Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Apr 26, 2020; 12(4): 288-302
Published online Apr 26, 2020. doi: 10.4252/wjsc.v12.i4.288
Human umbilical cord derived mesenchymal stem cells in peripheral nerve regeneration
Christine Bojanic, Kendrick To, Bridget Zhang, Christopher Mak, Wasim S Khan
Christine Bojanic, Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, United Kingdom
Kendrick To, Wasim S Khan, Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
Bridget Zhang, Christopher Mak, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
Author contributions: To K and Khan WS undertook conception and design of the study; Bojanic C wrote the manuscript under the guidance of To K and Khan WS; Zhang B and Mak C conducted risk of bias analysis; all authors reviewed, edited and approved the final manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors declare that the manuscript satisfies the PRISMA 2009 Checklist and the manuscript has been prepared and revised according to the checklist requirements.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wasim S Khan, CCST, FRCS (Ed), FRCS (Hon), MBChB, MSc, PhD, Lecturer, Surgeon, Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, United Kingdom.
Received: December 16, 2019
Peer-review started: December 16, 2019
First decision: February 20, 2020
Revised: March 15, 2020
Accepted: March 23, 2020
Article in press: March 23, 2020
Published online: April 26, 2020

Peripheral nerve injury can occur as a result of trauma or disease and carries significant morbidity including sensory and motor loss. The body has limited ability for nerve regeneration and functional recovery. Left untreated, nerve lesions can cause lifelong disability. Traditional treatment options such as neurorrhaphy and neurolysis have high failure rates. Surgical reconstruction with autograft carries donor site morbidity and often provide suboptimal results. Mesenchymal stem cells (MSCs) are known to have promising regenerative potential and have gained attention as a treatment option for nerve lesions. It is however, unclear whether it can be effectively used for nerve regeneration.


To evaluate the evidence for the use of human umbilical cord derived MSCs (UCMSCs) in peripheral nerve regeneration.


We carried out a systematic literature review in accordance with the PRISMA protocol. A literature search was performed from conception to September 2019 using PubMed, EMBASE and Web of Science. The results of eligible studies were appraised. A risk of bias analysis was carried out using Cochrane’s RoB 2.0 tool.


Fourteen studies were included in this review. A total of 279 subjects, including both human and animal were treated with UCMSCs. Four studies obtained UCMSCs from a third-party source and the remainder were harvested by the investigators. Out of the 14 studies, thirteen conducted xenogenic transplantation into nerve injury models. All studies reported significant improvement in nerve regeneration in the UCMSC treated groups compared with the various different controls and untreated groups.


The evidence summarised in this PRISMA systematic review of in vivo studies supports the notion that human UCMSC transplantation is an effective treatment option for peripheral nerve injury.

Keywords: Umbilical cord, Mesenchymal stem cells, Transplantation, Peripheral nerve regeneration

Core tip: While human umbilical cord derived mesenchymal stem cells hold promise as a treatment option for peripheral nerve lesions, robust in vivo models are required in order to determine the best method of delivering mesenchymal stem cells to sites of injury.