.3% to 23.8% after adjustment for publication bias. We estimate that a further 214 experiments (in addition to the 1,359 identified through rigorous systematic review; non publication rate 14%) have been conducted but not reported. It is probable that publication bias has an important impact in other animal disease models, and more broadly in the life sciences.
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Affiliation(s)
- Emily S. Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- National Stroke Research Institute, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
| | - H. Bart van der Worp
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands
| | - Philip M. W. Bath
- Stroke Trials Unit, University of Nottingham, Nottingham, England, United Kingdom
| | - David W. Howells
- National Stroke Research Institute, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Malcolm R. Macleod
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Department of Neurology, NHS Forth Valley, Stirling, Scotland, United Kingdom
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