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Wildeboer ACL, van Helsdingen CPM, Gallé CG, de Vries RBM, Derikx JPM, Bouvy ND. Enhancing intestinal anastomotic healing using butyrate: Systematic review and meta-analysis of experimental animal studies. PLoS One 2023; 18:e0286716. [PMID: 37310970 DOI: 10.1371/journal.pone.0286716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 05/22/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Despite advancements in surgical technique and perioperative care, intestinal anastomoses still have a 10-15 per cent risk of leakage, which results in considerable morbidity and/or mortality. Recent animal studies have suggested that administration of butyrate to the anastomotic site results in enhanced anastomotic strength, which may prevent leakage. This systematic review and meta-analysis summarises current evidence concerning the effect of butyrate administration on anastomotic healing and will form a scientific basis for the development of new research into this subject. METHODS Animal studies on the effect of butyrate-based interventions in models of intestinal anastomotic healing were systematically retrieved from online databases. Bibliographical data, study characteristics and outcome data were extracted, and internal validity of the studies was assessed. Outcomes studied through meta-analysis concerned: anastomotic strength, anastomotic leakage, collagen metabolism and general histologic parameters of wound healing. RESULTS A comprehensive search and selection identified 19 relevant studies containing 41 individual comparisons. Design and conduct of most experiments were poorly reported resulting in an unclear risk of bias. Meta-analyses showed that butyrate administration significantly increases anastomotic strength (SMD 1.24, 0.88 to 1.61), collagen synthesis (SMD 1.44, 0.72 to 2.15) and collagen maturation, making anastomoses less prone to leakage in the early postoperative period (OR 0.37, 0.15 to 0.93). CONCLUSION This systematic review and meta-analysis shows that there is potential ground to investigate the use of butyrate in clinical trials to prevent anastomotic leakage in intestinal surgery. However, more research is necessary to define the best application form, dosage and administration route.
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Affiliation(s)
- Aurelia C L Wildeboer
- Department of Surgery, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Claire P M van Helsdingen
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Camille G Gallé
- Department of General Surgery, Maastricht University, Maastricht, The Netherlands
| | - Rob B M de Vries
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joep P M Derikx
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
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Kat R, Arroyo-Araujo M, de Vries RBM, Koopmans MA, de Boer SF, Kas MJH. Translational validity and methodological underreporting in animal research: A systematic review and meta-analysis of the Fragile X syndrome (Fmr1 KO) rodent model. Neurosci Biobehav Rev 2022; 139:104722. [PMID: 35690123 DOI: 10.1016/j.neubiorev.2022.104722] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 02/07/2023]
Abstract
Predictive models are essential for advancing knowledge of brain disorders. High variation in study outcomes hampers progress. To address the validity of predictive models, we performed a systematic review and meta-analysis on behavioural phenotypes of the knock-out rodent model for Fragile X syndrome according to the PRISMA reporting guidelines. In addition, factors accountable for the heterogeneity between findings were analyzed. The knock-out model showed good translational validity and replicability for hyperactivity, cognitive and seizure phenotypes. Despite low replicability, translational validity was also found for social behaviour and sensory sensitivity, but not for attention, aggression and cognitive flexibility. Anxiety, acoustic startle and prepulse inhibition phenotypes, despite low replicability, were opposite to patient symptomatology. Subgroup analyses for experimental factors moderately explain the low replicability, these analyses were hindered by under-reporting of methodologies and environmental conditions. Together, the model has translational validity for most clinical phenotypes, but caution must be taken due to low effect sizes and high inter-study variability. These findings should be considered in view of other rodent models in preclinical research.
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Affiliation(s)
- Renate Kat
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG Groningen, the Netherlands.
| | - María Arroyo-Araujo
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG Groningen, the Netherlands.
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Geert Groteplein Zuid 21, 6525 EZ Nijmegen, the Netherlands.
| | - Marthe A Koopmans
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG Groningen, the Netherlands
| | - Sietse F de Boer
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG Groningen, the Netherlands.
| | - Martien J H Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, 9747 AG Groningen, the Netherlands.
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Mulder PPG, Koenen HJPM, Vlig M, Joosten I, de Vries RBM, Boekema BKHL. Burn-Induced Local and Systemic Immune Response: Systematic Review and Meta-Analysis of Animal Studies. J Invest Dermatol 2022; 142:3093-3109.e15. [PMID: 35623415 DOI: 10.1016/j.jid.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 10/31/2022]
Abstract
As burn injuries are often followed by a derailed immune response and excessive inflammation, a thorough understanding of the occurring reactions is key to prevent secondary complications. This systematic review, that includes 247 animal studies, shows the post-burn response of 14 different immune cell types involved in immediate and long-term effects, in both wound tissue and circulation. Peripheral blood neutrophil and monocyte numbers increased directly after burns, whereas thrombocyte numbers increased near the end of the first week. Lymphocyte numbers, however, were decreased for at least two weeks. In burn wound tissue, neutrophil and macrophage numbers accumulated during the first three weeks. Burns also altered cellular functions as we found increased migratory potential of leukocytes, impaired antibacterial activity of neutrophils and enhanced inflammatory mediator production by macrophages. Neutrophil surges were positively associated with burn size and were highest in rats. Altogether, this comprehensive overview of the temporal immune cell dynamics shows that unlike normal wound healing, burn injury induces a long-lasting inflammatory response. It provides a fundamental research basis to improve experimental set-ups, burn care and outcome.
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Affiliation(s)
- Patrick P G Mulder
- Association of Dutch Burn Centres (ADBC), Preclinical Research, Beverwijk, the Netherlands; Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Hans J P M Koenen
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres (ADBC), Preclinical Research, Beverwijk, the Netherlands
| | - Irma Joosten
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bouke K H L Boekema
- Association of Dutch Burn Centres (ADBC), Preclinical Research, Beverwijk, the Netherlands
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Koch SE, de Kort BJ, Holshuijsen N, Brouwer HFM, van der Valk DC, Dankers PYW, van Luijk JAKR, Hooijmans CR, de Vries RBM, Bouten CVC, Smits AIPM. Animal studies for the evaluation of in situ tissue-engineered vascular grafts - a systematic review, evidence map, and meta-analysis. NPJ Regen Med 2022; 7:17. [PMID: 35197483 PMCID: PMC8866508 DOI: 10.1038/s41536-022-00211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/11/2022] [Indexed: 12/12/2022] Open
Abstract
Vascular in situ tissue engineering (TE) is an approach that uses bioresorbable grafts to induce endogenous regeneration of damaged blood vessels. The evaluation of newly developed in situ TE vascular grafts heavily relies on animal experiments. However, no standard for in vivo models or study design has been defined, hampering inter-study comparisons and translational efficiency. To provide input for formulating such standard, the goal of this study was to map all animal experiments for vascular in situ TE using off-the-shelf available, resorbable synthetic vascular grafts. A literature search (PubMed, Embase) yielded 15,896 studies, of which 182 studies met the inclusion criteria (n = 5,101 animals). The reports displayed a wide variety of study designs, animal models, and biomaterials. Meta-analysis on graft patency with subgroup analysis for species, age, sex, implantation site, and follow-up time demonstrated model-specific variations. This study identifies possibilities for improved design and reporting of animal experiments to increase translational value.
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Affiliation(s)
- Suzanne E Koch
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bente J de Kort
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Noud Holshuijsen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Hannah F M Brouwer
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Dewy C van der Valk
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Patricia Y W Dankers
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Judith A K R van Luijk
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. .,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands.
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Pamies D, Leist M, Coecke S, Bowe G, Allen DG, Gstraunthaler G, Bal-Price A, Pistollato F, de Vries RBM, Hogberg HT, Hartung T, Stacey G. Guidance document on Good Cell and Tissue Culture Practice 2.0 (GCCP 2.0). ALTEX 2021; 39:30-70. [PMID: 34882777 DOI: 10.14573/altex.2111011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/09/2021] [Indexed: 06/13/2023]
Abstract
Good Cell and Tissue Culture Practice (GCCP) 2.0 is an updated guidance document from GCCP 1.0 (published by ECVAM in 2005), which was developed for practical use in the laboratory to assure the reproducibility of in vitro (cell-based) work. The update in the guidance was essential as cell models have advanced dramatically to more complex culture systems and need more comprehensive quality management to ensure reproducibility and high-quality scientific data. This document describes six main principles to consider when performing cell culture including characterization and maintenance of essential characteristics, quality management, documentation and reporting, safety, education and training, and ethics. The document does not intend to impose detailed procedures but to describe potential quality issues. It is foreseen that the document will require further updates as the science and technologies evolve over time.
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Affiliation(s)
- David Pamies
- Department of Biomedical Science, University of Lausanne, Lausanne, Vaud, Switzerland
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Marcel Leist
- Center for Alternatives to Animal Testing (CAAT) Europe, University of Konstanz, Konstanz, Germany
- In vitro Toxicology and Biomedicine, Dept inaugurated by the Doerenkamp-Zbinden Foundation, University of Konstanz, Konstanz, Germany
| | - Sandra Coecke
- European Commission Joint Research Centre (JRC), Ispra, Italy
| | - Gerard Bowe
- European Commission Joint Research Centre (JRC), Ispra, Italy
| | - David G Allen
- Integrated Laboratory Systems, LLC., Morrisville, NC, USA
| | | | - Anna Bal-Price
- European Commission Joint Research Centre (JRC), Ispra, Italy
| | | | - Rob B M de Vries
- Evidence-based Toxicology Collaboration, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Helena T Hogberg
- Center for Alternatives to Animal Testing (CAAT), Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Hartung
- Center for Alternatives to Animal Testing (CAAT) Europe, University of Konstanz, Konstanz, Germany
- Center for Alternatives to Animal Testing (CAAT), Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Glyn Stacey
- International Stem Cell Banking Initiative, Barley, Herts, UK
- National Stem Cell Resource Centre, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Innovation Academy for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China
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6
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Pacchierotti F, Ardoino L, Benassi B, Consales C, Cordelli E, Eleuteri P, Marino C, Sciortino M, Brinkworth MH, Chen G, McNamee JP, Wood AW, Hooijmans CR, de Vries RBM. Effects of Radiofrequency Electromagnetic Field (RF-EMF) exposure on male fertility and pregnancy and birth outcomes: Protocols for a systematic review of experimental studies in non-human mammals and in human sperm exposed in vitro. Environ Int 2021; 157:106806. [PMID: 34454359 PMCID: PMC8484860 DOI: 10.1016/j.envint.2021.106806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/09/2021] [Accepted: 07/27/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Radiofrequency Electromagnetic Fields (RF-EMF) at environmental level have been reported to induce adverse effects on the male reproductive system and developing embryos. However, despite the number of experiments conducted since the 1970s, the diversity of testing approaches and exposure conditions, inconsistencies among results, and dosimetric flaws have not yet permitted a solid assessment of the relationship between RF-EMF exposure and such effects, warranting a more systematic and methodologically rigorous approach to the evaluation of available data. OBJECTIVES This study aims at evaluating the effects of RF-EMF exposure on male fertility and pregnancy outcomes by a systematic review (SR) of experimental studies, conducted in compliance with international guidelines. The evidence will be organized into three streams: 1) Studies evaluating the impact of RF-EMF on the male reproductive system of experimental mammals; 2) studies evaluating the impact of RF-EMF on human sperm exposed in vitro; 3) studies evaluating the impact of RF-EMF on adverse pregnancy, birth outcomes and delayed effects in experimental mammals exposed in utero. STUDY ELIGIBILITY AND CRITERIA Eligible studies will include peer-reviewed articles reporting of original results about effects of controlled exposures to RF-EMF in the frequency range 100 kHz-300 GHz on the selected outcomes without any language or year-of-publication restrictions. Eligible studies will be retrieved by calibrated search strings applied to three electronic databases, PubMed, Scopus and EMF Portal and by manual search of the list of references of included papers and published reviews. STUDY APPRAISAL AND SYNTHESIS METHOD The internal validity of the studies will be evaluated using the Risk of Bias (RoB) Rating Tool developed by National Toxicology Program/Office of Health Assessment and Translation (NTP/OHAT) integrated with input from the SYRCLE RoB tool. Given sufficient commensurate data, meta-analyses will be performed, otherwise narrative syntheses will be produced. Finally, the certainty of the effects of RF-EMF exposure on male fertility and pregnancy and birth outcomes will be established following GRADE. FUNDING The study is financially supported by the World Health Organization. REGISTRATION OSF Registration DOI https://doi.org/10.17605/OSF.IO/7MUS3; PROSPERO CRD42021227729, CRD42021227746.
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Affiliation(s)
- Francesca Pacchierotti
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy.
| | - Lucia Ardoino
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Barbara Benassi
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Claudia Consales
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Eugenia Cordelli
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Patrizia Eleuteri
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Carmela Marino
- Division Health Protection Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome, Italy
| | - Maurizio Sciortino
- Section Technology Transfer to Developing Countries Relating to Climate Change, ENEA, Rome, Italy
| | - Martin H Brinkworth
- School of Chemistry and Bioscience, Faculty of Life Sciences, University of Bradford, Bradford, UK
| | - Guangdi Chen
- Bioelectromagnetics Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - James P McNamee
- Non-Ionizing Radiation Health Sciences Division, Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Canada
| | - Andrew William Wood
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, Australia
| | - Carlijn R Hooijmans
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
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Remmers SJA, de Wildt BWM, Vis MAM, Spaander ESR, de Vries RBM, Ito K, Hofmann S. Osteoblast-osteoclast co-cultures: A systematic review and map of available literature. PLoS One 2021; 16:e0257724. [PMID: 34735456 PMCID: PMC8568160 DOI: 10.1371/journal.pone.0257724] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/21/2021] [Indexed: 01/22/2023] Open
Abstract
Drug research with animal models is expensive, time-consuming and translation to clinical trials is often poor, resulting in a desire to replace, reduce, and refine the use of animal models. One approach to replace and reduce the use of animal models is to use in vitro cell-culture models. To study bone physiology, bone diseases and drugs, many studies have been published using osteoblast-osteoclast co-cultures. The use of osteoblast-osteoclast co-cultures is usually not clearly mentioned in the title and abstract, making it difficult to identify these studies without a systematic search and thorough review. As a result, researchers are all developing their own methods, leading to conceptually similar studies with many methodological differences and, as a consequence, incomparable results. The aim of this study was to systematically review existing osteoblast-osteoclast co-culture studies published up to 6 January 2020, and to give an overview of their methods, predetermined outcome measures (formation and resorption, and ALP and TRAP quantification as surrogate markers for formation and resorption, respectively), and other useful parameters for analysis. Information regarding these outcome measures was extracted and collected in a database, and each study was further evaluated on whether both the osteoblasts and osteoclasts were analyzed using relevant outcome measures. From these studies, additional details on methods, cells and culture conditions were extracted into a second database to allow searching on more characteristics. The two databases presented in this publication provide an unprecedented amount of information on cells, culture conditions and analytical techniques for using and studying osteoblast-osteoclast co-cultures. They allow researchers to identify publications relevant to their specific needs and allow easy validation and comparison with existing literature. Finally, we provide the information and tools necessary for others to use, manipulate and expand the databases for their needs.
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Affiliation(s)
- Stefan J. A. Remmers
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bregje W. M. de Wildt
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Michelle A. M. Vis
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Eva S. R. Spaander
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Rob B. M. de Vries
- Department for Health Evidence, SYRCLE, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands
| | - Keita Ito
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sandra Hofmann
- Department of Biomedical Engineering and the Institute of Complex Molecular Systems, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands
- * E-mail:
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Hoffmann S, Marigliani B, Akgün-Ölmez SG, Ireland D, Cruz R, Busquet F, Flick B, Lalu M, Ghandakly EC, de Vries RBM, Witters H, Wright RA, Ölmez M, Willett C, Hartung T, Stephens ML, Tsaioun K. A Systematic Review to Compare Chemical Hazard Predictions of the Zebrafish Embryotoxicity Test With Mammalian Prenatal Developmental Toxicity. Toxicol Sci 2021; 183:14-35. [PMID: 34109416 PMCID: PMC8404989 DOI: 10.1093/toxsci/kfab072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Originally developed to inform the acute toxicity of chemicals on fish, the zebrafish embryotoxicity test (ZET) has also been proposed for assessing the prenatal developmental toxicity of chemicals, potentially replacing mammalian studies. Although extensively evaluated in primary studies, a comprehensive review summarizing the available evidence for the ZET's capacity is lacking. Therefore, we conducted a systematic review of how well the presence or absence of exposure-related findings in the ZET predicts prenatal development toxicity in studies with rats and rabbits. A two-tiered systematic review of the developmental toxicity literature was performed, a review of the ZET literature was followed by one of the mammalian literature. Data were extracted using DistillerSR, and study validity was assessed with an amended SYRCLE's risk-of-bias tool. Extracted data were analyzed for each species and substance, which provided the basis for comparing the 2 test methods. Although limited by the number of 24 included chemicals, our results suggest that the ZET has potential to identify chemicals that are mammalian prenatal developmental toxicants, with a tendency for overprediction. Furthermore, our analysis confirmed the need for further standardization of the ZET. In addition, we identified contextual and methodological challenges in the application of systematic review approaches to toxicological questions. One key to overcoming these challenges is a transition to more comprehensive and transparent planning, conduct and reporting of toxicological studies. The first step toward bringing about this change is to create broad awareness in the toxicological community of the need for and benefits of more evidence-based approaches.
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Affiliation(s)
- Sebastian Hoffmann
- Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
- seh consulting + services, 33106 Paderborn, Germany
| | - Bianca Marigliani
- Department of Science and Technology, Federal University of São Paulo (UNIFESP), São José dos Campos, 12231-280 São Paulo, Brazil
| | - Sevcan Gül Akgün-Ölmez
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Marmara University, Istanbul, 34722, Turkey
| | - Danielle Ireland
- Department of Biology, Swarthmore College, Swarthmore, Pennsylvania 19081, USA
| | - Rebecca Cruz
- Laboratory of Dental Clinical Research, Universidade Federal Fluminense, Niterói, 20520-040 Rio de Janeiro, Brazil
| | | | - Burkhard Flick
- Experimental Toxicology and Ecology, BASF SE, 67063 Ludwigshafen am Rhein, Germany
| | - Manoj Lalu
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute, Ottawa, K1H 8L6 Ontario, Canada
| | - Elizabeth C Ghandakly
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Rob B M de Vries
- Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
- Systematic Review Centre for Laboratory Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, 6500HB Nijmegen, The Netherlands
| | | | - Robert A Wright
- William H. Welch Medical Library, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Metin Ölmez
- Umraniye Family Health Center (No. 44), Turkish Ministry of Health, 34760 Istanbul, Turkey
| | - Catherine Willett
- Humane Society International, Washington, 20037 District of Columbia, USA
| | - Thomas Hartung
- Center for Alternatives to Animal Testing (CAAT), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
| | - Martin L Stephens
- Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
| | - Katya Tsaioun
- Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Lutke Schipholt IJ, Coppieters MW, Meijer OG, Tompra N, de Vries RBM, Scholten-Peeters GGM. Effects of joint and nerve mobilisation on neuroimmune responses in animals and humans with neuromusculoskeletal conditions: a systematic review and meta-analysis. Pain Rep 2021; 6:e927. [PMID: 34104836 PMCID: PMC8177878 DOI: 10.1097/pr9.0000000000000927] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/18/2021] [Accepted: 03/12/2021] [Indexed: 12/14/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. There is evidence that joint and nerve mobilisations compared with sham or no intervention positively influence various neuroimmune responses in animal and human neuromusculoskeletal conditions. Several animal and human studies revealed that joint and nerve mobilisations positively influence neuroimmune responses in neuromusculoskeletal conditions. However, no systematic review and meta-analysis has been performed. Therefore, this study aimed to synthesize the effects of joint and nerve mobilisation compared with sham or no intervention on neuroimmune responses in animals and humans with neuromusculoskeletal conditions. Four electronic databases were searched for controlled trials. Two reviewers independently selected studies, extracted data, assessed the risk of bias, and graded the certainty of the evidence. Where possible, meta-analyses using random effects models were used to pool the results. Preliminary evidence from 13 animal studies report neuroimmune responses after joint and nerve mobilisations. In neuropathic pain models, meta-analysis revealed decreased spinal cord levels of glial fibrillary acidic protein, dorsal root ganglion levels of interleukin-1β, number of dorsal root ganglion nonneuronal cells, and increased spinal cord interleukin-10 levels. The 5 included human studies showed mixed effects of spinal manipulation on salivary/serum cortisol levels in people with spinal pain, and no significant effects on serum β-endorphin or interleukin-1β levels in people with spinal pain. There is evidence that joint and nerve mobilisations positively influence various neuroimmune responses. However, as most findings are based on single studies, the certainty of the evidence is low to very low. Further studies are needed.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, Amsterdam, the Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
| | - Onno G Meijer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China
| | - Nefeli Tompra
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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10
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Post WM, Ruiz-Zapata AM, Grens H, de Vries RBM, Poelmans G, Coenen MJH, Janssen DAW, Heesakkers JPFA, Oosterwijk E, Kluivers KB. Genetic variants and expression changes in urgency urinary incontinence: A systematic review. Neurourol Urodyn 2020; 39:2089-2110. [PMID: 32949220 PMCID: PMC7692907 DOI: 10.1002/nau.24512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/17/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022]
Abstract
Aim To perform a systematic review summarizing the knowledge of genetic variants, gene, and protein expression changes in humans and animals associated with urgency urinary incontinence (UUI) and to provide an overview of the known molecular mechanisms related to UUI. Methods A systematic search was performed on March 2, 2020, in PubMed, Embase, Web of Science, and the Cochrane library. Retrieved studies were screened for eligibility. The risk of bias was assessed using the ROBINS‐I (human) and SYRCLE (animal) tool. Data were presented in a structured manner and in the case of greater than five studies on a homogeneous outcome, a meta‐analysis was performed. Results Altogether, a total of 10,785 records were screened of which 37 studies met the inclusion criteria. Notably, 24/37 studies scored medium‐high to high on risk of bias, affecting the value of the included studies. The analysis of 70 unique genes and proteins and three genome‐wide association studies showed that specific signal transduction pathways and inflammation are associated with UUI. A meta‐analysis on the predictive value of urinary nerve growth factor (NGF) levels showed that increased urinary NGF levels correlate with UUI. Conclusion The collective evidence showed the involvement of two molecular mechanisms (signal transduction and inflammation) and NGF in UUI, enhancing our understanding of the pathophysiology of UUI. Unfortunately, the risk of bias was medium‐high to high for most studies and the value of many observations remains unclear. Future studies should focus on elucidating how deficits in the two identified molecular mechanisms contribute to UUI and should avoid bias.
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Affiliation(s)
- Wilke M Post
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alejandra M Ruiz-Zapata
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hilde Grens
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- Department for Health Evidence, SYRCLE, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick A W Janssen
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Egbert Oosterwijk
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kirsten B Kluivers
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
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11
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Lodoso-Torrecilla I, Klein Gunnewiek R, Grosfeld EC, de Vries RBM, Habibović P, Jansen JA, van den Beucken JJJP. Bioinorganic supplementation of calcium phosphate-based bone substitutes to improve in vivo performance: a systematic review and meta-analysis of animal studies. Biomater Sci 2020; 8:4792-4809. [PMID: 32729591 DOI: 10.1039/d0bm00599a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Supplementation of CaP-based bone graft substitutes with bioinorganics such as strontium, zinc or silicon is an interesting approach to increase the biological performance in terms of bone regenerative potential of calcium phosphate (CaP)-based bone substitutes. However, the in vivo efficacy of this approach has not been systematically analyzed, yet. Consequently, we performed a systematic review using the available literature regarding the effect of bioinorganic supplementation in CaP-based biomaterials on new bone formation and material degradation in preclinical animal bone defect models and studied this effect quantitatively by performing a meta-analysis. Additional subgroup analyses were used to study the effect of different bioinorganics, animal model, or phase category of CaP-based biomaterial on bone formation or material degradation. Results show that bioinorganic supplementation increases new bone formation (standardized mean difference [SMD]: 1.43 SD, confidence interval [CI]: 1.13-1.73). Additional subgroup analysis showed that strontium, magnesium and silica significantly enhanced bone formation, while zinc did not have any effect. This effect of bioinorganic supplementation on new bone formation was stronger for DCPD or β-TCP and biphasic CaPs than for HA or α-TCP (p < 0.001). In general, material degradation was slightly hindered by bioinorganic supplementation (mean difference [MD]: 0.84%, CI: 0.01-1.66), with the exception of strontium that significantly enhanced degradation. Overall, bioinorganic supplementation represents an effective approach to enhance the biological performance of CaP-based bone substitutes.
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12
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Pires GN, Bezerra AG, de Vries RBM, Leenaars CHC, Ritskes-Hoitinga M, Tufik S, Andersen ML. Effects of experimental sleep deprivation on aggressive, sexual and maternal behaviour in animals: a systematic review protocol. BMJ Open Science 2018; 2:e000041. [PMID: 35047677 PMCID: PMC8749292 DOI: 10.1136/bmjos-2017-000041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 10/24/2018] [Indexed: 12/11/2022] Open
Abstract
Objective Because of the relevance for the research on sleep deprivation and human behaviour, many preclinical studies have been conducted on aggressive, sexual and maternal behaviours in this field. Considering the available data and the complexity of the factors involved, the most appropriate way to summarise the effects of sleep deprivation on these behaviours is through systematic reviews and meta-analyses. This article describes the protocol for three independent systematic reviews and meta-analyses, evaluating the effects of sleep deprivation on aggressive, sexual and maternal behaviours in animals. Search strategy A bibliographic search will be performed in four databases: Pubmed, Scopus, Web of Science and Psychinfo, searching for three domains: sleep deprivation (as the intervention), animals (as the population) and behaviour (as the outcome). Screening and annotation Titles and abstracts will first be screened, followed by analysis of the full text and data extraction. Data management and reporting SYstematic Review Centre for Laboratory Animal Experimentation ’s risk of bias tool will be used to evaluate risk of bias; visual analysis of funnel plots, Egger’s regression and trim-and-fill will be employed to evaluate publication bias. Effect sizes will be calculated from the articles by either direct or standardised mean difference, depending on the nature of the data. Overall estimates will then be calculated using a random effects model. Heterogeneity will be assessed using both I2 index and Cochran’s Q test. These meta-analyses should be useful to summarise the available data on the relationship between sleep deprivation and behaviour, providing a solid background for future behavioural sleep deprivation experiments, improving their validity.
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Affiliation(s)
- Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | | | - Rob B M de Vries
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE) at Central Animal Facility, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Merel Ritskes-Hoitinga
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE) at Central Animal Facility, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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13
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van der Mierden S, Savelyev SA, IntHout J, de Vries RBM, Leenaars CHC. Intracerebral microdialysis of adenosine and adenosine monophosphate - a systematic review and meta-regression analysis of baseline concentrations. J Neurochem 2018; 147:58-70. [PMID: 30025168 PMCID: PMC6220825 DOI: 10.1111/jnc.14552] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/02/2018] [Accepted: 07/12/2018] [Indexed: 01/18/2023]
Abstract
Microdialysis is a method to study the extracellular space in vivo, based on the principle of diffusion. It can be used to measure various small molecules including the neuroregulator adenosine. Baseline levels of the compounds measured with microdialysis vary over studies. We systematically reviewed the literature to investigate the full range of reported baseline concentrations of adenosine and adenosine monophosphate in microdialysates. We performed a meta‐regression analysis to study the influence of flow rate, probe membrane surface area, species, brain area and anaesthesia versus freely behaving, on the adenosine concentration. Baseline adenosine concentrations in microdialysates ranged from 0.8 to 2100 nM. There was limited evidence on baseline adenosine monophosphate concentrations in microdialysates. Across studies, we found effects of flow rate and anaesthesia versus freely behaving on dialysate adenosine concentrations (p ≤ 0.001), but not of probe membrane surface, species, or brain area (p ≥ 0.14). With increasing flow rate, adenosine concentrations decreased. With anaesthesia, adenosine concentrations increased. The effect of other predictor variables on baseline adenosine concentrations, for example, post‐surgical recovery time, could not be analysed because of a lack of reported data. This study shows that meta‐regression can be used as an alternative to new animal experiments to answer research questions in the field of neurochemistry. However, current levels of reporting of primary studies are insufficient to reach the full potential of this approach; 63 out of 133 studies could not be included in the analysis because of insufficient reporting, and several potentially relevant factors had to be excluded from the analyses. The level of reporting of experimental detail needs to improve. ![]()
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Affiliation(s)
- Stevie van der Mierden
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Sergey A Savelyev
- Medical Biological Research & Development Centre 'Cytomed', St.-Petersburg, Russia
| | - Joanna IntHout
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cathalijn H C Leenaars
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany.,Department of Animals in Science and Society - Human-Animal Relationship, Utrecht University, Utrecht, The Netherlands
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14
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Hooijmans CR, de Vries RBM, Ritskes-Hoitinga M, Rovers MM, Leeflang MM, IntHout J, Wever KE, Hooft L, de Beer H, Kuijpers T, Macleod MR, Sena ES, ter Riet G, Morgan RL, Thayer KA, Rooney AA, Guyatt GH, Schünemann HJ, Langendam MW. Facilitating healthcare decisions by assessing the certainty in the evidence from preclinical animal studies. PLoS One 2018; 13:e0187271. [PMID: 29324741 PMCID: PMC5764235 DOI: 10.1371/journal.pone.0187271] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022] Open
Abstract
Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.g., toxicology), studies in experimental animals may provide the only relevant or controlled data and directly inform clinical management decisions. Systematic reviews and meta-analyses are important tools to provide robust and informative evidence summaries of these animal studies. Rating how certain we are about the evidence could provide important information about the translational probability of findings in experimental animal studies to clinical practice and probably improve it. Evidence summaries and certainty in the evidence ratings could also be used (1) to support selection of interventions with best therapeutic potential to be tested in clinical trials, (2) to justify a regulatory decision limiting human exposure (to drug or toxin), or to (3) support decisions on the utility of further animal experiments. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach is the most widely used framework to rate the certainty in the evidence and strength of health care recommendations. Here we present how the GRADE approach could be used to rate the certainty in the evidence of preclinical animal studies in the context of therapeutic interventions. We also discuss the methodological challenges that we identified, and for which further work is needed. Examples are defining the importance of consistency within and across animal species and using GRADE's indirectness domain as a tool to predict translation from animal models to humans.
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Affiliation(s)
- Carlijn R. Hooijmans
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B. M. de Vries
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Merel Ritskes-Hoitinga
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maroeska M. Rovers
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mariska M. Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joanna IntHout
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kimberley E. Wever
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, University Medical Center, Utrecht, The Netherlands
| | | | - Ton Kuijpers
- Dutch College of General Practitioners, Utrecht, The Netherlands
| | - Malcolm R. Macleod
- Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily S. Sena
- Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Gerben ter Riet
- Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Rebecca L. Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Kristina A. Thayer
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Washington, D.C., United States of America
| | - Andrew A. Rooney
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Washington, D.C., United States of America
| | - Gordon H. Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Miranda W. Langendam
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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15
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Pot MW, van Kuppevelt TH, Gonzales VK, Buma P, IntHout J, de Vries RBM, Daamen WF. Augmented cartilage regeneration by implantation of cellular versus acellular implants after bone marrow stimulation: a systematic review and meta-analysis of animal studies. PeerJ 2017; 5:e3927. [PMID: 29093996 PMCID: PMC5661456 DOI: 10.7717/peerj.3927] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/25/2017] [Indexed: 12/12/2022] Open
Abstract
Bone marrow stimulation may be applied to regenerate focal cartilage defects, but generally results in transient clinical improvement and formation of fibrocartilage rather than hyaline cartilage. Tissue engineering and regenerative medicine strive to develop new solutions to regenerate hyaline cartilage tissue. This systematic review and meta-analysis provides a comprehensive overview of current literature and assesses the efficacy of articular cartilage regeneration by implantation of cell-laden versus cell-free biomaterials in the knee and ankle joint in animals after bone marrow stimulation. PubMed and EMBASE (via OvidSP) were systematically searched using tissue engineering, cartilage and animals search strategies. Included were primary studies in which cellular and acellular biomaterials were implanted after applying bone marrow stimulation in the knee or ankle joint in healthy animals. Study characteristics were tabulated and outcome data were collected for meta-analysis for studies applying semi-quantitative histology as outcome measure (117 studies). Cartilage regeneration was expressed on an absolute 0–100% scale and random effects meta-analyses were performed. Implantation of cellular biomaterials significantly improved cartilage regeneration by 18.6% compared to acellular biomaterials. No significant differences were found between biomaterials loaded with stem cells and those loaded with somatic cells. Culture conditions of cells did not affect cartilage regeneration. Cartilage formation was reduced with adipose-derived stem cells compared to other cell types, but still improved compared to acellular scaffolds. Assessment of the risk of bias was impaired due to incomplete reporting for most studies. Implantation of cellular biomaterials improves cartilage regeneration compared to acellular biomaterials.
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Affiliation(s)
- Michiel W Pot
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Toin H van Kuppevelt
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Veronica K Gonzales
- Department of Orthopedics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Pieter Buma
- Department of Orthopedics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Joanna IntHout
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYRCLE (SYstematic Review Centre for Laboratory animal Experimentation), Central Animal Laboratory, Radboud university medical center, Nijmegen, The Netherlands
| | - Willeke F Daamen
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
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16
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Versteegden LRM, de Jonge PKJD, IntHout J, van Kuppevelt TH, Oosterwijk E, Feitz WFJ, de Vries RBM, Daamen WF. Tissue Engineering of the Urethra: A Systematic Review and Meta-analysis of Preclinical and Clinical Studies. Eur Urol 2017; 72:594-606. [PMID: 28385451 DOI: 10.1016/j.eururo.2017.03.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/17/2017] [Indexed: 01/31/2023]
Abstract
CONTEXT Urethra repair by tissue engineering has been extensively studied in laboratory animals and patients, but is not routinely used in clinical practice. OBJECTIVE To systematically investigate preclinical and clinical evidence of the efficacy of tissue engineering for urethra repair in order to stimulate translation of preclinical studies to the clinic. EVIDENCE ACQUISITION A systematic search strategy was applied in PubMed and EMBASE. Studies were independently screened for relevance by two reviewers, resulting in 80 preclinical and 23 clinical studies of which 63 and 13 were selected for meta-analysis to assess side effects, functionality, and study completion. Analyses for preclinical and clinical studies were performed separately. Full circumferential and inlay procedures were assessed independently. Evaluated parameters included seeding of cells and type of biomaterial. EVIDENCE SYNTHESIS Meta-analysis revealed that cell seeding significantly reduced the probability of encountering side effects in preclinical studies. Remarkably though, cells were only sparsely used in the clinic (4/23 studies) and showed no significant reduction of side effects. ln 21 out of 23 clinical studies, decellularized templates were used, while in preclinical studies other biomaterials showed promising outcomes as well. No direct comparison to current clinical practice could be made due to the limited number of randomized controlled studies. CONCLUSIONS Due to a lack of controlled (pre)clinical studies, the efficacy of tissue engineering for urethra repair could not be determined. Meta-analysis outcome measures were similar to current treatment options described in literature. Surprisingly, it appeared that favorable preclinical results, that is inclusion of cells, were not translated to the clinic. Improved (pre)clinical study designs may enhance clinical translation. PATIENT SUMMARY We reviewed all available literature on urethral tissue engineering to assess the efficacy in preclinical and clinical studies. We show that improvements to (pre)clinical study design is required to improve clinical translation of tissue engineering technologies.
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Affiliation(s)
- Luuk R M Versteegden
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Paul K J D de Jonge
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Joanna IntHout
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Toin H van Kuppevelt
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Wout F J Feitz
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands; Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYRCLE (SYstematic Review Centre for Laboratory Animal Experimentation), Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Willeke F Daamen
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands.
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17
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Pot MW, Gonzales VK, Buma P, IntHout J, van Kuppevelt TH, de Vries RBM, Daamen WF. Improved cartilage regeneration by implantation of acellular biomaterials after bone marrow stimulation: a systematic review and meta-analysis of animal studies. PeerJ 2016; 4:e2243. [PMID: 27651981 PMCID: PMC5018675 DOI: 10.7717/peerj.2243] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/21/2016] [Indexed: 12/21/2022] Open
Abstract
Microfracture surgery may be applied to treat cartilage defects. During the procedure the subchondral bone is penetrated, allowing bone marrow-derived mesenchymal stem cells to migrate towards the defect site and form new cartilage tissue. Microfracture surgery generally results in the formation of mechanically inferior fibrocartilage. As a result, this technique offers only temporary clinical improvement. Tissue engineering and regenerative medicine may improve the outcome of microfracture surgery. Filling the subchondral defect with a biomaterial may provide a template for the formation of new hyaline cartilage tissue. In this study, a systematic review and meta-analysis were performed to assess the current evidence for the efficacy of cartilage regeneration in preclinical models using acellular biomaterials implanted after marrow stimulating techniques (microfracturing and subchondral drilling) compared to the natural healing response of defects. The review aims to provide new insights into the most effective biomaterials, to provide an overview of currently existing knowledge, and to identify potential lacunae in current studies to direct future research. A comprehensive search was systematically performed in PubMed and EMBASE (via OvidSP) using search terms related to tissue engineering, cartilage and animals. Primary studies in which acellular biomaterials were implanted in osteochondral defects in the knee or ankle joint in healthy animals were included and study characteristics tabulated (283 studies out of 6,688 studies found). For studies comparing non-treated empty defects to defects containing implanted biomaterials and using semi-quantitative histology as outcome measure, the risk of bias (135 studies) was assessed and outcome data were collected for meta-analysis (151 studies). Random-effects meta-analyses were performed, using cartilage regeneration as outcome measure on an absolute 0–100% scale. Implantation of acellular biomaterials significantly improved cartilage regeneration by 15.6% compared to non-treated empty defect controls. The addition of biologics to biomaterials significantly improved cartilage regeneration by 7.6% compared to control biomaterials. No significant differences were found between biomaterials from natural or synthetic origin or between scaffolds, hydrogels and blends. No noticeable differences were found in outcome between animal models. The risk of bias assessment indicated poor reporting for the majority of studies, impeding an assessment of the actual risk of bias. In conclusion, implantation of biomaterials in osteochondral defects improves cartilage regeneration compared to natural healing, which is further improved by the incorporation of biologics.
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Affiliation(s)
- Michiel W Pot
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Veronica K Gonzales
- Department of Orthopedics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Pieter Buma
- Department of Orthopedics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Joanna IntHout
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Toin H van Kuppevelt
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYRCLE (SYstematic Review Centre for Laboratory animal Experimentation), Central Animal Laboratory, Radboud university medical center, Nijmegen, The Netherlands
| | - Willeke F Daamen
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
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Golbach LA, Portelli LA, Savelkoul HFJ, Terwel SR, Kuster N, de Vries RBM, Verburg-van Kemenade BML. Calcium homeostasis and low-frequency magnetic and electric field exposure: A systematic review and meta-analysis of in vitro studies. Environ Int 2016; 92-93:695-706. [PMID: 26872872 DOI: 10.1016/j.envint.2016.01.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 12/10/2015] [Accepted: 01/18/2016] [Indexed: 05/24/2023]
Abstract
Low frequency magnetic field (LF MF) exposure is recurrently suggested to have the ability to induce health effects in society. Therefore, in vitro model systems are used to investigate biological effects of exposure. LF MF induced changes of the cellular calcium homeostasis are frequently hypothesised to be the possible target, but this hypothesis is both substantiated and rejected by numerous studies in literature. Despite the large amount of data, no systematic analysis of in vitro studies has been conducted to address the strength of evidence for an association between LF MF exposure and calcium homeostasis. Our systematic review, with inclusion of 42 studies, showed evidence for an association of LF MF with internal calcium concentrations and calcium oscillation patterns. The oscillation frequency increased, while the amplitude and the percentage of oscillating cells remained constant. The intracellular calcium concentration increased (SMD 0.351, 95% CI 0.126, 0.576). Subgroup analysis revealed heterogeneous effects associated with the exposure frequency, magnetic flux density and duration. Moreover, we found support for the presence of MF-sensitive cell types. Nevertheless, some of the included studies may introduce a great risk of bias as a result of uncontrolled or not reported exposure conditions, temperature ranges and ambient fields. In addition, mathematical calculations of the parasitic induced electric fields (IEFs) disclosed their association with increased intracellular calcium. Our results demonstrate that LF MF might influence the calcium homeostasis in cells in vitro, but the risk of bias and high heterogeneity (I(2)>75%) weakens the analyses. Therefore any potential clinical implications await further investigation.
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Affiliation(s)
- Lieke A Golbach
- Cell Biology and Immunology Group, Wageningen University, P.O.Box 338, 6700AH Wageningen, The Netherlands
| | - Lucas A Portelli
- The Foundation for Research on Information Technologies in Society (IT'IS), Zeughausstrasse 43, CH-8004 Zurich, Switzerland
| | - Huub F J Savelkoul
- Cell Biology and Immunology Group, Wageningen University, P.O.Box 338, 6700AH Wageningen, The Netherlands
| | - Sofie R Terwel
- Cell Biology and Immunology Group, Wageningen University, P.O.Box 338, 6700AH Wageningen, The Netherlands
| | - Niels Kuster
- The Foundation for Research on Information Technologies in Society (IT'IS), Zeughausstrasse 43, CH-8004 Zurich, Switzerland; Department of Information Technology and Electrical Engineering, Swiss Federal Technical Institute (ETHZ), Gloriastrasse 35, CH-8092 Zurich, Switzerland
| | - Rob B M de Vries
- SYRCLE, Central Animal Laboratory, Radboud University Medical Center, The Netherlands
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Raavé R, de Vries RBM, Massuger LF, van Kuppevelt TH, Daamen WF. Drug delivery systems for ovarian cancer treatment: a systematic review and meta-analysis of animal studies. PeerJ 2015; 3:e1489. [PMID: 26713240 PMCID: PMC4690347 DOI: 10.7717/peerj.1489] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/19/2015] [Indexed: 01/04/2023] Open
Abstract
Current ovarian cancer treatment involves chemotherapy that has serious limitations, such as rapid clearance, unfavorable biodistribution and severe side effects. To overcome these limitations, drug delivery systems (DDS) have been developed to encapsulate chemotherapeutics for delivery to tumor cells. However, no systematic assessment of the efficacy of chemotherapy by DDS compared to free chemotherapy (not in a DDS) has been performed for animal studies. Here, we assess the efficacy of chemotherapy in DDS on survival and tumor growth inhibition in animal studies. We searched PubMed and EMBASE (via OvidSP) to systematically identify studies evaluating chemotherapeutics encapsulated in DDS for ovarian cancer treatment in animal studies. Studies were assessed for quality and risk of bias. Study characteristics were collected and outcome data (survival/hazard ratio or tumor growth inhibition) were extracted and used for meta-analyses. Meta-analysis was performed to identify and explore which characteristics of DDS influenced treatment efficacy. A total of 44 studies were included after thorough literature screening (2,735 studies found after initial search). The risk of bias was difficult to assess, mainly because of incomplete reporting. A total of 17 studies (377 animals) and 16 studies (259 animals) could be included in the meta-analysis for survival and tumor growth inhibition, respectively. In the majority of the included studies chemotherapeutics entrapped in a DDS significantly improved efficacy over free chemotherapeutics regarding both survival and tumor growth inhibition. Subgroup analyses, however, revealed that cisplatin entrapped in a DDS did not result in additional tumor growth inhibition compared to free cisplatin, although it did result in improved survival. Micelles did not show a significant tumor growth inhibition compared to free chemotherapeutics, which indicates that micelles may not be a suitable DDS for ovarian cancer treatment. Other subgroup analyses, such as targeted versus non-targeted DDS or IV versus IP administration route, did not identify specific characteristics of DDS that affected treatment efficacy. This systematic review shows the potential, but also the limitations of chemotherapy by drug delivery systems for ovarian cancer treatment. For future animal research, we emphasize that data need to be reported with ample attention to detailed reporting.
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Affiliation(s)
- René Raavé
- Department of Biochemistry, Radboud university medical center , Nijmegen , The Netherlands
| | - Rob B M de Vries
- Systematic Review Centre for Laboratory Animal Experimentation, Central Animal Facility, Radboud university medical center , Nijmegen , The Netherlands
| | - Leon F Massuger
- Department of Obstetrics and Gynaecology, Radboud university medical center , Nijmegen , The Netherlands
| | - Toin H van Kuppevelt
- Department of Biochemistry, Radboud university medical center , Nijmegen , The Netherlands
| | - Willeke F Daamen
- Department of Biochemistry, Radboud university medical center , Nijmegen , The Netherlands
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de Vries RBM, Wever KE, Avey MT, Stephens ML, Sena ES, Leenaars M. The usefulness of systematic reviews of animal experiments for the design of preclinical and clinical studies. ILAR J 2015; 55:427-37. [PMID: 25541545 PMCID: PMC4276599 DOI: 10.1093/ilar/ilu043] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The question of how animal studies should be designed, conducted, and analyzed remains underexposed in societal debates on animal experimentation. This is not only a scientific but also a moral question. After all, if animal experiments are not appropriately designed, conducted, and analyzed, the results produced are unlikely to be reliable and the animals have in effect been wasted. In this article, we focus on one particular method to address this moral question, namely systematic reviews of previously performed animal experiments. We discuss how the design, conduct, and analysis of future (animal and human) experiments may be optimized through such systematic reviews. In particular, we illustrate how these reviews can help improve the methodological quality of animal experiments, make the choice of an animal model and the translation of animal data to the clinic more evidence-based, and implement the 3Rs. Moreover, we discuss which measures are being taken and which need to be taken in the future to ensure that systematic reviews will actually contribute to optimizing experimental design and thereby to meeting a necessary condition for making the use of animals in these experiments justified.
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Yan XZ, Yang F, Jansen JA, de Vries RBM, van den Beucken JJJP. Cell-Based Approaches in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Periodontal Defect Models in Animal Experimental Work. Tissue Eng Part B Rev 2015; 21:411-26. [PMID: 25929285 DOI: 10.1089/ten.teb.2015.0049] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Various cell types have been assessed for experimental periodontal tissue regeneration in a variety of animal models. Nonetheless, the efficacy of cell-based approaches for periodontal regeneration is still controversial. Therefore, the purpose of this study was to systematically review cell-based approaches for periodontal regeneration in animal studies including a meta-analysis to obtain more clarity on their efficacy. The results of this systematic review and meta-analysis revealed that cell-based approaches have a favorable effect on periodontal tissue regeneration, as displayed by the positive effect of cell-based approaches on new bone, cementum, and periodontal ligament (PDL) formation in periodontal defects. Moreover, subgroup analysis showed a favorable effect on PDL formation by PDL-derived cells, but not by bone marrow mesenchymal stem cells (BMSCs). However, meta-analysis did not show any statistically significant differences in effect between PDL-derived cells and BMSCs. These results provide important information for the implementation of cell-based approaches in clinical practice as a routine treatment for periodontal regeneration in the future.
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Affiliation(s)
- Xiang-Zhen Yan
- 1 Radboudumc, Department of Biomaterials, Nijmegen, The Netherlands .,2 Department of Periodontology, the Affiliated Stomatology Hospital of Tongji University , Shanghai, China
| | - Fang Yang
- 1 Radboudumc, Department of Biomaterials, Nijmegen, The Netherlands
| | - John A Jansen
- 1 Radboudumc, Department of Biomaterials, Nijmegen, The Netherlands
| | - Rob B M de Vries
- 3 Radboudumc, SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) , Central Animal Laboratory, Nijmegen, The Netherlands
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de Vries RBM, Hooijmans CR, Langendam MW, van Luijk J, Leenaars M, Ritskes-Hoitinga M, Wever KE. A protocol format for the preparation, registration and publication of systematic reviews of animal intervention studies. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/ebm2.7] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Rob B. M. de Vries
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
| | - Carlijn R. Hooijmans
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
| | - Miranda W. Langendam
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics; Academic Medical Center (AMC); Amsterdam The Netherlands
| | - Judith van Luijk
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
| | - Marlies Leenaars
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
| | - Kimberley E. Wever
- SYRCLE, Central Animal Laboratory; Radboud University Medical Center; Nijmegen The Netherlands
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Hooijmans CR, Rovers MM, de Vries RBM, Leenaars M, Ritskes-Hoitinga M, Langendam MW. SYRCLE's risk of bias tool for animal studies. BMC Med Res Methodol 2014; 14:43. [PMID: 24667063 PMCID: PMC4230647 DOI: 10.1186/1471-2288-14-43] [Citation(s) in RCA: 1853] [Impact Index Per Article: 185.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 03/10/2014] [Indexed: 02/06/2023] Open
Abstract
Background Systematic Reviews (SRs) of experimental animal studies are not yet common practice, but awareness of the merits of conducting such SRs is steadily increasing. As animal intervention studies differ from randomized clinical trials (RCT) in many aspects, the methodology for SRs of clinical trials needs to be adapted and optimized for animal intervention studies. The Cochrane Collaboration developed a Risk of Bias (RoB) tool to establish consistency and avoid discrepancies in assessing the methodological quality of RCTs. A similar initiative is warranted in the field of animal experimentation. Methods We provide an RoB tool for animal intervention studies (SYRCLE’s RoB tool). This tool is based on the Cochrane RoB tool and has been adjusted for aspects of bias that play a specific role in animal intervention studies. To enhance transparency and applicability, we formulated signalling questions to facilitate judgment. Results The resulting RoB tool for animal studies contains 10 entries. These entries are related to selection bias, performance bias, detection bias, attrition bias, reporting bias and other biases. Half these items are in agreement with the items in the Cochrane RoB tool. Most of the variations between the two tools are due to differences in design between RCTs and animal studies. Shortcomings in, or unfamiliarity with, specific aspects of experimental design of animal studies compared to clinical studies also play a role. Conclusions SYRCLE’s RoB tool is an adapted version of the Cochrane RoB tool. Widespread adoption and implementation of this tool will facilitate and improve critical appraisal of evidence from animal studies. This may subsequently enhance the efficiency of translating animal research into clinical practice and increase awareness of the necessity of improving the methodological quality of animal studies.
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Affiliation(s)
- Carlijn R Hooijmans
- SYRCLE at Central Animal Laboratory, Radboud University Medical Center, Nijmegen, the Netherlands.
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van Luijk J, Bakker B, Rovers MM, Ritskes-Hoitinga M, de Vries RBM, Leenaars M. Systematic reviews of animal studies; missing link in translational research? PLoS One 2014; 9:e89981. [PMID: 24670965 PMCID: PMC3966727 DOI: 10.1371/journal.pone.0089981] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 01/25/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The methodological quality of animal studies is an important factor hampering the translation of results from animal studies to a clinical setting. Systematic reviews of animal studies may provide a suitable method to assess and thereby improve their methodological quality. OBJECTIVES The aims of this study were: 1) to evaluate the risk of bias assessment in animal-based systematic reviews, and 2) to study the internal validity of the primary animal studies included in these systematic reviews. DATA SOURCES We systematically searched Pubmed and Embase for SRs of preclinical animal studies published between 2005 and 2012. RESULTS A total of 91 systematic reviews met our inclusion criteria. The risk of bias was assessed in 48 (52.7%) of these 91 systematic reviews. Thirty-three (36.3%) SRs provided sufficient information to evaluate the internal validity of the included studies. Of the evaluated primary studies, 24.6% was randomized, 14.6% reported blinding of the investigator/caretaker, 23.9% blinded the outcome assessment, and 23.1% reported drop-outs. CONCLUSIONS To improve the translation of animal data to clinical practice, systematic reviews of animal studies are worthwhile, but the internal validity of primary animal studies needs to be improved. Furthermore, risk of bias should be assessed by systematic reviews of animal studies to provide insight into the reliability of the available evidence.
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Affiliation(s)
- Judith van Luijk
- SYRCLE - Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Brenda Bakker
- SYRCLE - Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Maroeska M Rovers
- Departments for Health Evidence and Operating rooms, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE - Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Rob B M de Vries
- SYRCLE - Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Marlies Leenaars
- SYRCLE - Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, the Netherlands
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de Vries RBM, Hooijmans CR, Tillema A, Leenaars M, Ritskes-Hoitinga M. Updated version of the Embase search filter for animal studies. Lab Anim 2013; 48:88. [PMID: 23836850 DOI: 10.1177/0023677213494374] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rob B M de Vries
- SYRCLE, Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen The Netherlands
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26
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de Vries RBM, Leenaars M, Tra J, Huijbregtse R, Bongers E, Jansen JA, Gordijn B, Ritskes-Hoitinga M. The potential of tissue engineering for developing alternatives to animal experiments: a systematic review. J Tissue Eng Regen Med 2013; 9:771-8. [PMID: 23554402 DOI: 10.1002/term.1703] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 11/28/2012] [Accepted: 12/20/2012] [Indexed: 01/18/2023]
Abstract
An underexposed ethical issue raised by tissue engineering is the use of laboratory animals in tissue engineering research. Even though this research results in suffering and loss of life in animals, tissue engineering also has great potential for the development of alternatives to animal experiments. With the objective of promoting a joint effort of tissue engineers and alternative experts to fully realise this potential, this study provides the first comprehensive overview of the possibilities of using tissue-engineered constructs as a replacement of laboratory animals. Through searches in two large biomedical databases (PubMed, Embase) and several specialised 3R databases, 244 relevant primary scientific articles, published between 1991 and 2011, were identified. By far most articles reviewed related to the use of tissue-engineered skin/epidermis for toxicological applications such as testing for skin irritation. This review article demonstrates, however, that the potential for the development of alternatives also extends to other tissues such as other epithelia and the liver, as well as to other fields of application such as drug screening and basic physiology. This review discusses which impediments need to be overcome to maximise the contributions that the field of tissue engineering can make, through the development of alternative methods, to the reduction of the use and suffering of laboratory animals.
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Affiliation(s)
- Rob B M de Vries
- 3R Research Centre / SYRCLE, Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Marlies Leenaars
- 3R Research Centre / SYRCLE, Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Joppe Tra
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Erik Bongers
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - John A Jansen
- Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Bert Gordijn
- Institute of Ethics, Dublin City University, Dublin, Ireland
| | - Merel Ritskes-Hoitinga
- 3R Research Centre / SYRCLE, Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Hooijmans CR, de Vries RBM, Rovers MM, Gooszen HG, Ritskes-Hoitinga M. The effects of probiotic supplementation on experimental acute pancreatitis: a systematic review and meta-analysis. PLoS One 2012; 7:e48811. [PMID: 23152810 PMCID: PMC3496732 DOI: 10.1371/journal.pone.0048811] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 10/05/2012] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In February 2008, the results of the PRObiotics in PAncreatitis TRIAl (PROPATRIA) were published. This study investigated the use of probiotics in patients suffering from severe acute pancreatitis. No differences between the groups were found for any of the primary endpoints. However, mortality in the probiotics group was significantly higher than in the placebo group. This result was unexpected in light of the results of the animal studies referred to in the trial protocol. We used the methods of systematic review and meta-analysis to take a closer look at the relation between the animal studies on probiotics and pancreatitis and the PROPATRIA-trial, focussing on indications for harmful effects and efficacy. METHODS AND RESULTS Both PubMed and Embase were searched for original articles concerning the effects of probiotics in experimental acute pancreatitis, yielding thirteen studies that met the inclusion criteria. Data on mortality, bacterial translocation and histological damage to the pancreas were extracted, as well as study quality indicators. Meta-analysis of the four animal studies published before PROPATRIA showed that probiotic supplementation did not diminish mortality, reduced the overall histopathological score of the pancreas and reduced bacterial translocation to pancreas and mesenteric lymph nodes. Comparable results were found when all relevant studies published so far were taken into account. CONCLUSIONS A more thorough analysis of all relevant animal studies carried out before (and after) the publication of the study protocol of the PROPATRIA trial could not have predicted the harmful effects of probiotics found in the PROPATRIA-trial. Moreover, meta-analysis of the preclinical animal studies did show evidence for efficacy. It may be suggested, however, that the most appropriate animal experiments in relation to the design of the human trial have not yet been conducted, which compromises a fair comparison between the results of the animal studies and the PROPATRIA trial.
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Affiliation(s)
- Carlijn R Hooijmans
- Radboud University Nijmegen Medical Centre, SYRCLE at Central Animal Laboratory, Nijmegen, The Netherlands.
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Hooijmans CR, Pasker-de Jong PCM, de Vries RBM, Ritskes-Hoitinga M. The effects of long-term omega-3 fatty acid supplementation on cognition and Alzheimer's pathology in animal models of Alzheimer's disease: a systematic review and meta-analysis. J Alzheimers Dis 2012; 28:191-209. [PMID: 22002791 DOI: 10.3233/jad-2011-111217] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To date, only a few randomized clinical trials (RCTs) have investigated the effects of omega-3 fatty acids (FA) on Alzheimer's disease (AD). Some of these studies demonstrated that patients with very mild AD or mild cognitive impairment benefit from omega-3 FA treatment, but none showed significant improvements in cognitive function in patients with moderate or advanced AD. All these RCTs had a relatively short duration of supplementation, however, and we hypothesized that this might be one of the reasons why no effects of omega-3 FA supplementation could be observed in patients with "moderate" or "advanced" AD. Animal studies offer better possibilities for controlled long-term supplementation than clinical studies. Therefore, we performed a systematic review (SR) and meta-analysis of the literature that focused on effects of the relatively long-term omega-3 FA supplementation (minimum period; 10% of average total lifespan) on cognitive impairment, amyloid-β pathology, and neuronal loss in animal models of AD. This SR shows that long-term omega-3 FA supplementation decreased the omega-6/omega-3 FA ratio and reduced the amount of amyloid-β in experimental animal models of AD. Omega-3 FA supplementation also improved cognitive function; this effect appeared larger in rats compared to mice, and in males compared to females. Moreover, omega-3 FA supplementation diminished the amount of neuronal loss, especially in female animals. The results of this SR indicate that it might be worthwhile to perform new clinical trials with long-term omega-3 FA supplementation in AD patients.
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Affiliation(s)
- Carlijn R Hooijmans
- Radboud University Nijmegen Medical Centre, Central Animal Laboratory and 3R Research Centre, Nijmegen, The Netherlands.
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de Vries RBM, Buma P, Leenaars M, Ritskes-Hoitinga M, Gordijn B. Reducing the number of laboratory animals used in tissue engineering research by restricting the variety of animal models. Articular cartilage tissue engineering as a case study. Tissue Eng Part B Rev 2012; 18:427-35. [PMID: 22571623 DOI: 10.1089/ten.teb.2012.0059] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of laboratory animals in tissue engineering research is an important underexposed ethical issue. Several ethical questions may be raised about this use of animals. This article focuses on the possibilities of reducing the number of animals used. Given that there is considerable debate about the adequacy of the current animal models in tissue engineering research, we investigate whether it is possible to reduce the number of laboratory animals by selecting and using only those models that have greatest predictive value for future clinical application of the tissue engineered product. The field of articular cartilage tissue engineering is used as a case study. Based on a study of the scientific literature and interviews with leading experts in the field, an overview is provided of the animal models used and the advantages and disadvantages of each model, particularly in terms of extrapolation to the human situation. Starting from this overview, it is shown that, by skipping the small models and using only one large preclinical model, it is indeed possible to restrict the number of animal models, thereby reducing the number of laboratory animals used. Moreover, it is argued that the selection of animal models should become more evidence based and that researchers should seize more opportunities to choose or create characteristics in the animal models that increase their predictive value.
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Affiliation(s)
- Rob B M de Vries
- SYRCLE/3R Research Centre, Central Animal Laboratory (Post 231), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Abstract
Collecting and analysing all available literature before starting a new animal experiment is important and it is indispensable when writing systematic reviews of animal research. In practice, finding all animal studies relevant to a specific research question turns out to be anything but simple. In order to facilitate this search process, we previously developed a search filter for retrieving animal studies in the most often used biomedical database, PubMed. It is a general requirement for systematic reviews, however, that at least two databases are searched. In this report, we therefore present a similar search filter for a second important database, namely Embase. We show that our filter retrieves more animal studies than (a combination of) the options currently available in Embase. Our search filters for PubMed and Embase therefore represent valuable tools for improving the quality of (systematic) reviews and thereby of new animal experiments.
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Affiliation(s)
- Rob B M de Vries
- 3R Research Centre, Central Animal Laboratory, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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Abstract
Tissue engineering (TE) is a promising new field of medical technology. However, like other new technologies, it is not free of ethical challenges. Identifying these ethical questions at an early stage is not only part of science's responsibility toward society, but also in the interest of the field itself. In this review, we map which ethical issues related to TE have already been documented in the scientific literature. The issues that turn out to dominate the debate are the use of human embryonic stem cells and therapeutic cloning. Nevertheless, a variety of other ethical aspects are mentioned, which relate to different phases in the development of the field. In addition, we discuss a number of ethical issues that have not yet been raised in the literature.
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Affiliation(s)
- Rob B M de Vries
- Section Ethics, Philosophy, and History of Medicine, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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