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Published on: June 6, 2025
Colony-Stimulating Factors on Mobilizing CD34+ Cells and Improving Neurological Functions in Patients With Stroke: A
Xiuqi Chen1, Wenbo Sun1, Ping Zhong2
1Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Insights
Colony-stimulating factor (CSF) therapy shows no significant impact on stroke survival or recurrence rates. However, CSF effectively increases CD34+ cell counts, suggesting a potential role in stroke recovery that requires further investigation.
Area of Science:
- Neurology
- Regenerative Medicine
- Clinical Trials
Background:
- Stroke remains a leading cause of disability and mortality worldwide.
- Colony-stimulating factor (CSF) therapy is being explored as a promising neuroprotective and regenerative approach for stroke patients.
- A comprehensive understanding of CSF's safety and efficacy in stroke is crucial for clinical application.
Purpose of the Study:
- To conduct a meta-analysis evaluating the safety and efficacy of Colony-stimulating factor (CSF) therapy in patients with stroke.
- To assess the impact of CSF on major adverse events, including all-cause death and recurrent stroke.
- To examine the effect of CSF on secondary outcomes such as CD34+ cell counts, NIH Stroke Scale (NIHSS), and Barthel Index (BI).
Main Methods:
- Systematic literature search and manual article retrieval were performed.
- Data extraction included study quality, intervention characteristics (CSF type, dose, administration), and patient baseline data.
- Meta-analysis was conducted using STATA13 software to compare outcomes between CSF and control groups.
Main Results:
- The meta-analysis included 485 patients from eight studies.
- CSF therapy did not show a statistically significant difference in all-cause death (RR=1.73) or recurrent stroke (RR=0.43) compared to controls.
- CSF significantly increased peripheral CD34+ cell counts at day 5 (SMD=1.23) but did not significantly alter NIHSS (SMD=-0.40) or BI (SMD=0.04) scores.
Conclusions:
- Colony-stimulating factor (CSF) administration is safe for stroke patients, showing no increased risk of detrimental outcomes.
- CSF therapy effectively enhances CD34+ cell mobilization, a marker associated with tissue repair and regeneration.
- While CSF shows potential in stroke recovery by increasing stem cell counts, its overall efficacy in improving neurological function requires further clinical validation.
Abstract:
Background and Purpose: CSF therapy is considered a promising therapeutic approach for stroke. We performed a meta-analysis to explore the safety and efficacy of CSF in published clinical stroke studies. Methods: We searched articles online and manually. Two reviewers selected studies independently, selecting data based on study quality, characteristics of intervention (administration time, observation time, type, dose, and injection approach of CSF), and the baseline characteristics of patients (age, sex, hypertension, diabetes, smoker, and lipids) were extracted. Main prognosis outcomes were measured as all-cause death in severe adverse events (SAE) and recurrent stroke in SAE. Secondary outcomes were measured as CD34+ cell counts in periphery blood at day 5, National Institutes of Health Stroke Scale (NIHSS), and Barthel index (BI), Side effects of CSF were taken as the indicator of safety. STATA13 software was used to perform the meta-analysis.Keywords: Stroke, Colony-stimulating factor, Meta-analysis, therapy, Neurological Diseases Results: This meta-analysis involved 485 patients from eight studies. Among them, 475 patients from seven studies were gauged SAE (all-cause death), 393 patients from six studies were checked SAE (recurrent stroke); 137 patients from three studies underwent CD34+ measurement, 389 patients from six studies were tested NIHSS and 307 patients from five studies accessed BI. Compared with the control group, both all-causes death (RR= 1.73, 95%CI= (0.61, 4.92), P=0.735, I2=0.0%) and recurrent stroke (RR= 0.43, 95%CI= (0.14, 1.32), P=0.214, I2=33.1%) present no statistical differences, indicating that the application of CSF does not statistically alter the prognosis of patients with stroke. The application of CSF effectively enhanced CD34+ cell counts in periphery blood at day 5 (SMD= 1.23, 95%CI= (0.54, 1.92), P=0.04, I2=69.0%) but did not statistically impact NIHSS (SMD= -0.40, 95%CI= (-0.93, 0.13), P ≤ 0.001, I2=79.7%) or BI (SMD= 0.04, 95%CI= (-0.38, 0.46), P=0.068, I2=54.3%). Conclusion: Our study consolidates the security of CSF administration for its exerting no effect on detrimental outcomes. It has proven to be effective in elevating CD34+ cell counts in periphery blood at day 5, indicating CSF may participate in stroke recovery, but its efficacy in stroke recovery remains detected.
